Chicago — Children with Crohn's disease who received growth hormone in addition to corticosteroids showed significant improvements in symptoms after 12 weeks, based on data from 20 children aged 7-18 years with active Crohn's disease.
Previous studies have shown that growth hormone may reduce symptoms in adults with Crohn's disease and may improve growth in children, but the effect of growth hormone on intestinal inflammation in children with Crohn's is not well known, said Dr. Lee Denson of Cincinnati Children's Hospital Medical Center.
To assess the impact of growth hormone on symptoms in children with Crohn's, Dr. Denson and colleagues randomized 10 children with active disease to receive corticosteroids alone, or to receive 0.075 mg/kg per day of growth hormone (somatropin) in addition to corticosteroids.
After 12 weeks, 65% of the children who received growth hormone showed clinical remission of their Crohn's, compared with 20% of the children who did not receive growth hormone, a statistically significant difference. Growth hormone is not currently approved by the Food and Drug Administration to treat Crohn's disease, Dr. Denson reported at the annual Digestive Disease Week.
Endoscopic disease activity (measured using the Crohn's Disease Endoscopic Index of Severity) was lower in the growth hormone group. The difference between the groups was not significant. But 70% of the children in the growth hormone group achieved inactive mucosal disease at 12 weeks, compared with 50% of the children who didn't take growth hormone.
Microarray analyses of colon biopsies showed increases in some cellular components involved in neurophysiological function, cell signaling, and solute transport in children who took growth hormone that were not seen in biopsies from children who didn't take growth hormone, but the implications of these differences aren't fully understood.
In addition, 61% of the children who received growth hormone maintained their clinical response through 64 weeks, and differences in their predicted adult height after 48 weeks compared with baseline indicated catch-up growth.
“In the longer phase of the study, we found that most children who received growth hormone had a catch-up [in growth] and got back to where they would have been without the illness,” said Dr. Denson said. The growth hormone was well tolerated, and the results indicate the need for a larger multicenter study to assess the overall benefit of using growth hormone to treat Crohn's disease symptoms in children.
Dr. Denson has received grant and research support from Abbott Laboratories and Genentech Inc. This study was sponsored in part by Genentech.