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Recombinant growth hormone therapy for X-linked hypophosphatemia in childrenYang HM, Mao M, Yang F, Wan CM
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SummarySynthetic human growth hormone for treating X-linked hypophosphatemia (or Vitamin D resistant rickets) in childrenStandard treatment of X-linked hypophosphatemia can heal rickets but does not always raise the level of phosphates in the blood or return growth levels to normal. It is unclear whether combining human growth hormone therapy with standard treatment improves the phosphate levels, growth rates and bone mineral density. Only one small trial with five children was included in this review. The human growth hormone treatment improved the z score for height and briefly increased the level of phosphates in the blood. However, we found no conclusive evidence that favours the use of human growth hormone treatment for this condition. There have not been enough trials of human growth hormone treatment for this condition and more research is needed.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2009 Issue 4, Copyright © 2009 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
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January 24. 2005 AbstractBackgroundConventional treatment of X-linked hypophosphatemia with oral phosphate and calcitriol can heal rickets, but it does not always raise serum phosphate concentrations significantly, nor does it always normalize linear growth. Some clinical trials suggest that combining recombinant human growth hormone therapy with conventional treatment improves growth velocity, phosphate retention, and bone mineral density, but some clinical trials suggest that it appears to aggravate the pre-existent disproportionate stature of such children. ObjectivesTo determine whether recombinant human growth hormone therapy for children with X-linked hypophosphatemia is associated with changes in longitudinal growth, mineral metabolism, endocrine function, renal function, bone mineral density, body proportions, and also with any adverse effects. Search strategyRelevant trials were identified from searching the Cochrane Central Register of Controlled Trials Issue 2, 2009 and Ovid MEDLINE 1966 to 26 May 2009. Additional trials were identified from the reference lists of identified trials and other reviews. We also searched the Journal of Bone and Mineral Research (1986 to 2003) and proceedings of the American Society for Bone and Mineral Research Annual Meeting (1st to 24th). Date of most recent search: 26 May 2009. Selection criteriaAll randomized controlled trials or quasi-randomized controlled trials comparing growth hormone (alone or combined with conventional treatment) with either placebo or conventional treatment alone in children with X-linked hypophosphatemia. Data collection and analysisTwo authors independently assessed trials for methodological quality and extracted data from eligible trials. Main resultsThe searches identified six trials, of which one met the inclusion criteria, including a total of five participants. In this trial, rhGH therapy improved the height standard deviation score (z score), and transiently increased serum phosphate and tubular maximum for phosphate reabsorption. Authors' conclusionsWe have found no conclusive evidence to indicate that the use of recombinant human growth hormone therapy in children with X-linked hypophosphatemia is associated with changes in longitudinal growth, mineral metabolism, endocrine, renal function, bone mineral density, and body proportions. |