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Background: In children with severe rheumatic disease (RD), treatment with cor ticosteroids (CS) is frequently needed and growth retardation and osteopenia may develop. A beneficial effect of human growth hormone (hGH) has been reported bu t mostly in trials without a control group. Aims: To study the effect of hGH on growth, bone mineral density (BMD), and body composition, taking the disease act ivity and CS use into account. Methods: Randomised controlled trial on 17 prepub ertal RD patients with growth retardation and/or decreased BMD. The hGH group (n = 10) received treatment with hGH 4 IU/m2/day (～0.045 mg/kg/ day) during two y ears. The controls (n = 7) received no GH treatment. Results: During the two yea r study period the disease activity, and use of CS and metho- trexate (MTX) did not differ between the groups. There was a significant mean increase in height standard deviation score (HSDS) in the hGH group (0.42±0.16 SDS) and a non-significant decrease in the controls (-0.18±0.11 SDS). Change in BMD did not differ significantly between the groups, although the increase in BMD for lumbar spine within the hGH group was significant. Lean body mass impro ved significantly in the hGH group compared to controls (0.64±0.19 SDS versus -0.20±0.17 SDS), while the decrease in percentage fat was not significant. Con clusions: There was a significant effect of hGH on growth and lean body mass, bu t a longer duration of treatment might be necessary to evaluate the effect of hG H on BMD.
Background: In children with severe rheumatic disease (RD), treatment with cor ticosteroids (CS) is frequently needed and growth retardation and osteopenia may develop. A beneficial effect of human growth hormone (hGH) has been reported bu t mostly in trials without a Control group. Aims: To study the effect of hGH on growth, bone mineral density (BMD), and body composition, taking the disease act ivity and CS use into account. Methods: Randomized controlled trial on 17 prepub ertal RD patients with growth retardation The controls (n = 7) received no treatment with hGH 4 IU / m2 / day (~ 0.045 mg / kg / day) during two y ears. Results: During the two yea r study period the disease activity, and use of CS and metho- trexate (MTX) did not differ between the groups. There was a significant mean increase in height standard deviation score (HSDS) in the hGH group ( 0.42 ± 0.16 SDS) and a non-significant decrease in the controls (-0 .18 ± 0.11 SDS). Change in BMD did not differ significantly between the groups, although the increase in BMD for lumbar spine within the hGH group was significant. Lean body mass impro ved significantly in the hGH group compared to controls (0.64 ± 0.19 SDS versus -0.20 ± 0.17 SDS), while the decrease in percentage fat was not significant. Con clusions: There was a significant effect of hGH on growth and lean body mass, bu ta longer duration of treatment might be necessary to evaluate the effect of hG H on BMD.