Growth hormone therapy does not elevate mortality in children with growth disorder
Paediatric growth hormone (GH) treatment does not increase mortality in children with idiopathic GH deficiency, idiopathic short stature, Turner syndrome, short stature homeobox-containing gene (SHOX) deficiency, history of benign neoplasia or born small for gestational age, suggests a recent study.
However, there is an increase in mortality among children with prior malignancy and those with underlying serious non-GH-deficient medical conditions.
A prospective, multinational, observational study was conducted on children with growth disorders from 827 study sites in 30 countries to investigate mortality in children receiving GH treatment. The main outcome measures were standardized mortality ratios (SMRs) and 95 percent CIs using age- and sex-specific rates from the general population.
A total of 9,504 GH-treated patients were followed for ≥4 years (67,163 person-years of follow-up). Of these, 42 deaths were reported (SMR, 0.77; 95 percent CI, 0.56 to 1.05).
Patients with history of malignant neoplasia had significantly elevated SMR (6.97; 3.81 to 11.69), and those with other serious non-GH-deficient conditions had borderline elevated SMR (2.47; 0.99 to 5.09).
Children with history of benign neoplasia (SMR, 1.44; 0.17 to 5.20), idiopathic GH deficiency (SMR, 0.11; 0.02 to 0.33), idiopathic short stature (SMR, 0.20; 0.01 to 1.10), short stature associated with small for gestational age birth (SMR, 0.66; 0.08 to 2.37), Turner syndrome (SMR, 0.51; 0.06 to 1.83) or SHOX gene deficiency (SMX, 0.83; 0.02 to 4.65) had no elevated SMRs.
“Although paediatric growth hormone treatment is generally considered safe for approved indications, concerns have been raised regarding potential for increased risk of mortality in adults treated with GH during childhood,” according to researchers.