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Growth Hormone Increases Final Height in Patients with Juvenile Idiopathic Arthritis: Data from a Randomized Controlled Study

University Children’s Hospital (S.B., R.D.P., W.B., H.P.S.), Division of Endocrinology and Diabetology, D-80337 Munich, Germany; and Children’s Hospital for Rheumatology (P.R., R.H., H.M.), D-82467 Garmisch-Partenkirchen, Germany

Address all correspondence and requests for reprints to: S. Bechtold, M.D., Kinderklinik und Kinderpoliklinik, Im Dr. von Haunerschen Kinderspital, Pediatric Endocrinology, Lindwurmstrasse 4, D-80337 München, Germany. E-mail: Susanne.Bechtold{at}med.uni-muenchen.de.

Background: GH treatment stimulates growth in short children with juvenile idiopathic arthritis (JIA). The extent to which this therapy increases final height is not known.

Methods: Thirty-one growth-retarded children with systemic and polyarticular idiopathic arthritis were enrolled in this controlled study. After a mean observational time of 8.4 yr, final height was reached in 13 patients (seven females and six males) treated with GH for a mean of 6.7 yr in a dose of 0.33 mg/kg body weight per week. Eighteen patients (12 females and six males) served as an untreated control group.

Results: Mean increment in height in the treatment group was 1.6 ± 0.8 SD, whereas the patients of the control group lost 0.7 ± 1.8 SD. Overall, mean final height in the treatment group was –1.6 SD and in the control group –3.4 SD. More GH-treated patients reached a final height within target height than untreated patients (11 of 13 vs. four of 18). Disease activity markers had a significant influence on height outcome. After adjustment for baseline and average disease activity, the difference between treatment and control group was still significant (mean 1.5 SD). Patients with a moderate overall disease activity profited most from GH treatment. No adverse events were noted throughout the study.

Conclusion: Our data suggest that long-term GH therapy has a beneficial effect on growth and final height in the majority of growth retarded children with severe forms of JIA.