RETRACTED: Effect of Weekly Long-Acting Growth Hormone Replacement Therapy Compared to Daily Growth Hormone on Children With Short Stature: A Meta-Analysis

Abstract

BackgroundWe performed a meta-analysis to evaluate the efficacy and safety of weekly long-acting growth hormone replacement therapy compared to daily growth hormone in children with short stature.MethodsA systematic literature search up to April 2021 was performed and 11 studies included 1,232 children with short stature treated with growth hormone replacement therapy at the start of the study; 737 of them were using weekly long-acting growth hormone replacement therapy and 495 were using daily growth hormone. They were reporting relationships between the efficacy and safety of long-acting growth hormone replacement therapy and daily growth hormone in children with short stature. We calculated the odds ratio (OR), and mean difference (MD) with 95% confidence intervals (CIs) to assess the efficacy and safety of weekly long-acting growth hormone replacement therapy compared to daily growth hormone in children with short stature using the dichotomous or continuous method with a random or fixed-effect model.ResultsLong-acting growth hormone replacement therapy had significantly lower height standard deviation scores chronological age (MD, −0.10; 95% CI, −0.13 to −0.08, p <0.001), and insulin-like growth factor binding protein-3 (MD, −0.69; 95% CI, −1.09 to −0.30, p <0.001) compared to daily growth hormone in children with short stature.However, growth hormone replacement therapy had no significantly difference in height velocity (MD, −0.09; 95% CI, −0.69–0.5, p = 0.76), height standard deviation scores bone age (MD, −0.04; 95% CI, −0.10–0.02, p = 0.16), insulin-like growth factor 1 standard deviation scores (MD, 0.26; 95% CI, −0.26–0.79, p = 0.33), and incidence of adverse events (OR, 1.16; 95% CI, 0.90–1.50, p = 0.25) compared to daily growth hormone in children with short stature.ConclusionsLong-acting growth hormone replacement therapy had significantly lower height standard deviation scores chronological age, and insulin-like growth factor binding protein-3 compared to daily growth hormone in children with short stature. However, growth hormone replacement therapy had no significant difference in height velocity, height standard deviation scores bone age, insulin-like growth factor 1 standard deviation scores, and incidence of adverse events compared to daily growth hormone in children with short stature. Further studies are required to validate these findings.

Comparing Dose-dependent Outcomes of Weekly and Daily Growth Hormone Therapy in Children with Growth Hormone Deficiency: A Systematic Review and Meta-analysis

“…This nding contradicts with Liyan Ma et al (32), which reported no signi cant difference in HV between daily GH and long-acting GH replacement treatment.…”

“…In our meta-analysis, the weekly GH group had a slightly higher incidence of adverse events than the daily GH group (OR = 1.38, 95% CI 0.58 to 3.28; P = 0.47), albeit this difference was statistically insigni cant. In contrast, Liyan Ma et al (32) found no signi cant difference in the incidence of adverse events between long-acting growth hormone replacement treatment and daily growth hormone in children with short height in their meta-analysis. This is consistent with our ndings, which show that both treatment methods have identical safety pro les.…”

Evolving growth hormone deficiency: proof of concept

“…But for all practical purposes the current agreed GH cut off in the United States remains to be 10 ng/dL ( 32 ). The current published literature on long-acting GH research is also based on the GHD cut off of 10 ng/dl ( 13 , 14 ). In our patient cohort 36% had a peak ≤ 7 ng/dL on repeat GST; had we waited extended periods, perhaps they may have had lower GH peak levels.…”

“…A peak growth hormone (GH) level below 10 µg/dL is largely still clinically considered the cut-off for the diagnosis of GHD (9)(10)(11) in the United States and in other countries across the globe (12). Recent multi center international clinical studies regarding long-acting GH also all utilized 10mcg/dl as the GHD cut off (13,14).…”