Treatment with growth hormone in children with idiopathic short stature: metanalysis

Postgraduate Thesis uoadl:2778578 546 Read counter

Unit:
ΠΜΣ Κλινική Παιδιατρική και Νοσηλευτική - Έρευνα
Library of the School of Health Sciences
Deposit date:
2018-07-13
Year:
2018
Author:
Dimitropoulos Ioannis
Supervisors info:
Ευαγγελία Χαρμανδάρη, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Γεώργιος Χρούσος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Χρυσάνθη Τζουμάκα-Μπακούλα, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Θεραπεία με αυξητική ορμόνη σε παιδιά με ιδιοπαθές κοντό ανάστημα: μετα-ανάλυση
Languages:
Greek
Translated title:
Treatment with growth hormone in children with idiopathic short stature: metanalysis
Summary:
Objective: The role of growth hormone in idiopathic short stature remains controversial, due to contradictory results of studies and the scientific, moral and economic issues that arise by its use. The aim of this study is to determine the impact of growth hormone treatment at growth and final adult height of children with idiopathic short stature.
Materials and methods: This study is a systematic review of randomized and non-randomized controlled trials. Data sources were Medline, Scopus and Cochrane Central Registry of Controlled Trials, from 1985 to February 2017. Inclusion criteria were initial height at least 2 SD below the mean, peak growth hormone response >10 μg/L, absence of comorbidity that impairs growth, no previous use of growth hormone or steroids, sample size ≥5 and administration of recombinant human growth hormone for at least six months during the trial. The main outcome of the study was the difference in height gain from the initial to final evaluation between treatment and control groups.
Results: Twenty-one studies (943 patients) met the inclusion criteria. Patients who received growth hormone had a significantly higher height gain during the first (0,69 SDS, 95% CI 0,18-1,15, p<0,05) and the second year of treatment (1,86 SDS, 95% CI 1,16-2,56, p<0,001) compared with the control group. At adult height evaluation, the height gain of the group that received treatment significantly exceeded that of controls by 0,72 SDS (95% CI 0,47-0,97), which equals to approximately 5 cm. At prepubertal population at the initiation of treatment, the mean height gain of treated children at adulthood exceeded that of controls by 0,83 SDS.
Conclusion: Treatment with growth hormone promotes short-term growth and increases final adult height. Nevertheless, the results of primary studies vary. Final decision of treatment should be individualized and balance the positive findings and the benefit of treatment at children’s psychology, family and moral and economic issues.
Main subject category:
Health Sciences
Keywords:
Growth hormone, Idiopathic short stature, Adult height, Growth
Index:
No
Number of index pages:
0
Contains images:
Yes
Number of references:
145
Number of pages:
xiv, 99
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