title: Stimulant use and its impact on growth in children receiving growth hormone therapy: an analysis of the KIGS International Growth Database.
abstract: BACKGROUND
  Children receiving stimulants for attention deficit hyperactivity disorder (ADHD) frequently present to pediatric endocrinology clinics for evaluation and treatment of growth disorders. The worldwide prevalence of stimulant use in children with ADHD also receiving recombinant human growth hormone (rhGH) and the impact on response to rhGH are unknown.
  
  
  METHODS
  Data on children enrolled in the KIGS® (Pfizer International Growth Study) registry were evaluated for the associated diagnosis of ADHD prior to initiation of Genotropin® rhGH. Concomitant stimulant medications and auxological information were captured. Response to rhGH was evaluated using established growth prediction models.
  
  
  RESULTS
  The prevalence of ADHD in KIGS was 2.3% (1,748/75,251), with stimulants used in 1.8% (1,326/75,251). Children with idiopathic growth hormone deficiency (IGHD) who received stimulants grew significantly less (1.1 cm) in the first year of rhGH therapy than expected for rhGH-treated non-ADHD IGHD children. After one year of rhGH, idiopathic short stature (ISS) children with ADHD were significantly shorter [0.74 cm (with stimulants) and 0.69 cm (without stimulants)] than non-ADHD ISS children.
  
  
  CONCLUSIONS
  We demonstrated an impaired response to rhGH in IGHD and ISS children with ADHD. Our findings suggest that the ADHD phenotype, alone or in conjunction with stimulant therapy, may impair the short-term growth response to rhGH.
authors.affiliation: Pediatrics, University of Minnesota Amplatz Children's Hospital, Minneapolis, Minn., USA.
authors.forename: Bradley S
authors.initials: BS
authors.lastname: Miller
authors.forename: Ferah
authors.initials: F
authors.lastname: Aydin
authors.forename: Frida
authors.initials: F
authors.lastname: Lundgren
authors.forename: Anders
authors.initials: A
authors.lastname: Lindberg
authors.forename: Mitchell E
authors.initials: ME
authors.lastname: Geffner
mesh_terms: D000293:Adolescent; D041923:Adolescent Development / Q000187:drug effects*; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D000697:Central Nervous System Stimulants / Q000008:administration & dosage*; D002648:Child; D002657:Child Development / Q000187:drug effects*; D002675:Child, Preschool; D016208:Databases, Factual; D004393:Dwarfism, Pituitary / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D020249:Hormone Replacement Therapy / Q000379:methods; D019382:Human Growth Hormone; D006801:Humans; D008297:Male; D015995:Prevalence
chemical_list: D000697:Central Nervous System Stimulants; D019382:Human Growth Hormone