Growth hormone use in pediatric inflammatory bowel disease

Melissa Crisci; Srisindu Vellanki; Robert N. Baldassano; Yong Chen; Yu-Lun Liu; Ronen Stein; Jacquelyn Hatch-Stein

doi:10.1515/jpem-2023-0125

Article

Growth hormone use in pediatric inflammatory bowel disease

Melissa Crisci , Srisindu Vellanki , Robert N. Baldassano , Yong Chen , Yu-Lun Liu , Ronen Stein and Jacquelyn Hatch-Stein

Published/Copyright: October 6, 2023

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From the journal Journal of Pediatric Endocrinology and Metabolism Volume 36 Issue 11

Abstract

Objectives

Impaired linear growth is a known complication of pediatric inflammatory bowel disease (IBD), but the use of growth hormone (GH) in this population is not well-described. The primary aim of this study is to determine whether growth hormone use in pediatric IBD leads to improved height outcomes.

Methods

This was a retrospective chart review of patients with IBD aged 0–21 years followed at a single center between 2018 and 2021 treated with at least 1 year of GH. Records collected included demographics, IBD phenotype, IBD disease activity scores, medications, weight z-score, height z-score, bone age, and details of GH therapy including testing for GH deficiency. The primary outcome measure was change in height z-score after 1 year of GH treatment.

Results

Forty-six patients were identified and 18 were excluded. Of the 28 patients included (7 female; 25.0 %), 26 (92.9 %) had a diagnosis of Crohn’s disease (CD) and 2 (7.1 %) had ulcerative colitis (UC). The mean (SD) age at GH initiation was 9.6 (3.4) years. Among all participants, there was a significant mean difference in height z-score from baseline to 1 year on therapy (−2.25 vs. −1.50, respectively; difference, 0.75; 95 % CI, 0.56 to 0.94; p<0.001). Among the 19 subjects that completed GH therapy there was a significant mean difference between baseline and final height z-scores (−2.41 vs. −0.77, respectively; difference, 1.64; 95 % CI, 1.30 to 1.98; p<0.001).

Conclusions

GH use was associated with improved height outcomes. The pediatric IBD patients in this cohort had significant improvements in height z-scores both after one year on therapy and at completion of GH therapy.

Keywords: growth hormone; inflammatory bowel disease; height z-score; TNFα; biologic

Corresponding author: Jacquelyn Hatch-Stein, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; and The Children’s Hospital of Philadelphia, Department of Pediatrics, Division of Endocrinology and Diabetes, 3500 Civic Center Blvd, HUB 7th floor, Philadelphia, PA 19104, USA, Phone: (215) 590-3174, Fax: (215) 590-3053. E-mail: hatchsteinj@chop.edu

Disclosure summary: The authors have nothing to disclose.

Research ethics: The study protocol was reviewed and exempted by the Institutional Review Board at the Children’s Hospital of Philadelphia.
Informed consent: Not applicable.
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.
Research funding: None declared.
Data availability: The raw data can be obtained on request from the corresponding author.

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Received: 2023-03-20

Accepted: 2023-09-18

Published Online: 2023-10-06

Published in Print: 2023-11-27

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Articles in the same Issue

https://doi.org/10.1515/jpem-2023-0125

Keywords for this article

growth hormone; inflammatory bowel disease; height z-score; TNFα; biologic