3P-RT-3

IMPROVEMENT OF ADULT HEIGHT AFTER GROWTH HORMONE (GH) TREATMENT IN EARLY PUBERTAL CHILDREN WITH SHORT STATURE AND FORMER INTRA-UTERINE GROWTH RETARDATION (IUGR): RESULTS OF A CONTROLLED STUDY

Carel J-C¹, David M², Colle M³, Chaussain J-L¹, Chatelain P⁴

¹Hospital Saint Vincent de Paul, Paris, ²Hospital Lyon Sud, Lyon, ³Cours Tournon, Bordeaux, ⁴Hospital Debouusse, Lyon

Recombinant GH treatment improves growth in prepubertal children with short stature and former IUGR. However, patients often seek treatment in early puberty, at a stage where bone age maturation limits the efficacy of therapeutic interventions.

Objectives: to evaluate the effects of GH on adult height of short children with former IUGR, treated around the onset of puberty.

Methods: randomized controlled study. Inclusion criteria: height –2.5 SD for age ,age >10.5 yr (girls) or >12.5 yr (boys), bone age≥9 yr (girls) or ≥10 yr (boys), pubertal stage 1 or 2 (tanner).Patients were randomized (2:1)to receive GH (Maxomat®, Sanofi-Synthelabo, France), 1.2 IU/Kg/w or no treatment. Treatment was discontinued after 2.7±0.6 yr, when growth velocity was <2 cm/yr or bone age >15 yr (girls) or >16yr (boys). Adult height was available for 89% of the treated and 76% of the control patients.

Results: Treated Controls

N (%males) 106(45%) 62(44%)

Target height (SDS) -1.2±0.9 -0.9±1.1

Birth length (SDS) -2.7±0.9 -2.9±0.8

Age at inclusion (yr) 12.7±1.4 12.7±1.5

Bone age at inclusion (yr) 10.5±1.4 10.9±1.5

Height at inclusion (SDS) -3.2±0.7 -3.3±0.6

Height gain (adult-inclusion, SDS) 1±0.9** 0.7±0.9

Adult height (SDS) -2.1±1* -2.6±0.9

Adult height (cm, M/F) 162±7/151±5 160±5/148±6

Means±SD; p<0.05; **p<0.1.

Conclusion: GH is effective to increase adult height, even when given at a late stage of the growth process.