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Baxter L, Bryant J, Cave CB, Milne R.
Cochrane Database of
Systematic Reviews 2007, Issue 1. Art. No.: CD003887. DOI:
10.1002/14651858.CD003887.pub2
The purpose of this review was to assess the effects of recombinant
growth hormone in children and adolescents with Turner Syndrome. Turner
syndrome (TS) is a genetic disorder affecting the sexual development and
appearance of girls and women. Women with TS are much shorter than normal
women within their respective populations (by about 21 cm or eight inches).
Recombinant human growth hormone (hGH) has been used to increase growth and
final height in girls who have Turner syndrome.
This review analyzed randomized controlled clinical trials which
were identified from a search of MEDLINE, EMBASE, The Cochrane Library,
LILACS, BIOSIS, Science Citation Index and reference lists. The reviewers
assessed studies for methodological quality and extracted data from four
studies which were carried out in children with TS before achieving final
height. The selected studies administered growth hormone for a minimum of
six months and compared the data with a placebo or no treatment control
condition. The primary outcomes were final height and growth. Secondary
outcomes included bone age, quality of life, cognitive performance, and
adverse effects.
The trials included 365 participants. Only one trial reported final
height in 61 treated women to be 148 cm versus 141 cm in 43 untreated women.
Short-term growth velocity was greater in treated than untreated girls after
one year and two years. Skeletal maturity was not accelerated by treatment
with recombinant growth hormone (hGH). Adverse effects were minimally
reported.
The reviewers concluded that recombinant human growth hormone (hGH)
doses between 0.3 to 0.375 mg/kg/wk increase short-term growth in girls with
Turner syndrome by approximately three cm in the first year and two cm in
the second year of treatment.
Treatment in one trial increased final height by approximately six cm over an untreated control group. Despite this increase, the final height of treated women was still outside the normal range.
