Growth hormone slightly improved height increase
Treatment with growth hormone may promote growth, near final height in children and adolescents with idiopathic short stature.
Children and adolescents with idiopathic short stature showed increased short-term growth and improved near final height when treated with growth hormone; however, additional research is necessary.
“Randomized controlled trials are required that focus on clear outcomes, such as final height, rather than outcomes which are poorly predictive surrogate markers, such as predicted adult height or target height,” Jackie Bryant, and colleagues wrote in the Cochrane Database of Systematic Reviews.
Researchers reviewed 10 randomized controlled trials that studied the effects of rhGH on growth and height in both children and adolescents.
The studies lasted between six months and 6.2 years and included 741 participants. Each study included between 18 and 121 participants. GH was administered for at least six months, and intervention included assignment of GH vs. placebo or GH vs. no treatment. The primary outcome was final height. Secondary outcomes included short-term growth and adverse events.
Small improvement in growth
Data from one trial showed GH treatment improved near final height in prepubertal girls. The GH group had near final heights of 155.3 cm vs. the control group (147.8 cm). The near final height standard deviation score for the growth hormone group was —1.14 compared with the control group (—2.37).
Findings from a trial that reported adult height standard deviation score showed children treated with GH were 3.7 cm taller than children in the placebo group (95% CI, 0.03-1.10).
Results from other trials that reported short-term growth outcomes suggested short-term height gains ranged from 0 to 0.7 standard deviation during the period of one year.
Quality of life
Quality of life was reported in one study in which participants completed questionnaires three times during a two-year period. No improvement in quality of life was observed in the growth hormone group compared with the control group.
Data from one study suggested there was no association between children and adolescents with ISS and problems in psychological adaptation or self-concept. GH treatment was associated with improvement in problem behavior as measured by questionnaires completed by the participants’ parents. No adverse events were reported in any study.
“Although treated individuals may be taller than nontreated individuals, they are still relatively short compared with peers of normal height,” said Bryant, senior research fellow at the University of Southampton, United Kingdom. “[Trials] should focus on final height and address quality of life and cost issues.”