Safety of Growth Hormone Treatment in Children with Juvenile Idiopathic Arthritis

Abstract

Background: Available data on growth hormone (GH) therapy in glucocorticoid-treated children with juvenile idiopathic arthritis (JIA) suggest a satisfactory safety profile. There have been few reports of adverse effects on the course of the joint disease (e.g., inflammatory flare-ups or osteoarticular complications). Despite strong concern that combined glucocorticoid and GH therapy might impair glucose tolerance, this has been uncommon in clinical trials. This article briefly reviews the published data and offers recommendations for monitoring patients with JIA who are receiving GH replacement therapy. Conclusions: The safety of GH therapy in children receiving glucocorticoid therapy for JIA seems satisfactory with few serious adverse events reported to date; however, given the small number of treated patients and the short periods of follow-up in each individual patient, the decision to initiate GH therapy in patients receiving glucocorticoids should be made cautiously.

Longitudinal Growth in Rheumatologic Conditions: Current and Emerging Treatments of Growth Delay in Children with Chronic Autoimmune Diseases

“…Thus, recombinant growth hormone treatment has been the mainstream since no other medications that induce skeletal growth are available to be used in pediatrics [36,37]. Nevertheless, even with GH treatment, catch-up growth is variable and is more dependent on the severity of the inflammatory state, duration, and additional corticosteroid treatment [34,[37][38][39][40][41].…”

Growth Hormone: Therapeutic Possibilities—An Overview

“…It has also been used clinically in muscle wasting diseases such as HIV [ 7 ], and in catabolic diseases like cystic fibrosis and inflammatory bowel disease [ 8 , 9 , 10 ] and improving body composition [ 11 ]. Thus, although GH is synonymous with growth, it also has many other therapeutic actions, including novel roles in bone metabolism [ 12 , 13 ] and arthritis [ 14 , 15 ], rejuvenation [ 16 , 17 , 18 ] and longevity [ 19 , 20 ], neuro-rehabilitation [ 21 , 22 ] and neuro-function [ 23 ], inflammatory bowel disease [ 24 , 25 ], critical illness [ 26 ] for wound healing and burns [ 27 , 28 , 29 ], fibromyalgia [ 30 ], hypertension [ 31 ], and postmenopausal osteoporosis [ 32 ]. These newly defined roles for GH include actions around reparation of tissue damage independent of a state of GH-deficiency [ 22 , 25 , 28 ].…”

Disease flare after 7 year‐remission of systemic type juvenile idiopathic arthritis: is growth hormone therapy a culprit or innocent bystander?

“…Dear Editor, The effect of growth hormone (GH) therapy in juvenile idiopathic arthritis (JIA) patients, particularly in terms of safety profile and efficacy on growth, has been widely investigated. 1,2 GH therapy has shown proven efficacy in treating glucocorticoid-induced growth retardation by positively affecting bone mass and body composition without evident systemic disease activity flare or local musculoskeletal complications. We recently experienced an interesting case with JIA which prompted considerable debate.…”