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GH Therapy in Juvenile Chronic Arthritis: Results of a Two-Year Controlled Study on Growth and Bone

Endocrine Division University Children’s Hospital, D-80337 Munich, Germany; Children’s Clinic for Rheumatology (P.R., H.T., R.H.), 82467 Garmisch-Partenkirchen, Germany; and Department of Clinical Chemistry, University Clinic Grosshadern (D.M.), 81377 Munich, Germany

Address all correspondence and requests for reprints to: Dr. S. Bechtold, Kinderklinik und Kinderpoliklinik, im Dr. von Haunerschen Kinderpital, Pädiatrische Endokrinologie, Lindwurmstrasse 4, D-80337 Munich, Germany. E-mail: susanne.bechtold{at}kk-i.med.uni-muenchen.de

Abstract

Disturbance of growth frequently occurs in children suffering from juvenile chronic arthritis (JCA). Recognition of growth impairment is important because reduced final height is one of the permanent consequences. The aim of this study was to evaluate the efficacy and safety of human GH (hGH) in growth-retarded prepubertal children with JCA. Thirty-five children were tested for GH deficiency (GHD) and randomly assigned to a study and an untreated control group; five were GH deficient and were part of the GHD group. All received glucocorticoids. The study group was treated with 1 IU/kg BW·wk hGH; the GHD group was given 0.5 IU. During 2 yr of hGH treatment growth velocity and height SD score increased compared with baseline values. There was a marked increase in growth velocity in the treated groups, but also some increase in the control group. Plasma levels of IGF-I and IGF-binding protein-3 increased with GH treatment.

These results suggest that hGH might be useful in the treatment of growth impairment in JCA. GH may counteract the adverse effects of glucocorticoid therapy, but its effect is dependent on the disease activity. Long-term controlled studies are needed to determine the risks and benefits of GH therapy in JCA.

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