title: The impact of growth hormone therapy on adult height in noonan syndrome: a systematic review.
abstract: BACKGROUND
  Recombinant human growth hormone (rhGH) is being used to promote linear growth in short children with Noonan syndrome. However, its efficacy is still controversial.
  
  
  OBJECTIVE
  To systematically determine the impact of rhGH therapy on adult height in children with Noonan syndrome.
  
  
  METHODS
  We searched the Cochrane Central Register of Controlled Trials, ISI Web of Science, MEDLINE, and the bibliographic references from all retrieved articles published until April 2014. Studies reporting adult/near-adult height in children with Noonan syndrome treated with rhGH or reporting at least a 3-year follow-up were analysed. Quality and strength of recommendation were assessed according to the Endocrine Society criteria.
  
  
  RESULTS
  No controlled trials reporting adult height were available. Five studies were identified reporting adult height or near adult height. Data comparison showed inter-individual variability in the response to rhGH, mean height gain standard deviation score ranging between 0.6 and 1.4 according to national standards, and between 0.6 and 2 according to Noonan standards. Significant biases affected all the studies.
  
  
  CONCLUSIONS
  High-quality controlled trials on the impact of rhGH therapy on adult height are lacking, and the robustness of available data is not sufficient to recommend such therapy in children with Noonan syndrome.
authors.affiliation: Dipartimento di Medicina Pediatrica, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Giacomozzi
authors.forename: Annalisa
authors.initials: A
authors.lastname: Deodati
authors.forename: Mohamad Guftar
authors.initials: MG
authors.lastname: Shaikh
authors.forename: Syed Faisal
authors.initials: SF
authors.lastname: Ahmed
authors.forename: Stefano
authors.initials: S
authors.lastname: Cianfarani
mesh_terms: D000293:Adolescent; D000328:Adult; D001827:Body Height / Q000187:drug effects*; D002648:Child; D002675:Child, Preschool; D020249:Hormone Replacement Therapy / Q000379:methods*; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D009634:Noonan Syndrome / Q000188:drug therapy*
chemical_list: D019382:Human Growth Hormone