Growth hormone treatment for growth failure in pediatric patients with Crohn's disease.

Author(s): Heyman MB, Garnett EA, Wojcicki J, Gupta N, Davis C, Cohen SA, Gold BD, Kirschner BS, Baldassano RN, Ferry GD, Winter HS, Kaplan S

Affiliation(s): Department of Pediatrics, University of California San Francisco, San Francisco, CA 94143-0136, USA. mheyman@peds.ucsf.edu

Publication date & source: 2008-11, J Pediatr., 153(5):651-8, 658.e1-3. Epub 2008 Jun 27.

Publication type: Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't

OBJECTIVE: To investigate the effect of human growth hormone (GH) injections on growth velocity in growth-impaired children with Crohn's disease (CD). STUDY DESIGN: Ten children and adolescents (mean age, 12.6 +/- 4.5 years; 6 males) with CD and poor height growth were treated with open-label recombinant GH, 0.043 mg/kg/day administered via subcutaneous injection, for 1 year. Patients were retrospectively matched with untreated patients (3 comparisons per case) by race, age, sex, and baseline height. Primary endpoint was height velocity; secondary endpoints were disease activity, body composition, and bone density determined by dual-energy x-ray absorptiometry scan. RESULTS: Mean height velocity increased by 5.33 +/- 3.40 (mean +/- standard deviation) cm/year in the GH-treated patients during the year of GH treatment, compared with 0.96 +/- 3.52 cm/year in the comparison group (P = .03). Height z-score increased by 0.76 +/- 0.38 in the treated group, compared with 0.16 +/- 0.40 in the comparison group (P < .01), and weight z-score increased by 0.81 +/- 0.89 in the treated group, compared with 0.00 +/- 0.57 in the comparison group (P < .01). Bone density revealed an increase of 0.31 +/- 0.33 in the lumbar spine z-score (P = .03 vs baseline). CONCLUSIONS: GH treatment increases height velocity and may enhance bone mineralization in children with CD. A randomized controlled trial in a large cohort of children is needed to evaluate the ultimate impact of GH treatment.