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

George Paltoglou; Ioannis Dimitropoulos; Georgia Kourlaba; Evangelia Charmandari

doi:10.1515/jpem-2020-0287

Article

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

George Paltoglou , Ioannis Dimitropoulos , Georgia Kourlaba and Evangelia Charmandari

Published/Copyright: October 9, 2020

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From the journal Journal of Pediatric Endocrinology and Metabolism Volume 33 Issue 12

Abstract

Objectives

Idiopathic 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).

Methods

A 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.

Results

Children 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.

Conclusion

In 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.

Keywords: adult height; growth hormone treatment; idiopathic short stature; ISS; meta-analysis; rhGH

Corresponding author: Dr. George Paltoglou, MD, PhD, Consultant Paediatric Endocrinologist, Department of Paediatric Endocrinology, Evelina Children’s Hospital, London, UK; and Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, Thivon & Levadeias Str, Athens, Greece, E-mail: gpaltoglou@med.uoa.gr.

George Paltoglou and Ioannis Dimitropoulos these authors contributed equally to the study.

Research funding: None declared.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors state no conflict of interest.
Statement of Ethics: This study was conducted in accordance with the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement.

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Received: 2020-05-17

Accepted: 2020-08-23

Published Online: 2020-10-09

Published in Print: 2020-12-16

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Articles in the same Issue

https://doi.org/10.1515/jpem-2020-0287

Keywords for this article

adult height; growth hormone treatment; idiopathic short stature; ISS; meta-analysis; rhGH