Growth in pre-pubertal children with myelomeningocele (MMC) on growth hormone (GH): the KIGS experience.
OBJECTIVE
To analyse the auxological data of children with myelomeningocele (MMC) on growth hormone (GH) therapy whose growth data was documented within KIGS (Pfizer International Growth Database). Longitudinal growth data of a sub-group of pre-pubertal children were studied after a treatment period of 3 years.


METHODS
Eighty patients (38 m, 42 f) with MMC with a median chronological age (CA) of 11.6 years (at latest visit) on GH were registered in the KIGS database. In 52 patients, GH deficiency was documented. GH therapy started with a median dose of 0.23 mg kg(-1) per week. The 3-year longitudinal growth was analysed in 21 patients (13 m, 8 f; median CA 9.2 years, latest visit), all of whom were pre-pubertal at start and during GH therapy.


RESULTS
GH therapy started at 7.5 years with a dose of 0.23 mg kg(-1) per week. Birth length SDS (-0.51) and mid-parental height SDS (+0.07) were in the normal range. BMI SDS at start was +0.24, at latest visit -0.03. After a median treatment duration of 3.0 years (latest visit), height SDS improved from -2.97 (start of GH) to -2.01. The sub-group of pre-pubertal MMC patients started GH therapy (dose 0.22 mg kg(-1) per week) at 6.2 years. Growth velocity (GV) SDS increased significantly (at start: -1.77; 1 year: +2.60, 2 years: +2.25, 3 years: +1.24), thus height SDS improved from -3.25 at start to -1.87 at 36 months. BMI SDS was in the normal range and remained unchanged during GH therapy. No major side effects of GH were recorded.


CONCLUSIONS
GH had positive effects on height SDS in MMC patients. The analysis of the longitudinal growth data of pre-pubertal MMC patients showed a significant increase in GV SDS and improvement of height SDS.
Trollmann
Regina
R
Department of Pediatrics, Friedrich-Alexander-University of Erlangen, Erlangen, Germany.
Bakker
Bert
B
Lundberg
Martin
M
Doerr
Helmuth G
HG
D001827:Body Height / Q000187:drug effects*; D002648:Child; D004305:Dose-Response Relationship, Drug; D005260:Female; D006128:Growth / Q000187:drug effects; D006130:Growth Disorders / Q000188:drug therapy* / Q000209:etiology; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008591:Meningomyelocele / Q000150:complications*; D011628:Puberty, Delayed; D011994:Recombinant Proteins / Q000627:therapeutic use*; D012189:Retrospective Studies
D011994:Recombinant Proteins; D019382:Human Growth Hormone