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Ma Y, Sheng J, Wang L, Zhang Y, Liu L. Therapeutic efficacy of recombinant human growth hormone in children with different etiologies of dwarfism from a pharmacoeconomic point of view. Medicine (Baltimore) 2024; 103:e38350. [PMID: 38905369 PMCID: PMC11191898 DOI: 10.1097/md.0000000000038350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 05/03/2024] [Indexed: 06/23/2024] Open
Abstract
Treatment outcomes for different causes of childhood dwarfism vary widely, and there are no studies on the economic burden of treatment in relation to outcomes. This paper compared the efficacy and healthcare costs per unit height of recombinant human growth hormone (rhGH) for the treatment of growth hormone deficiency (GHD) and idiopathic short stature (ISS) with a view to providing a more cost-effective treatment option for children. We retrospectively analyzed 117 cases (66 cases of GHD and 51 cases of ISS) of short-stature children who first visited Weifang People's Hospital between 2019.1 and 2022.1 and were treated with rhGH for 1 to 3 years to track the treatment effect and statistically analyzed by using paired t tests, non-parametric tests, and chi-square tests, to evaluate the efficacy of rhGH treatment for GHD and ISS children and the medicinal cost. The annual growth velocity (GV) of children with GHD and ISS increased the fastest during 3 to 6 months after treatment and then gradually slowed down. The GV of the GHD group was higher than that of the ISS group from 0 to 36 months after treatment (P < .05 at 3, 6, 9, and 12 months); the height standard deviation scores (HtSDS) of the children in the GHD and ISS groups increased gradually with the increase of the treatment time, and the changes in the height standard deviation scores (ΔHtSDS) of the GHD group were more significant than those of the ISS group (P < .05 at 3, 6, 9, and 12 months). (2) The medical costs in the pubertal group for a 1-cm increase in height were higher than those of children in the pre-pubertal group at the same stage (3 to 24 months P < .05). The longer the treatment time within the same group, the higher the medical cost of increasing 1cm height. RhGH is effective in treating children with dwarfism to promote height growth, and the effect on children with GHD is better than that of children with ISS; the earlier the treatment time, the lower the medical cost and the higher the comprehensive benefit.
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Affiliation(s)
- Yanxia Ma
- School of Clinical Medicine, Weifang Medical University, Weifang, China
| | - Jianping Sheng
- School of Clinical Medicine, Weifang Medical University, Weifang, China
| | - Lijie Wang
- School of Clinical Medicine, Weifang Medical University, Weifang, China
| | - Yanan Zhang
- School of Anesthesiology, Weifang Medical University, Weifang, China
| | - Lin Liu
- Department of Endocrinology, Weifang People’s Hospital, Weifang, China
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André J, Zhukouskaya VV, Lambert AS, Salles JP, Mignot B, Bardet C, Chaussain C, Rothenbuhler A, Linglart A. Growth hormone treatment improves final height in children with X-linked hypophosphatemia. Orphanet J Rare Dis 2022; 17:444. [PMID: 36544157 PMCID: PMC9768884 DOI: 10.1186/s13023-022-02590-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND/AIM Despite optimal conventional treatment (oral phosphate supplements and active vitamin D analogs), about 40-50% of children with well-controlled X-linked hypophosphatemia (XLH) show linear growth failure, making them less likely to achieve an acceptable final height. Here, we studied the hypothesis that rhGH treatment improves final height in children with XLH and growth failure. METHODS Two cohorts of children with XLH were included in this retrospective longitudinal analysis: (1) a cohort treated with rhGH for short stature (n = 34) and (2) a cohort not treated with rhGH (n = 29). The mean duration of rhGH treatment was 4.4 ± 2.9 years. We collected the auxological parameters at various time points during follow-up until final height. RESULTS In rhGH-treated children, 2 years of rhGH therapy was associated with a significant increase in height from - 2.4 ± 0.9 to - 1.5 ± 0.7 SDS (p < 0.001). Their mean height at rhGH discontinuation was - 1.2 ± 0.9 SDS and at final height was - 1.3 ± 0.9 SDS corresponding to 165.5 ± 6.4 cm in boys and 155.5 ± 6.3 cm in girls. Notably, the two groups had similar final heights; i.e., the final height in children not treated with rhGH being - 1.2 ± 1.1 SDS (165.4 ± 6.8 cm in boys and 153.7 ± 7.8 cm in girls), p = 0.7. CONCLUSION Treatment with rhGH permits to improve final height in children with XLH and growth failure, despite optimal conventional treatment. We propose therefore that rhGH therapy could be considered as an option for short stature in the context of XLH.
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Affiliation(s)
- Julia André
- grid.413784.d0000 0001 2181 7253AP-HP, Endocrinology and Diabetes for Children, Reference Center for Rare Diseases of Calcium and Phosphate Metabolism, DMU SEA, OSCAR Filière, EndoRare and BOND ERN, Bicêtre Paris Saclay Hospital, 78 Rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France
| | - Volha V. Zhukouskaya
- grid.413784.d0000 0001 2181 7253AP-HP, Endocrinology and Diabetes for Children, Reference Center for Rare Diseases of Calcium and Phosphate Metabolism, DMU SEA, OSCAR Filière, EndoRare and BOND ERN, Bicêtre Paris Saclay Hospital, 78 Rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France ,grid.508487.60000 0004 7885 7602Laboratory Orofacial Pathologies, Imaging and Biotherapies URP2496 and FHU-DDS-Net, Dental School, and Plateforme d’Imagerie du Vivant (PIV), Université Paris Cité, Montrouge, France
| | - Anne-Sophie Lambert
- grid.413784.d0000 0001 2181 7253AP-HP, Endocrinology and Diabetes for Children, Reference Center for Rare Diseases of Calcium and Phosphate Metabolism, DMU SEA, OSCAR Filière, EndoRare and BOND ERN, Bicêtre Paris Saclay Hospital, 78 Rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France ,grid.413784.d0000 0001 2181 7253AP-HP, Medicine for Adolescents, Bicêtre Paris Saclay Hospital, Le Kremlin Bicêtre, France
| | - Jean-Pierre Salles
- grid.508721.9Unit of Endocrinology and Bone Diseases, Children Hospital, Toulouse University Hospital, CHU de Toulouse, Université de Toulouse, ERN BOND, INSERM UMR 1291/CNRS 5051, INFINITY Center, Toulouse, France
| | - Brigitte Mignot
- grid.411158.80000 0004 0638 9213Department of Pediatrics, CHU of Besancon, Besançon, France
| | - Claire Bardet
- grid.508487.60000 0004 7885 7602Laboratory Orofacial Pathologies, Imaging and Biotherapies URP2496 and FHU-DDS-Net, Dental School, and Plateforme d’Imagerie du Vivant (PIV), Université Paris Cité, Montrouge, France
| | - Catherine Chaussain
- grid.413784.d0000 0001 2181 7253AP-HP, Endocrinology and Diabetes for Children, Reference Center for Rare Diseases of Calcium and Phosphate Metabolism, DMU SEA, OSCAR Filière, EndoRare and BOND ERN, Bicêtre Paris Saclay Hospital, 78 Rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France ,grid.508487.60000 0004 7885 7602Laboratory Orofacial Pathologies, Imaging and Biotherapies URP2496 and FHU-DDS-Net, Dental School, and Plateforme d’Imagerie du Vivant (PIV), Université Paris Cité, Montrouge, France ,grid.50550.350000 0001 2175 4109AP-HP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, Dental Medicine Department, Bretonneau Hospital, GHN-Universite de Paris, Paris, France
| | - Anya Rothenbuhler
- grid.413784.d0000 0001 2181 7253AP-HP, Endocrinology and Diabetes for Children, Reference Center for Rare Diseases of Calcium and Phosphate Metabolism, DMU SEA, OSCAR Filière, EndoRare and BOND ERN, Bicêtre Paris Saclay Hospital, 78 Rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France
| | - Agnès Linglart
- grid.413784.d0000 0001 2181 7253AP-HP, Endocrinology and Diabetes for Children, Reference Center for Rare Diseases of Calcium and Phosphate Metabolism, DMU SEA, OSCAR Filière, EndoRare and BOND ERN, Bicêtre Paris Saclay Hospital, 78 Rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France ,grid.460789.40000 0004 4910 6535INSERM, Physiologie Et Physiopathologie Endocrinienne, Bicêtre Paris Saclay Hospital, Paris Saclay University, Le Kremlin Bicêtre, France
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Luo X, Zhao S, Yang Y, Dong G, Chen L, Li P, Luo F, Gong C, Xu Z, Xu X, Gong H, Du H, Hou L, Zhong Y, Shi Q, Chen X, Chen X, Xu L, Cheng R, Su C, Ma Y, Xu L, Zhang L, Lu H. Long-acting PEGylated growth hormone in children with idiopathic short stature. Eur J Endocrinol 2022; 187:709-718. [PMID: 36130048 DOI: 10.1530/eje-22-0449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 09/21/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To evaluate the safety and efficacy of weekly PEGylated-recombinant human growth hormone (PEG-rhGH) in children with idiopathic short stature (ISS) in China. DESIGN AND METHODS This was a multicenter, phase II study in which all subjects were randomized 1:1:1 to weekly s.c. injections of PEG-rhGH 0.1 (low-dose (LD) group) or 0.2 mg/kg/week (high-dose (HD) group) or control for 52 weeks. The primary end point was change (Δ) in height s.d. score (HT-SDS) from baseline to week 52. Secondary end points were height velocity (HV), bone maturity, insulin-like growth factor-1 (IGF-1) SDS, and IGF-1/insulin-like growth factor-binding protein-3 (IGFBP-3) molar ratio. RESULTS A total of 360 children with ISS were recruited in the study (n = 120 in each group). At week 52, ΔHT-SDS was 0.56 ± 0.26, 0.98 ± 0.35, and 0.20 ± 0.26 in the LD, HD, and control groups, respectively (within-group P < 0.0001; intergroup P < 0.0001). Statistically significant values of ΔHV, IGF-1, IGF-1/IGFBP-3 ratio, and IGF-1 SDS at week 52 from baseline were observed in both treatment groups (P < 0.0001). There were clear dose-dependent responses for all auxological variables. PEG-rhGH was well tolerated throughout the treatment period with treatment-emergent adverse events (TEAEs) reported in 86.5%, 84.6%, and 91.3% of children in the HD, LD, and control groups, respectively. The incidence of TEAEs was similar in all treatment groups despite the difference in doses. A total of 27 (8.7%) children experienced drug-related TEAEs. CONCLUSION Fifty-two-week treatment with PEG-rhGH 0.1 or 0.2 mg/kg/week achieved significant improvement in HT-SDS and other growth-related variables, including HV, IGF-1 SDS, and IGF-1/IGFBP-3 ratio, in a dose-dependent manner. Both doses were well tolerated with similar safety profiles.
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Affiliation(s)
- Xiaoping Luo
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Sha Zhao
- Children's Health Center, Hunan Children's Hospital, Changsha, Hunan, China
| | - Yu Yang
- Department of Endocrinology, Genetics, and Metabolism, Jiangxi Provincial Children's Hospital, Nanchang, Jiangxi, China
| | - Guanping Dong
- Department of Endocrinology, The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Linqi Chen
- Department of Endocrinology, Genetics, and Metabolism, Children's Hospital Affiliated to Soochow University, Suzhou, Jiangsu, China
| | - Pin Li
- Department of Medical Genetics and Endocrinology, Children's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Children's Hospital, Shanghai, China
| | - Feihong Luo
- Department of Pediatric Endocrinology, Children's Hospital of Fudan University, Shanghai, China
| | - Chunxiu Gong
- Department of Endocrinology, Genetics, and Metabolism, Beijing Children's Hospital, Capital Medical University, National Centre for Children's Health, Beijing, China
| | - Zhuangjian Xu
- Department of Pediatrics, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Xu Xu
- Department of Pediatric Endocrinology, Wuxi Children's Hospital, Wuxi, Jiangsu, China
| | - Haihong Gong
- Department of Pediatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hongwei Du
- Department of Pediatric Endocrinology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Ling Hou
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Yan Zhong
- Children's Health Center, Hunan Children's Hospital, Changsha, Hunan, China
| | - Qiao Shi
- Department of Endocrinology, Genetics, and Metabolism, Jiangxi Provincial Children's Hospital, Nanchang, Jiangxi, China
| | - Xuefeng Chen
- Department of Endocrinology, The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xiuli Chen
- Department of Endocrinology, Genetics, and Metabolism, Children's Hospital Affiliated to Soochow University, Suzhou, Jiangsu, China
| | - Liya Xu
- Department of Medical Genetics and Endocrinology, Children's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Children's Hospital, Shanghai, China
| | - Ruoqian Cheng
- Department of Pediatric Endocrinology, Children's Hospital of Fudan University, Shanghai, China
| | - Chang Su
- Department of Endocrinology, Genetics, and Metabolism, Beijing Children's Hospital, Capital Medical University, National Centre for Children's Health, Beijing, China
| | - Yaping Ma
- Department of Pediatrics, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Lulian Xu
- Department of Pediatric Endocrinology, Wuxi Children's Hospital, Wuxi, Jiangsu, China
| | - Lina Zhang
- Department of Pediatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Honghua Lu
- Department of Pediatric Endocrinology, The First Hospital of Jilin University, Changchun, Jilin, China
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Wu Z, Yuan J, Li J, Du Z, Yin M, Cheng X, Liu X, Jia J. Hsa_circ_0008870 suppresses bone formation of growth plate through inhibition of miR-185-3p/ MAPK1 axis in idiopathic short stature. Front Bioeng Biotechnol 2022; 10:1022830. [PMID: 36304901 PMCID: PMC9592914 DOI: 10.3389/fbioe.2022.1022830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 09/26/2022] [Indexed: 11/26/2022] Open
Abstract
Idiopathic short stature (ISS) is the most common clinical cause of the short stature with an unclear aetiology and a lack of effective treatment. Circular RNAs have been shown to play a significant regulatory role through various signal transduction pathways in a variety of diseases in recent years. However, the role of circular RNAs on ISS is not yet well-understood and requires a special attention. The differentially expressed circular RNAs were screened by microarray chip analysis, and RT-qPCR was used to verify the expression of hsa_circ_0008870 in ISS patients. Subsequently, in vitro and in vivo experiments were conducted to determine the biological functions of hsa_circ_0008870 in ISS. The authors first confirmed that hsa_ circ_0008870 was downregulated in ISS children. Meanwhile, we also observed that the downregulated hsa_circ _0008870 significantly inhibited chondrocyte proliferation and endochondral ossification in vivo and in vitro. Mechanistically, hsa_circ_0008870 regulates MAPK1 expression by sponge miR-185-3p. This mechanism of action was further verified through rescue experiments. Finally, the authors revealed that the silencing of hsa_circ_0008870 induces low expression of MAPK1 by impairing the sponge action of miR-185-3p, thereby inhibiting chondrocyte proliferation, hypertrophy, and endochondral ossification, which results in a short stature phenotype. In addition to these, we also observed an interesting phenomenon that upregulated of miR-185-3p can in turn inhibit the expression of hsa_circ_0008870 in chondrocytes. This suggests that hsa_circ_0008870 could potentially serve as a therapeutic target for the treatment of ISS.
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Affiliation(s)
- Zhiwen Wu
- Department of Orthopaedics, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Institute of Orthopedics of Jiangxi Province, Nanchang University, Nanchang, Jiangxi, China
| | - Jinghong Yuan
- Department of Orthopaedics, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Institute of Minimally Invasive Orthopedics, Nanchang University, Nanchang, Jiangxi, China
| | - Jiantian Li
- Department of Orthopaedics, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Key Laboratory of Intervertebral Disc Disease, Nanchang University, Nanchang, Jiangxi, China
| | - Zhi Du
- Department of Orthopaedics, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Institute of Orthopedics of Jiangxi Province, Nanchang University, Nanchang, Jiangxi, China
| | - Ming Yin
- Department of Orthopaedics, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Institute of Minimally Invasive Orthopedics, Nanchang University, Nanchang, Jiangxi, China
| | - Xigao Cheng
- Department of Orthopaedics, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Institute of Orthopedics of Jiangxi Province, Nanchang University, Nanchang, Jiangxi, China
- Institute of Minimally Invasive Orthopedics, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Key Laboratory of Intervertebral Disc Disease, Nanchang University, Nanchang, Jiangxi, China
| | - Xijuan Liu
- Department of Paediatrics, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- *Correspondence: Xijuan Liu, ; Jingyu Jia,
| | - Jingyu Jia
- Department of Orthopaedics, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Institute of Orthopedics of Jiangxi Province, Nanchang University, Nanchang, Jiangxi, China
- Institute of Minimally Invasive Orthopedics, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Key Laboratory of Intervertebral Disc Disease, Nanchang University, Nanchang, Jiangxi, China
- *Correspondence: Xijuan Liu, ; Jingyu Jia,
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Casaña-Granell S, Lacomba-Trejo L, Montoya-Castilla I, Pérez-Marín M. Factors associated with stress when caring for a child with a short stature. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-020-01323-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Chae HW, Hwang IT, Lee JE, So CH, Rhie YJ, Lim JS, Kwon EB, Yi KH, Kim EY, Jo CK, Shim KS, Gil HY, Seong MJ, Nam CM, Moon JS, Hwang JS. Height outcomes in Korean children with idiopathic short stature receiving growth hormone treatment. Front Endocrinol (Lausanne) 2022; 13:925102. [PMID: 36157444 PMCID: PMC9490583 DOI: 10.3389/fendo.2022.925102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 08/11/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives Growth hormone (GH) therapy's capacity to increase height velocity and height at the end of the study in children with idiopathic short stature (ISS) is controversial. We aimed to investigate the height standard deviation score (SDS) and height velocity of patients with ISS in Korea who received GH treatment. Methods We retrospectively reviewed and performed linear mixed model and survival analyses on data from 12 tertiary hospitals in Korea, including subjects diagnosed with ISS from January 2009 to September 2019, treated with GH therapy for more than 6 months, and who were at a pre-pubertal state at the time of diagnosis. Results We included 578 children (330 boys and 248 girls). The mean daily dose of GH in this study was 0.051 mg/kg, which was lower than the approved dose in Korea of 0.062 - 0.067 mg/kg. Height SDS was higher in patients who started treatment before the age of 6 years. The probability of reaching the target SDS (-1 SDS) from the beginning of treatment to 2-3 years after its start was higher in children starting treatment before the age of 6 years. The hazard ratio to reach the target SDS (-1 SDS) when using automatic pen or electronic devices was 1.727 times higher than that when using the needle and syringe device. Conclusion ISS patients should start GH treatment at an early age, and even lower-than-recommended drug doses may be effective. The selection of automatic pen or electronic device can have a positive effect on reaching the target height SDS.
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Affiliation(s)
- Hyun Wook Chae
- Department of Pediatrics, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Il-Tae Hwang
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, South Korea
| | - Ji-Eun Lee
- Department of Pediatrics, Inha University Hospital, Inha University College of Medicine, Incheon, South Korea
| | - Cheol Hwan So
- Department of Pediatrics, Wonkwang University Hospital, Jeollabuk-do, South Korea
| | - Young-Jun Rhie
- Department of Pediatrics, Korea University Ansan Hospital, Gyeonggi-do, South Korea
| | - Jung Sub Lim
- Department of Pediatrics, Korea Cancer Center Hospital, Seoul, South Korea
| | - Eun Byul Kwon
- Department of Pediatrics, Hallym University Dongtan Sacred Heart Hospital, Hwaseong-si, South Korea
| | - Kyung Hee Yi
- Department of Pediatrics, Wonkwang University Sanbon Medical Center, Gyeonggi-do, South Korea
| | - Eun Young Kim
- Department of Pediatrics, Chosun University Hospital, Gwangju, South Korea
| | - Chae-Ku Jo
- Department of Pediatrics, Dong-A University College of Medicine, Busan, South Korea
| | - Kye Shik Shim
- Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Seoul, South Korea
| | - Ha-Yeong Gil
- Medical Research Project Team, Internal Medicine (IM) Medical, Pfizer Korea, Seoul, South Korea
| | - Min-Jeong Seong
- Rare Disease, Medical Affairs, Pfizer Korea, Seoul, South Korea
| | - Chung Mo Nam
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Ji-Su Moon
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Jin Soon Hwang
- Department of Pediatrics, Ajou University Hospital, Gyeonggi-do, South Korea
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Yuan J, Fu J, Wei H, Zhang G, Xiao Y, Du H, Gu W, Li Y, Chen L, Luo F, Zhong Y, Gong H. A Randomized Controlled Phase 3 Study on the Efficacy and Safety of Recombinant Human Growth Hormone in Children With Idiopathic Short Stature. Front Endocrinol (Lausanne) 2022; 13:864908. [PMID: 35573994 PMCID: PMC9102803 DOI: 10.3389/fendo.2022.864908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 03/09/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To evaluate the safety and efficacy of daily somatropin (Jintropin®), a recombinant human growth hormone, in prepubertal children with ISS in China. METHODS This study was a multicenter, randomized, controlled, open-label, phase 3 study. All subjects were randomized 3:1 to daily somatropin 0.05 mg/kg/day or no treatment for 52 weeks. A total of 481 subjects with a mean baseline age of 5.8 years were enrolled in the study. The primary endpoint was change in (△) height standard deviation score (HT-SDS) for chronological age (CA). Secondary endpoints included △height from baseline; △bone age (BA)/CA; △height velocity (HV) and △insulin-like growth factor 1 (IGF-1 SDS). RESULTS △HT-SDS at week 52 was 1.04 ± 0.31 in the treatment group and 0.20 ± 0.33 in the control group (P < 0.001). At week 52, statistical significance was observed in the treatment group compared with control for △height (10.19 ± 1.47 cm vs. 5.85 ± 1.80 cm; P < 0.001), △BA/CA (0.04 ± 0.09 vs. 0.004 ± 0.01; P < 0.001), △HV (5.17 ± 3.70 cm/year vs. 0.75 ± 4.34 cm/year; P < 0.001), and △IGF-1 SDS (2.31 ± 1.20 vs. 0.22 ± 0.98; P < 0.001). The frequencies of treatment-emergent adverse events (TEAEs) were similar for the treatment and the control groups (89.8% vs. 82.4%); most TEAEs were mild to moderate in severity and 23 AEs were considered study-drug related. CONCLUSIONS Daily subcutaneous administration of somatropin at 0.05 mg/kg/day for 52 weeks demonstrated improvement in growth outcomes and was well tolerated with a favorable safety profile. TRIAL REGISTRATION ClinicalTrials.gov (identifier: NCT03635580). URL: https://clinicaltrials.gov/ct2/show/NCT03635580.
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Affiliation(s)
- Jinna Yuan
- Endocrinology Department, Children’s Hospital of Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Junfen Fu
- Endocrinology Department, Children’s Hospital of Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
- *Correspondence: Junfen Fu,
| | - Haiyan Wei
- Department of Endocrinology, Genetics and Metabolism, Zhengzhou Children’s Hospital, Zhengzhou, China
| | - Gaixiu Zhang
- Department of Pediatrics and Endocrinology, Children’s Hospital of Shanxi, Taiyuan, China
| | - Yanfeng Xiao
- Department of Pediatrics, Second Affiliated Hospital of Xi’an Jiaotong University, Xi'an, China
| | - Hongwei Du
- Department of Pediatrics and Endocrinology, The First Hospital of Jilin University, Jilin, China
| | - Wei Gu
- Department of Endocrinology, Nanjing Children’s Hospital, Nanjing, China
| | - Yanhong Li
- Department of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Linqi Chen
- Department of Endocrinology, Genetics and Metabolism, Children’s Hospital of Soochow University, Suzhou, China
| | - Feihong Luo
- Department of Endocrinology, Children’s Hospital of Fudan University, Shanghai, China
| | - Yan Zhong
- Children Health Division, Hunan Children’s Hospital, Changsha, China
| | - Haihong Gong
- Department of Pediatrics, Jiangsu Provincial People’s Hospital, Nanjing, China
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8
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Sun M, Yan W, Zhao Q, Ji B, Ban B, Zhang M. Association Between Serum Calcium and Phosphorus Levels and Insulin-Like Growth Factor-1 in Chinese Children and Adolescents with Short Stature. Int J Gen Med 2020; 13:1167-1173. [PMID: 33244257 PMCID: PMC7683825 DOI: 10.2147/ijgm.s276261] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 10/30/2020] [Indexed: 12/15/2022] Open
Abstract
Objective The aim of this study was to investigate the effect of serum calcium and phosphorus levels on the insulin-like growth factor 1 (IGF-1) in Chinese children and adolescents with short stature. Methods In this cross-sectional analysis, the clinical data of 747 children with height below –2 SD who were evaluated at the Department of Endocrinology, Affiliated Hospital of Jining Medical University from March 1, 2013, to February 28, 2019, were selected. Anthropometric and biochemical indicators were measured. The relationship between the serum calcium and phosphorus levels and IGF-1 was analysed. Results The univariate analysis results showed that serum calcium or phosphorus was significantly associated with IGF-1 SDS. In addition, after adjusting for possible confounding factors, a linear relationship between serum calcium and IGF-1 SDS and a non-linear relationship between serum phosphorus and IGF-1 SDS were observed by smooth curve fitting. The results of the fully adjusted linear regression showed that serum calcium was positively associated with IGF-1 SDS (β 1.07, 95% CI 0.21, 1.92; p = 0.015). In the multivariate piecewise linear regression, when the serum phosphorus level was greater than 1.26 mmol/L, the IGF-1 SDS increased with the increase in serum phosphorus (β 1.92, 95% CI 1.36, 2.48; p < 0.001). However, we did not observe a significant relationship when the serum phosphorus level was less than 1.26 mmol/L (p = 0.223). Conclusion This study demonstrated that in Chinese children and adolescents with short stature, circulating calcium and phosphorus concentrations may be associated with the regulation of IGF-1 levels, and this relationship merits further investigation.
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Affiliation(s)
- Minghui Sun
- Department of Clinical Medicine, Jining Medical University, Jining, Shandong 272067, People's Republic of China
| | - Wenhua Yan
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong 272029, People's Republic of China.,Chinese Research Center for Behavior Medicine in Growth and Development, Jining, Shandong 272029, People's Republic of China
| | - Qianqian Zhao
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong 272029, People's Republic of China.,Chinese Research Center for Behavior Medicine in Growth and Development, Jining, Shandong 272029, People's Republic of China
| | - Baolan Ji
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong 272029, People's Republic of China.,Chinese Research Center for Behavior Medicine in Growth and Development, Jining, Shandong 272029, People's Republic of China
| | - Bo Ban
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong 272029, People's Republic of China.,Chinese Research Center for Behavior Medicine in Growth and Development, Jining, Shandong 272029, People's Republic of China
| | - Mei Zhang
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong 272029, People's Republic of China.,Chinese Research Center for Behavior Medicine in Growth and Development, Jining, Shandong 272029, People's Republic of China
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