Growth hormone treatment in boys with Duchenne muscular dystrophy and glucocorticoid-induced growth failure

Rutter MM, Collins J, Rose SR, et al. Growth hormone treatment in boys with Duchenne muscular dystrophy and glucocorticoid-induced growth failure. Neuromuscular disorders : NMD  2012;22:1046-56.

rutterwongdec2012229677890

Abstract

This study evaluated efficacy and safety of growth hormone treatment in Duchenne muscular dystrophy boys with glucocorticoid-induced growth failure. We reviewed 39 consecutive boys (average age 11.5 years; 32 ambulatory) treated with growth hormone for 1 year during a four-year period. Boys were on long-term daily deflazacort or prednisone (mean duration 5 +/- 2.2 years; dosing regimen prednisone 0.75 mg/kg/day equivalent). Primary outcomes were growth velocity and height-for-age z-scores (height SD) at 1 year. Height velocity increased from 1.3 +/- 0.2 to 5.2 +/- 0.4 cm/year on growth hormone (p<0.0001). Pre-growth hormone decline in height SD (-0.5 +/- 0.2SD/year) stabilized at height SD -2.9 +/- 0.2 on growth hormone (p<0.0001). The rate of weight gain was unchanged, at 2.8 +/- 0.6 kg/year pre-growth hormone and 2.6 +/- 0.7 kg/year at 1 year. Motor function decline was similar pre-growth hormone and at 1 year. Cardiopulmonary function was unchanged. Three experienced side effects. In this first comprehensive report of growth hormone in Duchenne muscular dystrophy, growth hormone improved growth at 1 year, without detrimental effects observed on neuromuscular and cardiopulmonary function.

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