October 2011. Volume 7. Number 3

Chidren with idiopatic short stature and therapy with growth hormone: current situation

 
 
 
 
 
 
 
 
 
 
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AVC | Critically appraised articles

Deodati A, Cianfarani S. Impact of growth hormone therapy on adult height of children with idiopathic short stature: systematic review. BMJ. 2011;342:c7157.
Reviewers: González de Dios J1, González Rodríguez MP2.
1Departamento de Pediatría. Hospital General Universitario de Alicante. España.
2CS Barrio del Pilar. Área 5. Madrid. España.
Correspondence: Javier González de Dios. Email: javier.gonzalezdedios@gmail.com
Reception date: 11/04/2011
Acceptance date: 23/04/2011
Publication date: 08/06/2011

Abstract

Authors' conclusions: growth hormone therapy in children with idiopathic short stature seems to be effective in partially reducing the deficit in height as adults, increasing adult height by about 4 cm, although the magnitude of effectiveness is on average less than that achieved in other conditions for which growth hormone is licensed. The individual response to therapy is highly variable, and additional studies are needed to identify the responders.

Reviewers' commentary: children with idiopathic short stature constitute a fixed proportion of the population, with about 2-3% of children 2 SD below the mean and 0.1% 3 SD below the mean. This high quality systematic review concludes that the administration of growth hormone in these children increases adult height by about 4 cm. Adding the cost of the therapy, the potential adverse effects (metabolic diseases and increased risk of malignancy into adult life) and difficulties for adequate adherence to the treatment, growth hormone therapy in short otherwise normal children, should be implemented with caution.

How to cite this article

González de Dios J, González Rodríguez MP. Niños con talla baja idiopática y tratamiento con hormona de crecimiento: situación actual. Evid Pediatr. 2011;7:55.

AVC | Critically appraised articles

Deodati A, Cianfarani S. Impact of growth hormone therapy on adult height of children with idiopathic short stature: systematic review. BMJ. 2011;342:c7157.
Reviewers: González de Dios J1, González Rodríguez MP2.
1Departamento de Pediatría. Hospital General Universitario de Alicante. España.
2CS Barrio del Pilar. Área 5. Madrid. España.
Correspondence: Javier González de Dios. Email: javier.gonzalezdedios@gmail.com
Reception date: 11/04/2011
Acceptance date: 23/04/2011
Publication date: 08/06/2011

How to cite this article

González de Dios J, González Rodríguez MP. Niños con talla baja idiopática y tratamiento con hormona de crecimiento: situación actual. Evid Pediatr. 2011;7:55.

References

  1. Maiorana A, Cianfarani S. Impact of growth hormone therapy on adult height of children born small for gestational age. Pediatrics. 2009;124:e519-31.
  2. Cohen P, Rogol AD, Deal CL, Saenger P, Reiter EO, Ross JL et al.; 2007 ISS Consensus Workshop participants. Consensus statement on the diagnosis and treatment of children with idiopathic short stature: a summary of the Growth Hormone Research Society, the Lawson Wilkins Pediatric Endocrine Society, and the European Society for Paediatric Endocrinology Workshop. J Clin Endocrinol Metab. 2008;93:4210-7.
  3. Criterios para la utilización racional de la hormona de crecimiento en niños. Comité asesor para la hormona de crecimiento del Ministerio de Sanidad y Consumo. 2003. Paseo del Prado 18-20. 28014 Madrid. [en línea] [fecha de consulta: 20-III-2011]. Disponible en: http://www.spao.info/archivos/Indicaciones%20hormona%20del%20crecimiento.pdf
  4. Bryant J, Baxter L, Cave CB, Milne R. Hormona de crecimiento recombinante para la baja talla idiopática en niños y adolescentes (Revisión Cochrane traducida). En: La Biblioteca Cochrane Plus, 2008 Número 4. Oxford: Update Software Ltd. Disponible en: http://www.update-software.com. (Traducida de The Cochrane Library, 2008 Issue 3. Chichester, UK: John Wiley & Sons, Ltd.).
  5. Urrutia G, Bonfill X. Declaración PRISMA: una propuesta para mejorar la publicación de revisiones sistemáticas y metaanálisis. Med Clin (Barc). 2010;135:507-11.
  6. Sánchez-Andrade R, González Rodríguez MP. ¿Hay que tratar a los niños con talla baja idiopática con hormona de crecimiento? Evid Pediatr. 2008;4:27.

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López Siguero JP. Talla baja idiopática y hormona de crecimiento: bastantes dudas y algunas recomendaciones. Evid Pediatr. 2011;7:51.
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