Growth hormone therapy and scoliosis in patients with Prader–Willi syndrome

Abstract

Growth hormone (GH) therapy for short stature in patients with Prader-Willi syndrome (PWS) has started worldwide, and various favorable effects have been reported. However, the possibility of progression of scoliosis arises as a new problem of the GH therapy. In this study, we analyzed whether 72 patients who have been followed up in our hospital have such a problem. They included 46 males and 26 females (41 patients with the GH therapy and 31 without it) aged from one to 49 years. Consequently, 33 (45.8%) of 72 patients had scoliosis with the Cobb angle of >10 degrees. Twenty (48.8%) of forty-one patients who received a GH therapy and 13 (41.9%) of 31 patients without the therapy had scoliosis, the frequency of scoliosis between the two groups showing no statistical difference (P = 0.56). Height velocity of scoliotic and non-scoliotic patients during the first year of the therapy was 8.59 +/- 1.92 and 10.70 +/- 2.54 cm, respectively, showing a significant difference (P < 0.001). This shows that accelerated height velocity may not induce scoliosis. Comparison of starting age of a GH treatment revealed that non-scoliotic patients received the therapy earlier than scoliotic patients (P = 0.021). Among 20 scoliotic patients who received the GH therapy, the degree of scoliosis progressed during the therapy in six patients, improved in three and fluctuated in one. Many patients showed progression of scoliosis with age irrespective of the use of GH, and some patients improved their scoliosis during the GH therapy. These findings showed that a GH therapy increases height velocity of PWS patients but does not necessarily develop scoliosis, and early start of the therapy may not be an exacerbating factor of scoliosis.

Endocrine Disorders in Children with Prader-Willi Syndrome – Data from 142 Children of the French Database

“…Similar to previously published data [30,31,32], 31% of children receiving GH treatment had scoliosis in our study. The prevalence increased with age but was already high in young children (14% in patients were under 5 years).…”

KIGS Highlights: Growth Hormone Treatment in Prader-Willi Syndrome

“…Additionally, Nagai et al showed that height velocity is not increased in patients with Prader-Willi syndrome who have scoliosis and receive GH therapy versus their counterparts those who do not [3]. Thus, a greater growth response to GH therapy is not a risk factor for scoliosis.…”

Growth hormone supplement treatment reduces the surgical risk for Prader–Willi Syndrome patients

“…Second, the possibility of deterioration in scoliosis was suggested, although we have particularly reported that there was no connection between the frequencies of scoliosis in GH treatment and non-treatment groups [14,15]. Based on the backgrounds of these studies, GH treatment has recently been recommended at an early age, and it is assumed that its long-term use is not a problem.…”