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A preliminary trial of the effect of recombinant human growth hormone on short-term linear growth and glucose homeostasis in children with Crohn's disease.

Author(s): Wong SC, Kumar P, Galloway PJ, Blair JC, Didi M, Dalzell AM, Hassan K, McGrogan P, Ahmed SF

Affiliation(s): Developmental Endocrinology Research Group, Royal Hospital for Sick Children, Glasgow, UK.

Publication date & source: 2011-05, Clin Endocrinol (Oxf)., 74(5):599-607.

Publication type: Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

BACKGROUND: It is unclear whether recombinant human growth hormone (rhGH) improves linear growth in children with Crohn's disease (CD). AIMS: To investigate the effects of rhGH on height velocity (HV) and glucose homeostasis over a 6-month period. DESIGN AND SETTING: Randomized controlled trial in two tertiary children's hospitals in 22 children with inflammatory bowel disease amongst whom 21 had CD. Duration of disease from diagnosis and number of acute relapses requiring either exclusive enteral nutrition or therapeutic dose of oral prednisolone were similar in the treatment and control groups. INTERVENTION: Either rhGH (0.067 mg/kg per day) as daily subcutaneous injections (rhGH group; n, 11) or no rhGH, (Ctrl; n, 11) for 6 months. MAIN OUTCOME MEASURE: Percentage change in HV after 6 months in the two groups. Auxology, puberty, skeletal age, disease factors, treatment and glucose homeostasis were also assessed. RESULTS: Median HV increased from 4.5 (range, 0.6, 8.9) at baseline to 10.8 (6.1, 15.0) cm/year at 6 month (P = 0.003) in the rhGH group, whereas in the Ctrl group, it was 3.8 (1.4, 6.7) and 3.5 cm/year (2.0, 9.6), respectively (P = 0.58). Median percentage increase in HV after 6 months in the rhGH group was 140% (16.7, 916.7) compared with 17.4% (-42.1%, 97.7%) in the Ctrl group (P < 0.001). There were no significant differences in disease activity and proinflammatory cytokines at baseline and 6 months in both groups and change in bone age for chronological age was also similar in the two groups. In the rhGH group, fasting insulin increased from 4.0 (2.0, 11.0) to 7.0 mU/l (2.0, 16.0) (P = 0.02), whereas in the Ctrl group, it was 3.0 (1.2, 12.7) and 3.8 mU/l (2.1, 7.0) (P = 0.72), respectively. CONCLUSIONS: Although this pilot trial shows that rhGH can improve short-term linear growth in children with CD, the clinical efficacy of this therapy needs to be further studied in longer-term studies of growth, glucose homeostasis and disease status. (c) 2011 Blackwell Publishing Ltd.

Page last updated: 2011-12-09

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