Erratum to “Effects of the use of growth hormone in children, adolescents with juvenile idiopathic arthritis: a systematic review” (Rev Bras Reumatol. 2017;57(2):100-106)

Frittoli, Renan Bazuco; Longhi, Bárbara Sugui; Silva, Amanda Meireles; Filho, Antônio de Azevedo Barros; Monteiro, Maria Ângela Reis de Góes; Appenzeller, Simone

doi:10.1016/j.rbre.2017.09.003

Cited by 3 publications

(1 citation statement)

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“…Poor growth is also a feature of GC therapy, most often due to a direct adverse effect of GC on the growth plate, rather than abnormal GH secretory status. In patients with recombinant human growth hormone (rhGH)-treated inflammatory disorders, the effect of rhGH on height has been modest at best, with most trials nevertheless describing a favorable effect on muscle and bone (79,80). However, some children also experienced adverse events, including glucose intolerance, reactivation of the underlying disease, and osteonecrosis (79,80); whether these side effects were related to the rhGH, to concomitant GC administration, or to other factors, is unclear.…”

Section: Prevention Of First-ever Osteoporotic Fractures Walks the Timentioning

confidence: 99%

Glucocorticoid-Induced Osteoporosis: Why Kids Are Different

Ward

2020

Front. Endocrinol.

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Glucocorticoids (GC) are an important risk factor for bone fragility in children with serious illnesses, largely due to their direct adverse effects on skeletal metabolism. To better appreciate the natural history of fractures in this setting, over a decade ago the Canadian STeroid-associated Osteoporosis in the Pediatric Population (“STOPP”) Consortium launched a 6 year, multi-center observational cohort study in GC-treated children. This study unveiled numerous key clinical-biological principles about GC-induced osteoporosis (GIO), many of which are unique to the growing skeleton. This was important, because most GIO recommendations to date have been guided by adult studies, and therefore do not acknowledge the pediatric-specific principles that inform monitoring, diagnosis and treatment strategies in the young. Some of the most informative observations from the STOPP study were that vertebral fractures are the hallmark of pediatric GIO, they occur early in the GC treatment course, and they are frequently asymptomatic (thereby undetected in the absence of routine monitoring). At the same time, some children have the unique, growth-mediated ability to restore normal vertebral body dimensions following vertebral fractures. This is an important index of recovery, since spontaneous vertebral body reshaping may preclude the need for osteoporosis therapy. Furthermore, we now better understand that children with poor growth, older children with less residual growth potential, and children with ongoing bone health threats have less potential for vertebral body reshaping following spine fractures, which can result in permanent vertebral deformity if treatment is not initiated in a timely fashion. Therefore, pediatric GIO management is now predicated upon early identification of vertebral fractures in those at risk, and timely intervention when there is limited potential for spontaneous recovery. A single, low-trauma long bone fracture can also signal an osteoporotic event, and a need for treatment. Intravenous bisphosphonates are currently the recommended therapy for pediatric GC-induced bone fragility, typically prescribed to children with limited potential for medication-unassisted recovery. It is recognized, however, that even early identification of bone fragility, combined with timely introduction of intravenous bisphosphonate therapy, may not completely rescue the osteoporosis in those with the most aggressive forms, opening the door to novel strategies.

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Section: Prevention Of First-ever Osteoporotic Fractures Walks the Timentioning

confidence: 99%

Glucocorticoid-Induced Osteoporosis: Why Kids Are Different

Ward

2020

Front. Endocrinol.

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Anabolic Therapy for the Treatment of Osteoporosis in Childhood

Ward

Rauch

2018

Curr Osteoporos Rep

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While growth hormone and androgens appears to be relatively weak anabolic modulators of bone mass, emerging therapies targeting bone formation pathways (anti-transforming growth factor beta antibody and anti-sclerostin antibody) hold considerable promise. Teriparatide remains an attractive option that merits formal study for patients post-epiphyseal fusion, although it must be considered that adult studies have shown its effect is blunted when administered following bisphosphonate therapy. Mechanical stimulation of bone through whole body vibration therapy appears to be much less effective than bisphosphonate therapy for treating osteoporosis in children. New anabolic therapies which target important pathways in skeletal metabolism merit further study in children, including their effects on fracture risk reduction and after treatment discontinuation.

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GH therapy in children with juvenile idiopathic arthritis: a four-decade review

Sassano,

La Bella,

Di Ludovico

et al. 2024

Clin Pediatr Endocrinol

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. Chronic inflammatory conditions, such as juvenile idiopathic arthritis, are associated with growth failure. Growth failure appears to be correlated with both the effects of inflammation and negative effects of glucocorticoids (used as therapeutic option) on the growth hormone axis and locally on the growth plate and bone metabolism. In the last decade, the introduction of biologics has changed the disease course regarding consequences and outcomes. Anyway in some cases, treatment with biologics has failed in restoring normal growth in patients with juvenile idiopathic arthritis; in contrast, several studies have reported improved height velocity and growth rate in patients with juvenile idiopathic arthritis treated with growth hormone. This study aimed to evaluate the impact of growth hormone treatment on the growth and pubertal development in juvenile idiopathic arthritis patients through a narrative review of the literature over the last four decades.

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Erratum to “Effects of the use of growth hormone in children, adolescents with juvenile idiopathic arthritis: a systematic review” (Rev Bras Reumatol. 2017;57(2):100-106)

Cited by 3 publications

References 0 publications

Glucocorticoid-Induced Osteoporosis: Why Kids Are Different

Glucocorticoid-Induced Osteoporosis: Why Kids Are Different

Anabolic Therapy for the Treatment of Osteoporosis in Childhood

GH therapy in children with juvenile idiopathic arthritis: a four-decade review

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