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Evidence summaries

Recombinant Growth Hormone for Idiopathic Short Stature in Children and Adolescents

Recombinant human growth hormone appears to increase short-term growth and may improve (near) final adult height in children with idiopathic short stature. Level of evidence: "B"

A Cochrane review (abstract , review [Abstract]) included 10 studies with a total of 741 patients. One trial reported near final height in girls and found that girls treated with growth hormone were 7.5 cm taller than untreated controls (GH group, 155.3 cm ± 6.4; control, 147.8 cm ± 2.6; p = 0.003). Another trial which reported adult height standard deviation score found that children treated with GH were 3.7 cm taller than children in a placebo-treated group (95% CI 0.03 to 1.10; P < 0.04). The other trials reported short term outcomes. Results suggest that short-term height gains can range from none to approximately 0.7 SD over one year. One study reported health related quality of life and showed no significant improvement in GH treated children compared with those in the control group, whilst another found no significant evidence that GH treatment impacts psychological adaptation or self-perception in children with ISS. No serious adverse effects of treatment were reported.

Comment: The quality of evidence is downgraded by study quality (inadequate or unclear blinding, allocation concealment and reporting of drop outs).

    References

    • Bryant J, Baxter L, Cave CB, Milne R. Recombinant growth hormone for idiopathic short stature in children and adolescents. Cochrane Database Syst Rev 2007 Jul 18;(3):CD004440. [PubMed]

Primary/Secondary Keywords