title: Long-term effects of recombinant human growth hormone therapy in children with Prader-Willi syndrome.
abstract: OBJECTIVE
  Recombinant human growth hormone (hGH) therapy in children with Prader-Willi syndrome (PWS) improves linear growth, body composition, physical strength and agility, and other metabolic parameters. These benefits must be weighed against potential adverse effects, including rare occurrences of sudden death. This review summarizes recent evidence important to a benefit-risk analysis of hGH use in children with PWS.
  
  
  RESULTS
  Studies consistently show that hGH improves stature, body composition, fat percentage and distribution, and other metabolic markers in children with PWS. Preliminary reports of improved cognitive development during hGH have also emerged. Scoliosis progression is influenced by growth rate, but frequency of occurrence and severity are not increased by hGH exposure. PWS genotype does not appear to affect response to hGH. Concerns about hGH-associated sudden death persist, but recent studies show either absence of change in sleep-disordered breathing or improved sleep cardiovascular function during hGH therapy.
  
  
  CONCLUSIONS
  Recent studies confirm and expand reported benefits of hGH therapy in children with PWS, including a possible salutary role in cognitive development. These findings support previous assertions that hGH can reduce morbidity and improve function in children with PWS, and suggest that potential risks of such treatment are favorably balanced by its benefits.
authors.affiliation: Department of Pediatrics, University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin 53792-4108, USA.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Wolfgram
authors.forename: Aaron L
authors.initials: AL
authors.lastname: Carrel
authors.forename: David B
authors.initials: DB
authors.lastname: Allen
mesh_terms: D001823:Body Composition / Q000187:drug effects; D002648:Child; D003072:Cognition Disorders / Q000188:drug therapy / Q000209:etiology; D006128:Growth / Q000187:drug effects; D019382:Human Growth Hormone / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D011218:Prader-Willi Syndrome / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D011994:Recombinant Proteins; D019382:Human Growth Hormone