Meta-analysis of metabolic changes in children with idiopathic growth hormone deficiency after recombinant human growth hormone replacement therapy

Yuan, Yuan; Zhou, Bo; Liu, Shufang; Wang, Yunfeng; Wang, Kundi; Zhang, Zhixin; Niu, Wenquan

doi:10.1007/s12020-020-02435-w

Cited by 6 publications

(3 citation statements)

References 40 publications

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“…It has been observed that the blood glucose and lipid levels decrease after rhGH treatment ( Ciresi et al, 2007 ; Slattery et al, 2014 ; Kubo et al, 2017 ), while other clinical trials have not found significant changes in glucose metabolism after rhGH treatment ( Czepielewski et al, 2019 ). A recent meta-analysis revealed a favorable role of rhGH therapy in lipid metabolism, which might depend on the duration of the intervention; however, the role of rhGH in glucose metabolism was not significant ( Yuan et al, 2021 ). For instance, an increase in HbA1c level was observed after 1 year of rhGH therapy in a retrospective study of 101 pediatric patients with GHD ( Pellegrin et al, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

Short-term efficacy and safety of a lower dose of polyethylene glycol recombinant human growth hormone in children with growth hormone deficiency: A randomized, dose-comparison study

et al. 2022

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Objective: Polyethylene glycol recombinant human growth hormone (PEG-rhGH, Jintrolong®) is the first long-acting rhGH preparation that is approved to treat children with growth hormone deficiency (GHD) in China. Clinical experience with dose selections of PEG-rhGH is scarce. The present study compared the efficacy and safety of a lower dose to increase dosing regimens of PEG-rhGH treatment.Methods: A multicenter, randomized, open-label, dose-comparison clinical study was conducted to compare the improvements in the height standard deviation score (Ht SDS), height velocity (HV), insulin-like growth factor-1 (IGF-1) SDS, and safety profiles of children with GHD who are treated with 0.2 mg/kg/week of PEG-rhGH dose or 0.14 mg/kg/week for 26 weeks.Results: Ht SDS, HV, and IGF-1 SDS increased significantly after PEG-rhGH treatment in the two dose groups (p < 0.05). The improvements of Ht SDS, HV, and IGF-1 SDS were more significant in the high-dose group than in the low-dose group (p < 0.05). Ht SDS improvement in low-dose group was not non-inferiority to that in the high-dose group (p = 0.2987). The incidences of adverse events were comparable between the two groups.Conclusion: The improvements of Ht SDS, HV, and IGF-1 SDS were more significant in the high-dose group than in the low-dose group (p < 0.05). PEG-rhGH at the dose of 0.14 mg/kg/week was effective and safe for children with GHD.Clinical Trial Registration:clinicaltrials.gov, identifier NCT02908958.

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Section: Discussionmentioning

confidence: 99%

Short-term efficacy and safety of a lower dose of polyethylene glycol recombinant human growth hormone in children with growth hormone deficiency: A randomized, dose-comparison study

et al. 2022

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“…Growth hormone therapy is indicated for a heterogeneous set of growth disorders; in addition to growth hormone deficiency, approved pediatric indications include Turner syndrome, short stature after being born small for gestational age, Noonan syndrome, Prader-Willi syndrome, SHOX (short stature homeobox-containing gene) deficiency, chronic renal failure, and idiopathic short stature, although licensed indications vary by country and growth hormone formulations [10,11]. Importantly, growth hormone affects not only growth of children, but also metabolism, cardiovascular health, bone strength, and quality of life in the short and long term [12][13][14]. These effects continue into adult life, and a proportion of patients treated as children continue to require growth hormone therapy as adults.…”

Section: Opportunities Of Ehealth For Patient Empowerment In Growth Hormone Therapymentioning

confidence: 99%

“…Importantly, growth hormone affects not only growth of children, but also metabolism, cardiovascular health, bone strength, and quality of life in the short and long term [ 12 - 14 ]. These effects continue into adult life, and a proportion of patients treated as children continue to require growth hormone therapy as adults.…”

Section: Introductionmentioning

confidence: 99%

An eHealth Framework for Managing Pediatric Growth Disorders and Growth Hormone Therapy

Dimitri¹,

Fernández-Luque²,

Banerjee³

et al. 2021

J Med Internet Res

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Background The use of technology to support health and health care has grown rapidly in the last decade across all ages and medical specialties. Newly developed eHealth tools are being implemented in long-term management of growth failure in children, a low prevalence pediatric endocrine disorder. Objective Our objective was to create a framework that can guide future implementation and research on the use of eHealth tools to support patients with growth disorders who require growth hormone therapy. Methods A total of 12 pediatric endocrinologists with experience in eHealth, from a wide geographical distribution, participated in a series of online discussions. We summarized the discussions of 3 workshops, conducted during 2020, on the use of eHealth in the management of growth disorders, which were structured to provide insights on existing challenges, opportunities, and solutions for the implementation of eHealth tools across the patient journey, from referral to the end of pediatric therapy. Results A total of 815 responses were collected from 2 questionnaire-based activities covering referral and diagnosis of growth disorders, and subsequent growth hormone therapy stages of the patient pathway, relating to physicians, nurses, and patients, parents, or caregivers. We mapped the feedback from those discussions into a framework that we developed as a guide to integration of eHealth tools across the patient journey. Responses focused on improved clinical management, such as growth monitoring and automation of referral for early detection of growth disorders, which could trigger rapid evaluation and diagnosis. Patient support included the use of eHealth for enhanced patient and caregiver communication, better access to educational opportunities, and enhanced medical and psychological support during growth hormone therapy management. Given the potential availability of patient data from connected devices, artificial intelligence can be used to predict adherence and personalize patient support. Providing evidence to demonstrate the value and utility of eHealth tools will ensure that these tools are widely accepted, trusted, and used in clinical practice, but implementation issues (eg, adaptation to specific clinical settings) must be addressed. Conclusions The use of eHealth in growth hormone therapy has major potential to improve the management of growth disorders along the patient journey. Combining objective clinical information and patient adherence data is vital in supporting decision-making and the development of new eHealth tools. Involvement of clinicians and patients in the process of integrating such technologies into clinical practice is essential for implementation and developing evidence that eHealth tools can provide value across the patient pathway.

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Minimising Cardiometabolic Risk Factors in Patients with Hypopituitarism

Armeni

Grossman

2022

Pituitary Disorders Throughout the Life Cycle

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Meta-analysis of metabolic changes in children with idiopathic growth hormone deficiency after recombinant human growth hormone replacement therapy

Cited by 6 publications

References 40 publications

Short-term efficacy and safety of a lower dose of polyethylene glycol recombinant human growth hormone in children with growth hormone deficiency: A randomized, dose-comparison study

Short-term efficacy and safety of a lower dose of polyethylene glycol recombinant human growth hormone in children with growth hormone deficiency: A randomized, dose-comparison study

An eHealth Framework for Managing Pediatric Growth Disorders and Growth Hormone Therapy

Minimising Cardiometabolic Risk Factors in Patients with Hypopituitarism

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