Effects on bone metabolism of one year recombinant human growth hormone administration to children with juvenile chronic arthritis undergoing chronic steroid therapy.
OBJECTIVE
To study the effects on bone metabolism of treatment with recombinant human growth hormone (rhGH) in children with juvenile chronic arthritis (JCA) who are undergoing treatment with glucocorticoids (GC) and have severe bone lesions.


METHODS
We assessed the effects of rhGH treatment (1.4 U/kg/week) on bone metabolism markers and bone density measured during a one year treatment course in 14 patients with systemic forms of JCA undergoing longterm GC treatment.


RESULTS
All patients at inclusion showed severe bone demineralization (mean bone density: -3.7 standard deviation score for chronological age). Compared to pretreatment values, bone formation markers (blood levels of osteocalcin and C-terminal propeptide of type 1 procollagen) and bone resorption markers (urinary hydroxyproline, pyridinoline, and deoxypyridinoline levels) increased significantly during treatment and returned to pretreatment values after discontinuation of rhGH. We observed that plasma level of osteocalcin was the best predictive variable of growth response to rhGH treatment in these patients.


CONCLUSIONS
The results reflect an increase in bone turnover in these patients. Despite these biochemical changes no improvement of bone density was observed during the one year treatment. Treatment of longer duration is necessary to evaluate the curative effects of GH.
Touati
G
G
Centre d'Investigation Clinique et Service Endocrinologie-Diabétologie Pédiatrique, INSERM U457, Hôpital Robert Debré, Paris, France.
Ruiz
J C
JC
Porquet
D
D
Kindermans
C
C
Prieur
A M
AM
Czernichow
P
P
D000293:Adolescent; D001171:Arthritis, Juvenile / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D015415:Biomarkers / Q000032:analysis; D015519:Bone Density / Q000187:drug effects; D001842:Bone and Bones / Q000378:metabolism* / Q000473:pathology; D002648:Child; D005260:Female; D019382:Human Growth Hormone / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D015675:Osteocalcin / Q000097:blood; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D012600:Scoliosis / Q000209:etiology
D015415:Biomarkers; D011994:Recombinant Proteins; D015675:Osteocalcin; D019382:Human Growth Hormone