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Growth Hormone Is Effective in the Treatment of Severe Growth Retardation in Children with Juvenile Chronic Arthritis. Double Blind Placebo-Controlled Followup Study

MARJA-TERTTU SAHA, JARKKO HAAPASAARI, SIRPA HANNULA, SEPPO SARNA, and HANNA LIISA LENKO

ABSTRACT.

Objective.
To assess the efficacy of growth hormone (GH) treatment in severe growth retardation in prepubertal children with juvenile chronic arthritis (JCA).

Methods. In a randomized, double-blind placebo-controlled study, we treated 25 prepubertal children (7 boys, 18 girls, mean age 9.0 yrs) with severe growth retardation due to JCA with human recombinant GH (6 months) and placebo (6 months).

Results. A significant response to GH treatment, compared with placebo, was seen in most children. The median height velocity standard deviation score was 2.09 (range –7.18 to 9.49) during the 6 month period of GH therapy and –1.11 (range –10.00 to 1.11) during placebo treatment (p = 0.0002). The median height standard deviation score increased from –2.08 to –1.79 during GH treatment and from –2.18 to –2.02 during placebo (p = 0.0268). All children except one completed the study, showing high compliance. The treatment was well tolerated, and no significant alterations in the disease activity were recorded during the study.

Conclusion. We conclude that human recombinant GH may be of benefit in the treatment of severe growth retardation in children with JCA. The response was seen after only 6 months and was independent of initial growth hormone status of the child. (J Rheumatol 2004;31:1413-7)

Key Indexing Terms:

GROWTH
GROWTH HORMONE
JUVENILE CHRONIC ARTHRITIS


From Tampere University Hospital, Department of Paediatrics, Tampere; Rheumatism Foundation Hospital, Heinola; and University of Helsinki, Helsinki, Finland.

Dr. Saha was supported by a personal grant from the Medical Research Fund of Tampere University Hospital.

M-T. Saha, MD, PhD, Senior Consultant in Paediatric Endocrinology, Tampere University Hospital; J. Haapasaari, MD, Chief Physician; S. Hannula, MD, Assistant Physician, Rheumatism Foundation Hospital; S. Sarna, PhD, Senior Consultant in Statistics and Biometry, University of Helsinki; H.L. Lenko, MD, PhD, Chief Physician, Tampere University Hospital.

Address reprint requests to Dr. M-T. Saha, Tampere University Hospital, Department of Paediatrics, P.O. Box 2000, FIN 33521 Tampere, Finland.

Submitted July 8, 2003; revision accepted February 1, 2004.




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