The effect of treatment with recombinant human growth hormone (rhGH) on linear growth and adult height in children with idiopathic short stature (ISS): a systematic review and meta-analysis

Abstract

ObjectivesIdiopathic short stature (ISS) is a recognized, albeit a controversial indication for treatment with recombinant human growth hormone (rhGH).The objective of the present study was to conduct a systematic review of the literature and meta-analyses of selected studies about the use of rhGH in children with ISS on linear growth and adult height (AH).MethodsA systematic literature search was conducted to identify relevant studies published till February 28, 2017 in the following databases: Medline (PubMed), Scopus and Cochrane Central Registry of Controlled Trials. After exclusion of duplicate studies, 3,609 studies were initially identified. Of those, 3,497 studies were excluded during the process of assessing the title and/or the abstract. The remaining 112 studies were evaluated further by assessing the full text; 21 of them fulfilled all the criteria in order to be included in the current meta-analysis.ResultsChildren who received rhGH had significantly higher height increment at the end of the first year, an effect that persisted in the second year of treatment and achieved significantly higher AH than the control group. The difference between the two groups was equal to 5.3 cm (95% CI: 3.4–7 cm) for male and 4.7 cm (95% CI: 3.1–6.3 cm) for female patients.ConclusionIn children with ISS, treatment with rhGH improves short-term linear growth and increases AH compared with control subjects. However, the final decision should be made on an individual basis, following detailed diagnostic evaluation and careful consideration of both risks and benefits of rhGH administration.

Isolated Growth Hormone Deficiency and Idiopathic Short Stature: Comparative Efficiency after Growth Hormone Treatment up to Adult Height

“…Cochrane’s review established that children with ISS underwent an increase in their final height of 3.7–7.5 cm, but nevertheless, they reached a shorter than average final height [ 23 ]. On the contrary, in a meta-analysis of 21 studies, Paltoglou et al showed that treatment with GH improves short-term linear growth and increases adult height as compared to control subjects without treatment [ 26 ]; in our study, the observed adult height was similar to the parental and normal population heights. This supports the hypothesis that different responses occur depending on the type of treatment received.…”

Analysis of the Influence of High-Dose rhGH Therapy on Serum Vitamin D and IGF-1 Levels in School-Age Children with Idiopathic Short Stature

“…Recombinant human growth hormone (rhGH) is currently the most commonly used and effective drug for the clinical treatment of ISS. rhGH can stimulate the liver and other organs to produce insulin-like growth factor-1(IGF-1), act on the chondrocytes in the epiphyseal plate, facilitate the synthesis of collagen and mucopolysaccharide sulfate, and promote and affect the synthesis and metabolism of protein, thereby playing a role in promoting bone growth [ 6 , 7 ]. However, the optimal dose of rhGH has always been a hot topic in the treatment of children with ISS.…”

A Clinical Study on the Treatment of Children’s Short Stature with Auxiliary Comprehensive Management Combined with Growth Patch

“…In addition to the disease that can cause children with short stature, children may be accompanied by mental and psychological disorders, introverted personality, lack of cognition, activity, and social skills [7,8]. For the treatment of short stature in children, modern medicine usually adopts subcutaneous injection of GH, but the response of GH treatment to individuals is difficult to predict, and it has brought heavy economic and psychological burdens to many families [9][10][11].…”