Final adult height of children with idiopathic short stature: a multicenter study on GH therapy alone started during peri-puberty

Background. Data on adult height outcomes of the use of Anastrozole and Growth Hormone (GH) in pubertal males with Growth hormone deficiency (GHD) and Idiopathic short stature (ISS) are limited. Objective. We examined the effect of Anastrozole and GH therapy on near adult height (NAH) with pubertal males with GHD or ISS. Methods. Retrospective review of 419 charts from 2008 to 2015. The primary outcomes are NAH compared to mid-parental target height (MPTH) and predicted adult height (PAH). Results. We identified 23 patients (5 SGA/IUGR, 1 Noonan syndrome, 6 GHD, and 11 ISS). Six patients (4 GHD; 2 ISS) achieved NAH. Prior to Anastrozole treatment, the mean chronological age was 13.9±0.2 years (range 13.7–14.4), bone age was 13.6±0.6 years (range 12.5–14), mean height SDS was -1.5±0.5 (range −0.8 to −2.3), and mean PAH was 162.6±5.9 cm (range 153.5–168.6). MPTH was 173.6 cm ± 7 (range 161.8–181.6). Patients received Anastrozole for an average of 30.5 months (range 19–36 months). At NAH, the mean chronological age was 16.7±0.8 years (range 15.9–18.1 years) and height was 170±1.8 cm (range 168.5–173.4 cm). The mean height SDS improved to +0.81±0.6 (range +0.08 to +1.92, p=0.002). Net height gain was 7.3 cm compared to pretreatment PAH (p<0.01) and overall the mean adult height remained 3.5 cm below MPTH. Conclusion. Anastrozole and GH therapy can be effective in augmenting adult height without significant side effects. However, the long-term safety and efficacy of aromatase inhibitor use in pediatrics remain limited.

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In children with idiopathic short stature, what advantage does administering recombinant growth hormone have over observation in final adult height?Part B: Clinical commentary

Paediatrics & Child Health ◽

10.1093/pch/8.9.571 ◽

2003 ◽

Keyword(s):

Growth Hormone ◽

Short Stature ◽

Adult Height ◽

Idiopathic Short Stature ◽

Recombinant Growth Hormone ◽

Final Adult Height

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The Effect of Gonadotropin-Releasing Hormone Analogue on Final Adult Height in Children with Idiopathic Short Stature

Medical Principles and Practice ◽

10.1159/000499929 ◽

2019 ◽

Vol 28 (6) ◽

pp. 509-516 ◽

Cited By ~ 1

Author(s):

Nahla Khawaja ◽

Hala Owaineh ◽

Anwar Batieha ◽

Oraib Frahid ◽

Mohammed EL-Khateeb ◽

...

Keyword(s):

Short Stature ◽

Adult Height ◽

Gonadotropin Releasing Hormone ◽

Idiopathic Short Stature ◽

Hormone Analogue ◽

Historical Cohort ◽

Releasing Hormone ◽

Final Adult Height ◽

Gonadotropin Releasing Hormone Analogue ◽

Height Gain

Objective: To assess final adult height (FAH) in children with short stature treated with gonadotropin-releasing hormone analogue (GnRHa). Methods: All patients with idiopathic short stature (ISS) with normally timed puberty and a Tanner stage between 2 and 3, who achieved their FAH between 2005 and 2015, were included in this clinical historical cohort study. Height gain, FAH, and mid-parental height of 28 children with ISS who received GnRHa treatment for 1.8 ± 1.0 years to delay their puberty were compared to 31 untreated children. Results: The FAHs of the treated and the untreated girls were 151.3 ± 5.1 and 146.8 ± 3.8 cm (p = 0.01), respectively. The FAHs of the treated and the untreated boys were 156.4 ± 4.7 and 152.3 ± 5.7 cm (p = 0.111), respectively. The height gain in the treated and the untreated girls was 1.6 ± 7.8 and –3.6 ± 5.7 cm (p = 0.036), respectively. Height gain in the treated and the untreated boys was –5.1 ± 13.6 and –11.5 ± 8.4 cm (p = 0.171), respectively. Conclusion: GnRHa therapy has a modest effect in improving FAH in adolescent females with ISS but not in boys.

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The effect of treatment with recombinant human growth hormone (rhGH) on linear growth and adult height in children with idiopathic short stature (ISS): a systematic review and meta-analysis

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2020-0287 ◽

2020 ◽

Vol 33 (12) ◽

pp. 1577-1588

Author(s):

George Paltoglou ◽

Ioannis Dimitropoulos ◽

Georgia Kourlaba ◽

Evangelia Charmandari

Keyword(s):

Systematic Review ◽

Growth Hormone ◽

Short Stature ◽

Human Growth Hormone ◽

Adult Height ◽

Linear Growth ◽

Meta Analysis ◽

Recombinant Human Growth Hormone ◽

Human Growth ◽

Idiopathic Short Stature

AbstractObjectivesIdiopathic short stature (ISS) is a recognized, albeit a controversial indication for treatment with recombinant human growth hormone (rhGH).The objective of the present study was to conduct a systematic review of the literature and meta-analyses of selected studies about the use of rhGH in children with ISS on linear growth and adult height (AH).MethodsA systematic literature search was conducted to identify relevant studies published till February 28, 2017 in the following databases: Medline (PubMed), Scopus and Cochrane Central Registry of Controlled Trials. After exclusion of duplicate studies, 3,609 studies were initially identified. Of those, 3,497 studies were excluded during the process of assessing the title and/or the abstract. The remaining 112 studies were evaluated further by assessing the full text; 21 of them fulfilled all the criteria in order to be included in the current meta-analysis.ResultsChildren who received rhGH had significantly higher height increment at the end of the first year, an effect that persisted in the second year of treatment and achieved significantly higher AH than the control group. The difference between the two groups was equal to 5.3 cm (95% CI: 3.4–7 cm) for male and 4.7 cm (95% CI: 3.1–6.3 cm) for female patients.ConclusionIn children with ISS, treatment with rhGH improves short-term linear growth and increases AH compared with control subjects. However, the final decision should be made on an individual basis, following detailed diagnostic evaluation and careful consideration of both risks and benefits of rhGH administration.

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Idiopathic Short Stature

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2001-s209 ◽

2001 ◽

Vol 14 (s2) ◽

Cited By ~ 4

Author(s):

A.M. Pasquino ◽

A. Albanese ◽

M. Bozzola ◽

G.E. Butler ◽

F. Buzi ◽

...

Keyword(s):

Short Stature ◽

Adult Height ◽

Idiopathic Short Stature ◽

Psychological Benefits ◽

Normal Children ◽

Gh Treatment ◽

Number Of Children ◽

The Status ◽

Gonadotrophin Releasing Hormone

AbstractIdiopathic short stature (ISS) is a term used to describe the status of children with short stature that cannot be attributed to a specific cause. Many children diagnosed as having ISS have partial GH insensitivity, which can result from disturbances at various points of the GH-IGF-I axis. Several clinical studies on spontaneous growth in ISS showed that adult height was almost in the range of target height. GH treatment led to adult height not significantly higher than the pretreatment predicted adult height in most reports. No metabolic side effects have been observed, even when the dose was higher than in GH deficiency. Manipulation of puberty with gonadotrophin releasing hormone analogues reported by a few authors in a small number of children has shown conflicting results. Long-term psychological benefits of GH therapy for short normal children have not been demonstrated to date.

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