Effects on bone metabolism of human growth hormone to children with JRA on steroids

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J Rheumatol 2000 May;27(5):1287-93

Effects on bone metabolism of one year recombinant human growth hormone administration to children with juvenile chronic arthritis undergoing chronic steroid therapy.Touati G, Ruiz JC, Porquet D, Kindermans C, Prieur AM, Czernichow P.Centre d'Investigation Clinique et Service Endocrinologie-Diabetologie Pediatrique, INSERM U457, Hopital Debre, Paris, France.OBJECTIVE: To study the effects on bone metabolism of treatment with recombinant human growth hormone (rhGH) in children with juvenile chronic arthritis (JCA) who are undergoing treatment with glucocorticoids (GC) and have severe bone lesions.

METHODS: We assessed the effects of rhGH treatment (1.4 U/kg/week) on bone metabolism markers and bone density measured during a one year treatment course in 14 patients with systemic forms of JCA undergoing longterm GC treatment.

RESULT: All patients at inclusion showed severe bone demineralization. Compared to pretreatment values, bone formation markers (blood levels of osteocalcin and C-terminal propeptide of type 1 procollagen) and bone resorption markers (urinary hydroxyproline, pyridinoline, and deoxypyridinoline levels) increased significantly during treatment and returned to pretreatment values after discontinuation of rhGH. We observed that plasma level of osteocalcin was the best predictive variable of growth response to rhGH treatment in these patients.

CONCLUSION: The results reflect an increase in bone turnover in these patients. Despite these biochemical changes no improvement of bone density was observed during the one year treatment. Treatment of longer duration is necessary to evaluate the curative effects of GH.PMID: 10813303 [PubMed - indexed for MEDLINE]

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Date: Fri, 28 Dec 2001 14:04:39 -1000

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Subject: Effects on bone metabolism of human growth hormone to children with JRA on steroids

J Rheumatol 2000 May;27(5):1287-93

Effects on bone metabolism of one year recombinant human growth hormone administration to children with juvenile chronic arthritis undergoing chronic steroid therapy.

Touati G, Ruiz JC, Porquet D, Kindermans C, Prieur AM, Czernichow P.

Centre d'Investigation Clinique et Service Endocrinologie-Diabetologie Pediatrique, INSERM U457, Hopital Debre, Paris, France.

OBJECTIVE: To study the effects on bone metabolism of treatment with recombinant human growth hormone (rhGH) in children with juvenile chronic arthritis (JCA) who are undergoing treatment with glucocorticoids (GC) and have severe bone lesions.

METHODS: We assessed the effects of rhGH treatment (1.4 U/kg/week) on bone metabolism markers and bone density measured during a one year treatment course in 14 patients with systemic forms of JCA undergoing longterm GC treatment.

RESULT: All patients at inclusion showed severe bone demineralization. Compared to pretreatment values, bone formation markers (blood levels of osteocalcin and C-terminal propeptide of type 1 procollagen) and bone resorption markers (urinary hydroxyproline, pyridinoline, and deoxypyridinoline levels) increased significantly during treatment and returned to pretreatment values after discontinuation of rhGH. We observed that plasma level of osteocalcin was the best predictive variable of growth response to rhGH treatment in these patients.

CONCLUSION: The results reflect an increase in bone turnover in these patients. Despite these biochemical changes no improvement of bone density was observed during the one year treatment. Treatment of longer duration is necessary to evaluate the curative effects of GH.

PMID: 10813303 [PubMed - indexed for MEDLINE]