Büyüme Hormonunun Tedavisinde Kanıta Dayalı Uygulamalar

Öz

Büyüme hormonu BH tedavisi giderek daha çok sayıda BH eksikliği BHE vakasında ve ayrıca, BHE dışında boy kısalığı ile giden çeşitli hastalıklarda uygulanmaya başlandı. BH tedavisinin amacı kısa dönemde büyüme hızını arttırmak ve uzun dönemde nihai boyun iyileştirilmesini sağlamaktır. BHE’de fizyolojik, BHE dışındaki diğer uygulamalarda ise daha yüksek BH dozları verilmektedir. BH tedavisine büyüme yanıtını etkileyen çeşitli faktörler vardır. Bu faktörler arasında BH verilme sıklığı, diğer hormonların varsa eksikliklerinin yerine konması, beslenme durumu, tedaviye başlama yaşı, BH dozu ve tedavi süresi sayılabilir. Tedavi hergün uygulanırsa, ne kadar erken yaşta başlanırsa ve uygun dozlarda verilirse büyüme yanıtı o kadar iyidir. Büyüme yanıtı özellikle prepubertal dönemde yüksektir. Bu derlemede BH tedavisinin çocukluk döneminde büyüme üzerine etkileri ve olası yan etkileri farklı hastalık gruplarında kanıta dayalı olarak sunulmaktadır

Anahtar Kelimeler

• Büyüme hormonu,çocukluk çağı,büyüme,yan etki

Growth Hormone Therapy in Childhood: EvidenceBased Approach

Öz

Growth hormone GH is being used in GH deficiency GHD and also in recent years in other indications that go with short stature. The aim of GH therapy is to increase the growth velocity at short term and improve final adult height at longterm. Physiological doses of GH are used in GHD and higher doses in non- GHD conditions. There are several factors that have an effect on the growth response on GH treatment. The frequency of injections, replacement therapy of other hormones, if necessary, nutritional status, age at onset of therapy, GH dose and duration of therapy are some of these confounding factors. If GH therapy is given daily in adequate doses and started at younger ages the growth response will be beter. The prepubertal period is very important in obtaining a good growth response. In this paper, the effects of GH therapy on growth in different disorders in childhood and possible adverse effects will be reviewed with an evidence based approach.

Anahtar Kelimeler

• Growth hormone,childhod,growth,adverse effect

Kaynakça

1. Quigley CA. Growth hormone treatment of non-growth hor- mone deficient growth disorders. Endo Metab Clin North Am 2007; 36:131-86.
2. Growth Hormone Therapy in Pediatrics. 20 years of KIGS. Ed. MB Ranke, DA Price, EO Reiter. Karger, Basel, 2007.
3. Darendeliler F, Bundak R, Neyzi O. Hipofiz ön lobu. Pediatri kitabında. Ed. O Neyzi ve T Ertuğrul. Nobel Tıp Kitapevi 2002; 1215-21.
4. ergenlik döneminde büyüme hormonu eksikliği tanı ve tedavi- si uzlaşı raporu (Bölüm 1): Büyüme hormon eksikliği tanısı. Çocuk Dergisi 2006; 6:11-6.
5. short stature. A report by the Drug and Therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society. J Pediatr 1995; 127:857-67.
6. the use of recombinant human growth hormone in children. American Academy of Pediatrics Committee on Drugs and Committee on Bioethics. Pediatrics; 1997; 99:122-9.
7. atment of growth hormone deficiency in children and adoles- cents; towards a consensus. Horm Res 1998; 50:320-40.
8. GH Research Society. Consesus Guidelines for the diganosis and treatment of growth hormone (GH) deficiency in childho- od and adolescence: Summary statement of the GH research society. J Clin Endocrinol Metab 2000; 11:3990-3.

9. Pediatric Endocrinology Society Drug and Therapeutics Committee. Update of guidelines for the use of growth hormo- ne in children: the Lawson Wilkins Pediatric Endocrinology Society Drug and Therapeutics Committee. J Pediatr 2003; 143:415-21.
10. nosis of growth hormone deficiency in children and adults. Endocr Rev 1998; 19:203-23.
11. Laron Z. Diagnosis and management of growth hormone deficiency in childhood and adolescence. Part 1: diagnosis of growth hormone deficiency. Growth Horm IGF Res 2001; 11:137-65.
12. Keizer Schrama S. Drugs and Therapeutics Committee of the European Society for Paediatric Endocrinology (ESPE). European audit of current practice in diagnosis and treatment of childhood growth hormone deficiency. Horm Res 2002; 13. Ulusal Pediatrik Endokrinoloji Derneği adına Darendeliler F, Darcan Ş. Çocukluk ve ergenlik döneminde büyüme hor- monu eksikliği tanı ve tedavisi uzlaşı raporu (Bölüm 2) Büyüme hormonu eksikliği tedavisi. Çocuk Dergisi 2006; 6:89-94.
13. human growth hormone administration: Statement from the growth hormone research society. J Clin Endocrinol Metab 2001; 86:1868-70.
14. Sizonenko PC. Diagnosis and management of growth hormo- ne deficiency in childhood and adolescence -Part 2: Growth hormone treatment in growıh hormone deficient children. Growth Hormone & IGF Research 2002; 12:323-41.
15. Growth hormone treatment of children with brain tumors and risk of tumor recurrence. J Clin Endocrinol Metab 2000; 85:4444-9.
16. rence and second neoplasms in survivors of childhood cancer treated with growth hormone: A report from the childhoad cancer survivor study. J Clin Endocrinol Metab 2002; 87:3136- 41.
17. Albertsson-Wikland K, Anthony Price D. On Behalf of The Kigs International Board. Recurrence of brain tumours in patients treated with growth hormone: analysis of KIGS (Pfizer International Growth Database). Acta Paediatr 2006; 95:1284-90.
18. hormone therapy in childhood. Ped Endo Rev 2004; 2(Suppl 1):68-76.
19. pathic intracranial hypertension and slipped capital femoral epiphysis during growth hormone treatment: A safety update from the Kigs database. Horm Res 2007; 68(Suppl 5):41-8.
20. Furth SL. Growth and nutrition in children with chronic kid- ney disease. Adv Chronic Kidney Dis 2005; 12:366-71.
21. Vimalachandra D, Hodson EM, Willis NS, et al. Growth hormon efor children with chronic kidney disease. Cochrane Database Syst Rev 2001; 3 CD003264.
22. Curr Opin Pediatr 1995; 7:171-5.
23. hormone in short children after renal transplantation. French Society of Pediatric Nephrology. Pediatr Nephrol 1998; 25. Fine RN, Ho M, Tejani A, et al. Adverse events with rhGH treatment of patients with chronic renal insufficiency and end- stage renal disease. J Pediatr 2003; 142:539-45.
24. Maneatis T, Baptista J, Connelly K, et al. Growth hormone safety update from the National Cooperative Growth Study. J Pediatr Endocrinol Metab 2000; 13:1035-44.
25. me: spontaneous growth in 150 cases and review of the litera- ture. Eur J Pediatr 1983; 141:81-8.
26. Turner syndrome. Arch Dis Child 1985; 60:932-5.
27. ons encompassing a novel homeobox gene cause growth fai- lure in idiopathic short stature and Turner syndrome. Nat Genet 1997; 16:54-63.
28. in children and adolescents with Turner syndrome. Cochrane Database Syst Rev 2003; CD003887.
29. therapy of Turner’s Syndrome: beneficial effect on adult height. J Pediatr 1998; 132:319-24.
30. therapy of Turner syndrome: the impact of age of estrogen replacement on final height. Genentech, Inc., Collaborative Study Group. J Clin Endocrinol Metab 2000; 85:2439-45.
31. Quigley CA, Crowe BJ, Anglin DG, et al. Growth hormone and low dose estrogen in Turner syndrome: results of a United States multi-center trial to near-final height. J Clin Endocrinol Metab 2002; 87:2033-41.
32. Endocrine Group. Impact of growth hormone supplementa- tion on adult height in Turner syndrome: results of the Canadian randomized controlled trial. J Clin Endocrinol Metab 2005; 90:3360-6.
33. a guideline of the Turner Syndrome Study Group. J Clin Endocrinol Metab 2007; 92:10.
34. diabetes mellitus and impaired glucose tolerance in children and adolescents receiving growth – hormone treatment. Lancet 2000; 355(9204):610-3.
35. from gene to protein. Archives of Physiology and Biochemistry 2007; 113:116-23.
36. ency and Leri-Weill dyschondrosteosis : Prevalence and growth failure in relation to mutation, sex, and degree of wrist deformity. J Clin Endocrinol Metab 2004; 89:4403-08.
37. Ross JL, Kowal K, Quigley CA, et al. The phenotype of short stature homeobox gene (SHOX) deficiency in childho- od: contrasting children with Leri-Weill dyschondrosteosis and Turner Syndrome. J Pediatr 2005; 147:499-507.
38. Group. Growth hormone is effective in treatment of short stature associated with short stature homeobox-containing gene deficiency: Two-year results of a randomized, controlled, multicenter trial. J Clin Endocrinol Metab 2007; 92:219-28.
39. Hokken-Koelega AC, de Ridder MAJ, Lemmen RJ, den Hartog H, de Muinck Keizer-Schrama SM, Drop SLS. Children born small for gestational age: do they catch up? Pediatr Res 1995; 38:267-71.
40. small-for-gestational-age infants: from birth to adult height. Pediatr Res 1995; 38:733-9.
41. Keizer-Schrama SM, Drop SL. Endogenous and stimulated GH secretion, urinary GH excretion and plasma IGF-I and IGF-II levels in prepubertal children with short stature after intrauterine growth retardation. The Dutch Working Group on Growth Hormone. Clin Endocrinol (Oxf), 1994; 41:621-30.
42. Johnston LB, Dahlgren J, Leger J, et al. Association betwe- en insulin-Iike growth factor I (IGF-I) polymorphisms, circu- lating IGF-I, and pre- and postnatal growth in two European small for gestational age populations. J Clin Endocrinol Metab 2003; 88:4805-10.
43. for children born small for gestational age: height gain is less dose dependent over long term than over the short term. Pediatrics 2005; 115:e458-62.
44. ment of product characteristics]. EMEA/CPMP/1404/03. Available at: http://www.emea.eu.int/pdfs/human/referral/ norditropin/347803en.pdf. Accessed January 4, 2007.
45. adult height after growth hormone treatment in adolescents with short stature born smal for gestational age: results of a randomized controlled study. J Clin Endocrinol Metab 2003; 88:1587-93.
46. Waal HA. Glucose tolerance, insulin sensitivity, and insulin secretion in children born small for gestational age. J Clin Endocrinol Metab 2002; 87:4657-61.
47. growth hormone treatment in children born small for gestatio- nal age: the US trial and KIGS analysis. Horm Res 2006; 65(Suppl 3):153-9.
48. short children born small for gestational age. Early Hum Devel 2005; 81:973-80.
49. hic short stature. Horm Res 1996; 45(Suppl2):64-6.
50. hic short stature. Horm Res 1996; 45(Suppl 2):59-63.
51. response to growth hormone treatment in children with growth hormone deficiency and idiopathic short stature. Pediatr Res 1996; 39:295-302.
52. final heights of growth hormone treated vs. untreated children with idiopathic growth failure. J Clin Endocrinol Metab 1998; 55. Leschek EW, Rose SR, Yanovski JA, et al. Effect of growth hormone treatment on adult height in peripubertal children with idiopathic short stature: a randomized, double-blind, placebo-controlled trial. J Clin Endocrinol Metab 2004; 89:3140-8.
53. hormone (GH) treatment to final height in children with idio- pathic short stature: evidence for a dose effect. J Pediatr 2005; 146:45-53.
54. Short Stature Group. Effect of growth hormone dose on bone maturation and puberty in children with idiopathic short statu- re. J Clin Endocrinol Metab 2006; 91:169-75.
55. growth hormone therapy on height in children with idiopathic short stature: a meta-analysis. Arch Pediatr Adolesc Med 2002; 156:230-40.
56. for idiopathic short stature in children and adolescents. Cochrane Database Syst Rev 2003; 27:CD004440.
57. results of long-term growth hormone treatment of idiopathic short stature. J Clin Endocrinol Metab 2005; 90:5247-53.
58. Quigley CA, Gill AM, Crowe BJ, et al. Safety of GH treat- ment in patients with idiopathic short stature. J Clin Endocrinol Metab 2005; 90:5188-96.
59. Cassidy SB. The changing purpose of Prader-Willi syndrome clinical diagnostic criteria and proposed revised criteria. Pediatrics 2001; 108:e92.
60. chromosome 15. Cytogenet Genome Res 2006; 113:292-9.
61. Butler MG, Meaney FJ. Standards for selected anthropomet- ric measurements in Prader-Willi syndrome. Pediatrics 1991; 88:853-60.
62. Reference values for height and weight in Prader-Willi syndrome based on 315 patients. Eur J Pediatr 1998; 157:634- 42.
63. Gasser T. Spontaneous growth in German children and ado- lescents with genetically confirmed Prader-Willi syndrome. Acta Paediatr 2000; 89:1302-11.
64. L, Chiumello G. Peculiar body composition in patients with Prader-Labhart-Willi syndrome. Am J Clin Nutr 1997; 68. Schluter B, Buschatz D, Trowitzsch E, Aksu F, Andler W. Respiratory control in children with Prader- Willi syndrome. Eur Pediatr 1997; 156:65-8.
65. Eiholzer U, Stutz K, Weinmann C, Torresani T, Molinari L, Prader A. Low insulin, IGF-I and IGFBP-3 levels in child- ren with Prader-Labhart-Willi syndrome. Eur Pediatr 1998; 157:890-93.
66. Morabito F. Reduced growth hormone (GH) responsiveness to combined GH-releasing hormone and pyridostigmine admi- nistration in the Prader-Willi syndrome. Clin Endocrinol (Oxf) 1998; 48:769-75.
67. hormone improves body composition, fat utilization, physical strength and agility, and growth in Prader-Willi syndrome: a controlled study. Pediatr 1999; 134:215-21.
68. treatment of children with Prader-Willi syndrome affects line- ar growth and body composition favourably. Acta Paediatr 1998; 87:28-31.
69. short stature in Prader-Willi syndrome. Acta Paediatr Suppl 1997; 423:63-5.
70. hormone on height, weight, and body composition in Prader- Willi syndrome. Arch Dis Child 1998; 78:474-6.
71. Lindgren AC, Ritzen EM. Five years of growth hormone treatment in children with Prader-Willi syndrome. Acta Paediatr Suppl 1999; 433:109-11.
72. height, prediction of final height and hand length in children with Prader-Willi syndrome after 4 years of therapy. Horm Res 2000; 53:185-92.
73. hormone treatment on growth and body composition in Prader-Willi syndrome: a preliminary report. Acta Paediatr Suppl 1997; 423:60-2.
74. benefit after 2 years of growth hormone on body composition, fat utilization, physical strength and agility, and growth in Prader-Willi syndrome. J Pediatr 2000; 137:42-9.
75. treatment of children with Prader-Willi syndrome: effects on glucose and insulin hemostasis. Swedish National Growth Hormone Advisory Group. Horm Res 1999; 51:157-61.
76. Haqq AM, Stadler DD, Jackson RH, Rosenfeld RG, Purnell JQ, LaFranchi SH. Effects of growth hormone on pulmonary function, sleep quality, behavior, cognition, growth velocity, body composition and resting energy expenditure in Prader-Willi syndrome. J Clin Endocrinol Metab 2003; 88:2206-12.