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dc.contributor.authorNwosu, Benjamin U.
dc.contributor.authorJasmin, Gabrielle
dc.contributor.authorParajuli, Sadichchha
dc.contributor.authorRogol, Alan D.
dc.contributor.authorWallace, Ellen C.
dc.contributor.authorLee, Austin F.
dc.date2022-08-11T08:09:59.000
dc.date.accessioned2022-08-23T16:51:21Z
dc.date.available2022-08-23T16:51:21Z
dc.date.issued2021-03-05
dc.date.submitted2021-06-14
dc.identifier.citation<p>Nwosu BU, Jasmin G, Parajuli S, Rogol AD, Wallace EC, Lee AF. Long-term GH Therapy Does Not Advance Skeletal Maturation in Children and Adolescents. J Endocr Soc. 2021 Mar 5;5(5):bvab036. doi: 10.1210/jendso/bvab036. PMID: 33860132; PMCID: PMC8035984. <a href="https://doi.org/10.1210/jendso/bvab036">Link to article on publisher's site</a></p>
dc.identifier.issn2472-1972 (Linking)
dc.identifier.doi10.1210/jendso/bvab036
dc.identifier.pmid33860132
dc.identifier.urihttp://hdl.handle.net/20.500.14038/41842
dc.description.abstractContext: There is no consensus on the effect of recombinant human GH (rhGH) therapy on skeletal maturation in children despite the current practice of annual monitoring of skeletal maturation with bone age in children on rhGH therapy. Aims: To investigate the effects of long-term rhGH therapy on skeletal age in children and explore the accuracy of bone age-predicted adult height (BAPAH) at different ages based on 13 years of longitudinal data. Methods: A retrospective longitudinal study of 71 subjects aged 2 to 16 years, mean 9.9 +/- 3.8 years, treated with rhGH for nonsyndromic short stature for a duration of 2 to 14 years, mean, 5.5 +/- 2.6 years. Subjects with syndromic short stature and systemic illnesses such as renal failure were excluded. Results: Bone age minus chronological age (BA-CA) did not differ significantly between baseline and the end of rhGH therapy (-1.05 +/- 1.42 vs -0.69 +/- 1.63, P = 0.09). Piecewise regression, however, showed a quantifiable catch-up phenomenon in BA of 1.5 months per year of rhGH therapy in the first 6.5 years (P = 0.017) that plateaued thereafter (P = 0.88). BAPAH overestimated near-adult height in younger subjects but became more accurate in older subjects (P < 0.0001). IGF-I levels correlated significantly with increases in child's height and BA-CA. Conclusion: Long-term rhGH therapy demonstrated an initial catch-up phenomenon in skeletal maturation in the first 6.5 years that plateaued thereafter with no overall significant advancement in bone age. These findings are reassuring and support strategic, but not the insurance company mandated reflexive annual monitoring of skeletal maturation with bone age in children receiving rhGH therapy.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=33860132&dopt=Abstract">Link to Article in PubMed</a></p>
dc.rightsCopyright © The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectbone age
dc.subjectgrowth hormone deficiency
dc.subjectheight velocity
dc.subjectshort stature
dc.subjectEndocrinology, Diabetes, and Metabolism
dc.subjectHormones, Hormone Substitutes, and Hormone Antagonists
dc.subjectPediatrics
dc.titleLong-term GH Therapy Does Not Advance Skeletal Maturation in Children and Adolescents
dc.typeJournal Article
dc.source.journaltitleJournal of the Endocrine Society
dc.source.volume5
dc.source.issue5
dc.identifier.legacyfulltexthttps://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=5675&amp;context=oapubs&amp;unstamped=1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/oapubs/4644
dc.identifier.contextkey23344515
refterms.dateFOA2022-08-23T16:51:22Z
html.description.abstract<p>Context: There is no consensus on the effect of recombinant human GH (rhGH) therapy on skeletal maturation in children despite the current practice of annual monitoring of skeletal maturation with bone age in children on rhGH therapy.</p> <p>Aims: To investigate the effects of long-term rhGH therapy on skeletal age in children and explore the accuracy of bone age-predicted adult height (BAPAH) at different ages based on 13 years of longitudinal data.</p> <p>Methods: A retrospective longitudinal study of 71 subjects aged 2 to 16 years, mean 9.9 +/- 3.8 years, treated with rhGH for nonsyndromic short stature for a duration of 2 to 14 years, mean, 5.5 +/- 2.6 years. Subjects with syndromic short stature and systemic illnesses such as renal failure were excluded.</p> <p>Results: Bone age minus chronological age (BA-CA) did not differ significantly between baseline and the end of rhGH therapy (-1.05 +/- 1.42 vs -0.69 +/- 1.63, P = 0.09). Piecewise regression, however, showed a quantifiable catch-up phenomenon in BA of 1.5 months per year of rhGH therapy in the first 6.5 years (P = 0.017) that plateaued thereafter (P = 0.88). BAPAH overestimated near-adult height in younger subjects but became more accurate in older subjects (P < 0.0001). IGF-I levels correlated significantly with increases in child's height and BA-CA.</p> <p>Conclusion: Long-term rhGH therapy demonstrated an initial catch-up phenomenon in skeletal maturation in the first 6.5 years that plateaued thereafter with no overall significant advancement in bone age. These findings are reassuring and support strategic, but not the insurance company mandated reflexive annual monitoring of skeletal maturation with bone age in children receiving rhGH therapy.</p>
dc.identifier.submissionpathoapubs/4644
dc.contributor.departmentDepartment of Population and Quantitative Health Sciences
dc.contributor.departmentDepartment of Radiology
dc.contributor.departmentDivision of Endocrinology, Department of Pediatrics
dc.source.pagesbvab036


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Copyright © The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
Except where otherwise noted, this item's license is described as Copyright © The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com