Treatment of Juvenile Rheumatoid Arthritis with Growth Hormone

Abstract

Severe growth retardation and profoundly altered body composition are observed in children with juvenile chronic arthritis receiving glucocorticoids. This study assessed the effects of growth hormone (GH) on height velocity, body composition and bone density. Fourteen patients were treated with GH (1.4 U/kg/week) for 1 year and then studied for a 2nd year off GH. The treatment increased insulin-like growth factor 1 and insulin-like growth factor binding protein 3 plasma levels. All patients showed an increase in height velocity. Lean body mass increased by 12%. After the cessation of GH therapy, height velocity fell to pretreatment values, and weight and fat mass increased markedly. Bone formation and resorption markers significantly increased during treatment and returned to pretreatment values after discontinuation of GH treatment. These results suggest that GH may partially counteract the adverse effects of glucocorticoids on growth and metabolism in patients with chronic inflammatory disease.

Glucocorticoid-induced bone loss in children

“…The investigators found an increase in bone mineral content and height as well as in osteocalcin levels, which correlated with height velocity. Simon et al (102) reported nearly identical results in their rHGH trial. The standard dose of rHGH given to children with growth hormone deficiency is 0.05 mg/kg/d.…”

Secondary Osteoporosis in Patients with Juvenile Idiopathic Arthritis

“…Growth hormone was effective in stimulating collagen production and improving liner growth in JIA [81–83]. However, long-term controlled studies are needed to determine impact on bone mass and bone turnover and the risks of growth hormone therapy [84].…”

Endocrine problems in adolescents with chronic illness and disabilities

“…Growth hormone studies reveal a state of mild GH resistance with normal GH secretion and mildly low Brought to you by | Biblioteca de la Universidad de Sevilla Authenticated Download Date | 6/16/15 10:20 AM IGF-1 levels. Growth hormone treatment is not approved by the FDA for JRA but has been used in a clinical trial in which an increase in the rate of linear growth was shown (52,53).…”