scholarly journals Can growth hormone treatment improve growth in children with severe growth failure due to anorexia nervosa? A preliminary pilot study

2017 ◽  
Vol 6 (8) ◽  
pp. 839-846 ◽  
Author(s):  
Juliane Léger ◽  
Anne Fjellestad-Paulsen ◽  
Anne Bargiacchi ◽  
Catherine Doyen ◽  
Emmanuel Ecosse ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Adult Height ◽  
Controlled Trial ◽  
Growth Failure ◽  
Rare Condition ◽  
Height Velocity ◽  
Delayed Puberty ◽  
Gh Treatment ◽  
One Year ◽  
Severe Growth

Background/Aims Growth failure is a difficult but key aspect of care in children with anorexia nervosa (AN). The effects of hGH therapy have not been studied. The aim was to investigate the effect of hGH treatment on height velocity (HV) in children with AN. Methods We carried out a retrospective observational study. Ten girls diagnosed with AN at 10.0 ± 1.9 years, with prolonged severe growth failure (HV < 2.5 cm/year for at least 18 months) at the age of 13.3 ± 1.1 years and delayed puberty after nutritional rehabilitation, were treated with hGH (0.040 mg/kg/day) from a bone age of 10.9 ± 1.7 years until they reached adult height. Height and HV were measured before treatment and at 12-month intervals during treatment. Results Mean body mass index SDS remained unchanged, but HV increased significantly, from a median of 1.0 (0.7–2.1) to 7.1 (6.0–9.5) cm/year after one year (P < 0.002) and 5.6 (4.8–6.2) cm/year after two years of treatment. Height SDS increased from −2.2 ± 1.3 to −1.6 ± 1.3 after one year (P < 0.002) and −1.1 ± 1.5 after two years of GH treatment. Adult height (−0.1 ± 1.0 SDS) was close to target height after 3.6 ± 1.4 years of GH treatment. Serum IGF-I levels increased significantly during treatment (P < 0.01). The treatment was well tolerated. Conclusions This proof-of-concept study shows that hGH treatment is associated with significant improvements in linear growth in adolescents with AN and severe growth failure. A randomized placebo-controlled trial is required to determine the ultimate impact of GH treatment in patients with this severe, rare condition.

One year of GH treatment for growth failure in children with anorexia nervosa: a randomized placebo-controlled trial

2021 ◽  
Author(s):  
Juliane Léger ◽  
Anne Fjellestad-Paulsen ◽  
Anne Bargiacchi ◽  
Pages Justine ◽  
Didier Chevenne ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Placebo Group ◽  
Controlled Trial ◽  
Growth Failure ◽  
Human Growth ◽  
Bone Age ◽  
Height Velocity ◽  
Gh Treatment ◽  
Double Blind ◽  
Severe Growth

Abstract Context Children with anorexia nervosa (AN) are at risk of adult height deficit due to prolonged low height velocity (HV). Objective To investigate the effects of human growth hormone (GH) injections on HV in children with AN and severe growth impairment. Design and participants In this prospective, randomized, double-blind, single-center, proof-of-concept trial, children with AN and low HV (≤2 cm/y) for at least 18 months, and a bone age ≤12 years for girls and 14 years for boys, were randomized to receive daily subcutaneous injections of hGH (0.050 mg/kg/d) or placebo for 12 months. Main outcome measures Change in HV after 12 months. Results In total, eight patients were assigned to the GH group and six to the placebo group. Patients had a median (25-75 th percentile) HV of 1.0 (0.5;1.5) cm/year. The effect of GH treatment increased strongly after six months, with a height gain after 12 months of 9.65 (8.0;11.6) cm for the GH group vs.3.85 (1.7;7.3) cm for the placebo group, with an absolute median (2.5 th-97.5 th percentile) difference between the groups of 5.8 (-1.85;9.68) cm after bootstrapping. The percentage of patients with a HV&gt;5 cm/y during the study period was higher in the GH group than in the placebo group (100% vs.50%, p=0.05). Adverse events occurred in similar numbers in the two groups, were mild or non-fatal, and did not lead to treatment being stopped. Conclusion GH administration to improve HV is a potentially valid option for increasing HV in children with AN and prolonged severe growth failure.

OR1-4: Successful GH treatment for severe growth failure in pediatric patients with anorexia nervosa

2014 ◽  
Vol 24 ◽  
pp. S6
Author(s):  
A. Fjellestad-Paulsen ◽  
A. Bargiacchi ◽  
C. Doyen ◽  
C. Raverdy ◽  
J.-C. Carel ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Pediatric Patients ◽  
Growth Failure ◽  
Gh Treatment ◽  
Severe Growth

scholarly journals Growth Hormone Treatment in Short Children Born Prematurely—Data from KIGS

2011 ◽  
Vol 96 (6) ◽  
pp. 1687-1694 ◽  
Author(s):  
Margaret C. S. Boguszewski ◽  
Hanna Karlsson ◽  
Hartmut A. Wollmann ◽  
Patrick Wilton ◽  
Jovanna Dahlgren
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Growth Response ◽  
Growth Failure ◽  
Hormone Treatment ◽  
Height Velocity ◽  
First Year ◽  
Gh Treatment ◽  
Provocative Test ◽  
Short Children

Context: Children born prematurely with growth failure might benefit from GH treatment. Objectives: The aim was to evaluate the first year growth response to GH treatment in short children born prematurely and to identify predictors of the growth response. Design/Patients: A total of 3215 prepubertal children born prematurely who were on GH treatment were selected from KIGS (The Pfizer International Growth Database), a large observational database. They were classified according to gestational age as preterm (PT; 33 to no more than 37 wk) and very preterm (VPT; &lt;33 wk), and according to birth weight as appropriate for gestational age [AGA; between −2 and +2 sd score (SDS)] and small for gestational age (SGA; −2 SDS or below). Results: Four groups were identified: PT AGA (n = 1928), VPT AGA (n = 629), PT SGA (n = 519), and VPT SGA (n = 139). GH treatment was started at a median age of 7.5, 7.2, 6.7, and 6.0 yr, respectively. After the first year of GH treatment, all four groups presented a significant increase in weight gain and height velocity, with a median increase in height SDS higher than 0.6. Using multiple stepwise regression analysis, 27% of the variation in height velocity could be explained by the GH dose, GH peak during provocative test, weight and age at GH start, adjusted parental height, and birth weight SDS. The first year growth response of the children born PT and SGA could be estimated by the SGA model published previously. Conclusion: Short children born prematurely respond well to the first year of GH treatment. Long-term follow-up is needed.

A specific aromatase inhibitor and potential increase in adult height in boys with delayed puberty: a randomised controlled trial

The Lancet ◽  
2001 ◽  
Vol 357 (9270) ◽  
pp. 1743-1748 ◽  
Author(s):  
Sanna Wickman ◽  
Ilkka Sipilä ◽  
Carina Ankarberg-Lindgren ◽  
Ensio Norjavaara ◽  
Leo Dunkel
Keyword(s):  
Randomised Controlled Trial ◽  
Aromatase Inhibitor ◽  
Adult Height ◽  
Controlled Trial ◽  
Delayed Puberty ◽  
Potential Increase ◽  
Randomised Controlled

scholarly journals Factors Predicting the Near-Final Height in Growth Hormone-Treated Children and Adolescents with Chronic Kidney Disease

2008 ◽  
Vol 93 (4) ◽  
pp. 1359-1365 ◽  
Author(s):  
Richard Nissel ◽  
Anders Lindberg ◽  
Otto Mehls ◽  
Dieter Haffner
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Conservative Treatment ◽  
Outcome Measures ◽  
Growth Response ◽  
Adult Height ◽  
Final Height ◽  
Delayed Puberty ◽  
Gh Therapy ◽  
Gh Treatment

Abstract Context: GH therapy is an accepted measure to increase adult height in young prepubertal patients suffering from growth failure related to chronic kidney disease (CKD). The impact of GH therapy on final height (FH) in CKD patients of pubertal age is unclear. Objective: This study set out to analyze near-FH in a cohort of GH-treated CKD patients. Design, Settings, and Patients: Of 240 evaluable patients in the Pfizer International Growth Database (KIGS) with CKD, 39% were prepubertal and 61% were pubertal at baseline; 45% were on conservative treatment for CKD, 28% were on dialysis, and 27% were in the period after renal transplantation. Main Outcome Measures: Near-FH, relation to pubertal stage, and factors predictive of growth response were the main outcome measures. Results: Mean height sd scores increased continuously during GH treatment until near-FH by 1.2 and 1.6 in boys and girls, respectively. Mean near-FH differed significantly from prepubertal patients showing severely delayed puberty (−3.6), late pubertal patients (−2.9), early pubertal patients (−2.2), and prepubertal patients with normal onset of puberty (−2.0). The initial degree of stunting, degree of bone age retardation, duration of GH therapy, time spent on conservative treatment/dialysis, pubertal delay (&gt;2 sd), gender, and age at start of GH treatment were significant predictors of growth response to GH therapy, explaining between 33 and 61% of the overall variability. Conclusions: Long-term GH therapy of CKD patients in prepubertal and pubertal age results in an increased adult height, but response is diminished in patients on dialysis and/or with severely delayed puberty.

scholarly journals Early growth hormone treatment start in childhood growth hormone deficiency improves near adult height: analysis from NordiNet® International Outcome Study

2017 ◽  
Vol 177 (5) ◽  
pp. 421-429 ◽  
Author(s):  
Michel Polak ◽  
Jo Blair ◽  
Primoz Kotnik ◽  
Effie Pournara ◽  
Birgitte Tønnes Pedersen ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Regression Analysis ◽  
Multiple Regression Analysis ◽  
Multiple Regression ◽  
Adult Height ◽  
Height Velocity ◽  
Outcome Study ◽  
Gh Treatment ◽  
Treatment Start ◽  
Effect Of Age

Objective To investigate the effect of age at growth hormone (GH) treatment start on near adult height (NAH) in children with isolated GH deficiency (GHD). Design NordiNet® International Outcome Study (IOS) (Nbib960128), a non-interventional, multicentre study, evaluates the long-term effectiveness and safety of Norditropin® (somatropin) (Novo Nordisk A/S) in the real-life clinical setting. Methods Patients (n = 172) treated to NAH (height at ≥18 years, or height velocity <2 cm/year at ≥16 (boys) or ≥15 (girls) years) were grouped by age (years) at treatment start (early (girls, <8; boys, <9), intermediate (girls, 8–10; boys, 9–11) or late (girls, >10; boys, >11)) and GHD severity (<3 ng/mL or 3 to ≤10 ng/mL). Multiple regression analysis was used to evaluate the effect of age at treatment start (as a categorical and continuous variable) on NAH standard deviation score (SDS). Results Age at treatment start had a marked effect on NAH SDS; NAH SDS achieved by patients starting treatment early (n = 40 (boys, 70.0%); least squares mean (standard error) −0.76 (0.14)) exceeded that achieved by those starting later (intermediate, n = 42 (boys, 57.1%); −1.14 (0.15); late, n = 90 (boys, 68.9%); −1.21 (0.10)). Multiple regression analysis showed a significant association between NAH SDS and age at treatment start (P < 0.0242), baseline height SDS (HSDS) (P < 0.0001), target HSDS (P < 0.0001), and GHD severity (P = 0.0012). Most (78.5%) patients achieved a normal NAH irrespective of age at treatment start. Conclusions Early initiation of GH treatment in children with isolated GHD improves their chance of achieving their genetic height potential.

Successful treatment of short stature with growth hormone replacement therapy in a patient with anorexia nervosa

2015 ◽  
Vol 29 (4) ◽  
Author(s):  
Yuji Koike ◽  
Masaya Akibayashi ◽  
Yukako Yokouchi
Keyword(s):  
Growth Hormone ◽  
Anorexia Nervosa ◽  
Replacement Therapy ◽  
Short Stature ◽  
Hormone Replacement ◽  
Bone Age ◽  
Delayed Puberty ◽  
Primary Amenorrhea ◽  
Gh Treatment ◽  
Igf I

Abstract A 19-year-old woman visited our outpatient clinic requesting treatment for short stature. She had been repeatedly hospitalized at a psychiatric unit and was subsequently diagnosed with anorexia nervosa (AN). She was 139.3 cm (–3.6 SD) tall and weighed 25.5 kg (23% lower than standard weight). She had primary amenorrhea and her bone age (BA) was 11.8 years. She had low insulin-like growth factor (IGF)-I (80 ng/mL) and a basal growth hormone (GH) level of 1.47 ng/mL. Treatment with recombinant GH was initiated. At 22 years of age, she was 152.2 cm (–1.1 SD) tall and weighed 39.7 kg. As she had shown a favorable response to GH treatment, therapy was discontinued. We suggest that it is worthwhile treating AN patients with GH replacement therapy for short stature, once low IGF-I levels without GH resistance, delayed puberty, delay in BA, and nutritional stabilization are taken into consideration.

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