Effectiveness of growth-promoting therapies: comparison among growth hormone, clonidine, and levodopa

Article Abstract:

Growth hormone (GH, or somatotropin) is known to increase the growth rate (height velocity, HV) of short children whose pituitary glands (where GH is secreted) are normal; however, the clinical response to treatment cannot be predicted with certainty. To compare the effects of GH with those of clonidine and levodopa (two substances that stimulate the release of GH from the pituitary), which also have been shown to accelerate growth, 40 short children (aged 9 to 11) were randomly assigned to receive either no medication (10 subjects), or one of the 3 drugs (10 subjects in each group) for six months. Subjects' height, weight, HV, and stage of puberty were evaluated every three months. In addition, kidney, liver, thyroid function, and glucose metabolism were evaluated. Results showed that GH led to increased HV, HV standard deviation score (HVSDS), and height standard deviation score (HSDS). Clonidine increased HV and HVSDS, while levodopa increased HVSDS only. Children in the control group showed decreased HSDS. A considerably greater proportion of patients who received GH than those receiving either other drug had increases in HV of more than two centimeters per year. Results from the biochemical tests were normal for all children studied. Although the high costs and uncertain outcomes of GH therapy may encourage treatment with agents such as clonidine or levodopa, GH was the most effective drug tested. A review is presented of the medical literature concerning the effectiveness of these different agents. The fact that both affected growth positively, though to a lesser degree than GH, indicates that other treatment avenues for short stature may be open. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Dopa, L-dopa, Clonidine

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The growing conundrum: growth hormone treatment of the non-growth hormone deficient child

Article Abstract:

Many pediatricians are treating short children with growth hormone even though the children do not have a growth hormone deficiency. Surveys have shown that they do so not because clinical studies have shown growth hormone to be effective in these children but because of social, psychological and emotional factors. Many parents are afraid their children will be at a disadvantage socially and economically. Several studies have shown that not all short children will respond to growth hormone and whatever gains in height they experience will be small.

Editorial

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