A multicenter, randomized, double-blind, placebo-controlled trial to evaluate the metabolic and respiratory effects of growth hormone in children with cystic fibrosis

Pediatrics. 2007 Jun;119(6):e1230-8. doi: 10.1542/peds.2006-2783.

Abstract

Objective: Positive effects of growth hormone therapy on growth, nutritional status, and lung function have been observed in patients with cystic fibrosis, but the current evidence is based on unblinded studies that involved a small number of patients. This trial was designed as a multicenter, randomized, placebo-controlled, double-blind study to assess the efficacy and safety of 2 dosages of growth hormone in cystic fibrosis.

Methods: Sixty-three dystrophic patients with cystic fibrosis were randomly assigned for 24 weeks to 1 of 3 treatment arms: growth hormone dosage of 0.11 IU/kg body weight per day, growth hormone dosage of 0.21 IU/kg body weight per day, or placebo. The 24-week double-blind period was followed by an open treatment period of 24 weeks. The primary outcome measure was the change in forced expiratory volume in 1 second in percentage predicted from baseline. Secondary outcome measures were changes in height, weight, and exercise tolerance.

Results: Height, growth velocity, and growth factors (insulin-like growth factor 1 and insulin-like growth factor-binding protein 3) increased significantly in both treatment groups, whereas weight gain did not differ between the growth hormone groups and placebo. A trend toward improvement in absolute forced vital capacity was observed in patients who received the higher growth hormone dosage, whereas forced expiratory volume in 1 second did not change significantly with growth hormone treatment. Maximal oxygen uptake during peak exercise increased significantly in treated patients. There were no significant differences in the frequency or severity of adverse effects or in the incidence of abnormalities in glucose metabolism.

Conclusions: These data suggest that in the group investigated, growth hormone therapy was well tolerated and had positive metabolic effects but did not result in short-term improvement of lung function in patients with cystic fibrosis.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Body Height / drug effects
  • Body Height / physiology
  • Body Weight / drug effects
  • Body Weight / physiology
  • Child
  • Cystic Fibrosis / drug therapy*
  • Cystic Fibrosis / epidemiology
  • Cystic Fibrosis / physiopathology
  • Double-Blind Method
  • Energy Metabolism / drug effects*
  • Energy Metabolism / physiology
  • Exercise Tolerance / drug effects
  • Exercise Tolerance / physiology
  • Female
  • Forced Expiratory Volume / drug effects*
  • Forced Expiratory Volume / physiology
  • Human Growth Hormone / pharmacology
  • Human Growth Hormone / therapeutic use*
  • Humans
  • Male
  • Respiratory Function Tests / methods

Substances

  • Human Growth Hormone