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DOI: 10.1055/s-0033-1343449
The Efficacy and Safety of Long-term Norditropin® Treatment in Children with Prader-Willi Syndrome
Publication History
received 03 October 2012
accepted 27 March 2013
Publication Date:
30 April 2013 (online)
Abstract
Prader-Willi syndrome is a genetic disorder that is associated with short stature, partial growth hormone deficiency, small hands and feet, learning and behavioural problems, and hyperphagia leading to severe, often morbid, obesity. Growth hormone therapy is associated with an improvement in height and body composition. We evaluated the efficacy and safety of long-term growth hormone treatment in a retrospective observational multinational study of 41 prepubertal children (mean age 3.8±3.0 years) with genetically diagnosed Prader-Willi syndrome treated with growth hormone (0.03–0.06 mg/kg/day) for >12 months [mean duration 4.1 (range 0.9–9.5) years]. Height, weight, and body composition measurements were recorded at baseline and at 6 month intervals until last observation. Mean (SD) gain in height at 12 months was 0.9 (0.2) SD score (p<0.0001). At last observation (after approximately 6 years) mean gain in height was 1.3 (0.3) (p=0.0001) with 85% of children achieving height>− 2 SD score. Body composition improved during treatment with an estimated 9.1% increase in lean body mass and 9.1% decrease in fat mass at last observation (p=0.019). Scoliosis was reported in 3 patients at baseline and 8 patients at last observation. Sleep apnoea was recorded in 3 (7.3%) patients. There were no other severe adverse events reported. Long-term growth hormone treatment of prepubertal children with Prader-Willi syndrome was associated with significant improvements in height and body composition. Treatment was well tolerated. The development of scoliosis warrants monitoring by an orthopaedic specialist.
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References
- 1 Goldstone AP, Holland AJ, Hauffa BP, Hokken-Koelega AC, Tauber M. Recommendations for the diagnosis and management of Prader-Willi syndrome. J Clin Endocrinol Metab 2008; 93: 4183-4197
- 2 Molinas C, Cazals L, Diene G, Glattard M, Arnaud C, Tauber M. French database of children and adolescents with Prader-Willi syndrome. BMC Med Genet 2008; 9: 89
- 3 Horsthemke B, Buiting K. Imprinting defects on human chromosome 15. Cytogenet Genome Res 2006; 113: 292-299
- 4 Bittel DC, Butler MG. Prader-Willi syndrome: clinical genetics, cytogenetics and molecular biology. Expert Rev Mol Med 2005; 8: 1-20
- 5 Wattendorf DJ, Muenke M. Prader-Willi syndrome. Am Fam Physician 2005; 72: 827-830
- 6 Angulo M, Castro-Magana M, Mazur B, Canas JA, Vitollo PM, Sarrantonio M. Growth hormone secretion and effects of growth hormone therapy on growth velocity and weight gain in children with Prader-Willi syndrome. J Pediatr Endocrinol Metab 1996; 3: 393-399
- 7 Costeff H, Holm VA, Ruvalcaba R, Shaver I. Growth hormone secretion in Prader-Willi syndrome. Acta Paediatr Scand 1990; 79: 1059-1062
- 8 Thacker MJ, Hainline B, St Dennis-Feezle L, Johnson NB, Pescovitz OH. Growth failure in Prader-Willi syndrome is secondary to growth hormone deficiency. Horm Res 1998; 49: 216-220
- 9 Angulo MA, Castro-Magana M, Lamerson M, Arguello R, Accacha S, Khan A. Final adult height in children with Prader-Willi syndrome with and without human GH treatment. Am J Med Genet 2007; 43: 1456-1461
- 10 Eiholzer U, Gisin R, Weinmann C, Kriemler S, Steinert H, Torresani T, Zachmann M, Prader A. Treatment with human growth hormone in patients with Prader-Labhart-Willi syndrome reduces body fat and increases muscle mass and physical performance. Eur J Pediatr 1998; 157: 368-377
- 11 Haqq AM, Stadler DD, Jackson RH, Rosenfeld RG, Purnell JQ, LaFranchi SH. Effects of growth hormone on pulmonary function, sleep quality, behaviour, cognition, growth velocity, body composition and resting energy expenditure in Prader-Willi syndrome. J Clin Endocrinol Metab 2003; 88: 2206-2212
- 12 Craig ME, Cowell CT, Larsson P, Zipf WB, Reiter EO, Albertsson Wikland K, Ranke MB, Price DA. Growth hormone treatment and adverse events in Prader-Willi syndrome: data from KIGS (the Pfizer International Growth Database). Clin Endocrinol 2006; 65: 178-185
- 13 Carrel AL, Myers SE, Whitman BY, Allen DB. Benefits of long-term GH therapy in Prader-Willi syndrome: A 4 year study. J Clin Endocrinol Metab 2002; 87: 1581-1585
- 14 de Lind van Wijngaarden RF, Siemensma EP, Festen DA, Otten BJ, van Mil EG, Rotteveel J, Odink RJ, Bindels-de Heus GC, van Leeuwen M, Haring DA, Bocca G, Houdjik EC, Hoorweg-Nijman JJ, Vreuls RC, Jira PE, van Trotsenburg AS, Bakker B, Schroor EJ, Pilon JW, Wit JM, Drop SL, Hokken-Koelega AC. Efficacy and safety of long-term continuous growth hormone treatment in children with Prader-Willi syndrome. J Clin Endocrinol Metab 2009; 94: 4205-4215
- 15 WHO Multicentre Growth Reference Study Group . WHO Child Growth Standards: length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: methods and development. Geneva: World Health Organization; 2006
- 16 Wollmann HA, Schultz U, Grauer ML, Ranke MB. Reference values for height and weight in Prader-Willi syndrome based on 315 patients. Eur J Pediatr 1998; 157: 634-642
- 17 Roede MJ, van Wieringen JC. Growth diagrams 1980. Tijdschrift Soc Gezondheidszorg 1985; 63 (Suppl) 1-34
- 18 Colmenares A, Pinto G, Taupin P, Giuseppe A, Odent T, Trivin C, Laborde K, Souberbielle JC, Polak M. Effects on growth and metabolism of growth hormone treatment for 3 years in 36 children with Prader-Willi syndrome. Horm Res Paediatr 2011; 75: 123-130
- 19 Carrel AL, Myers SE, Whitman BY, Eickhoff J, Allen DB. Long-term growth hormone therapy changes the natural history of body composition and motor function in children with Prader-Willi syndrome. J Clin Endocrinol Metab 2010; 95: 1131-1136
- 20 Reus L, Zwarts M, van Vimmeren LA, Willemsen MA, Otten BJ, Nijhuis-van der Sander MW. Motor problems in Prader-Willi syndrome: A systematic review on body composition and neuromuscular functioning. Neurosci Biobehav Rev 2011; 35: 956-969
- 21 Eiholzer U, Nordmann Y, l’Allemand D, Schlmupf M, Schmid S, Krometer-Hauschild K. Improving body composition and physical activity in Prader-Willi syndrome. J Pediatr 2003; 142: 73-78
- 22 Brambilla P, Crinò A, Bedogni G, Bosio L, Cappa M, Corrias A, Delvecchio M, Di Candia S, Gargantini L, Grechi E, Lughetti L, Mussa A, Ragusa L, Sacco M, Salvatoni A, Chiumello G, Grugni G. Metabolic syndrome in children with Prader-Willi syndrome: the effect of obesity. Nutr Metab Cardiovasc Dis 2011; 21: 269-276
- 23 Eiholzer U, Whitman BY. A comprehensive team approach to the management of patients with Prader-Willi syndrome. J Pediatr Endocrinol Metab 2004; 17: 1153-1175
- 24 Holm VA, Laurnen EL. Prader-Willi syndrome and scoliosis. Develop Med Child Neurol 1981; 23: 192-201
- 25 Odent T, Accadbled F, Koureas G, Cournot M, Moine A, Diene G, Molinas C, Pinto G, Tauber M, Gomes B, Sales de Gauzy J, Glorion C. Scoliosis in patients with Prader-Willi syndrome. Pediatrics 2008; 122: e499-e503
- 26 de Lind van Wijngaarden RFA, de Klerk LWL, Festen DAM, Duivenvoorden HJ, Otten BJ, Hokken-Koeleg ACS. Randomised controlled trial to investigate the effects of growth hormone treatment on scoliosis in children with Prader-Willi syndrome. J Clin Endocrinol Metab 2009; 94: 1274-1280