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Response to growth hormone treatment in P rader– W illi syndrome: Auxological criteria versus genetic diagnosis
Author(s) -
Scheermeyer Elly,
Hughes Ian,
Harris Mark,
Ambler Geoff,
Crock Patricia,
Verge Charles F,
Craig Maria E,
Bergman Phil,
Werther George,
Driel Mieke,
Davies Peter SW,
Choong Catherine SY
Publication year - 2013
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.12294
Subject(s) - medicine , short stature , bone age , cohort , body mass index , waist , pediatrics , endocrinology , adverse effect , gastroenterology
Aim The Australian Prader‐Willi Syndrome (PWS) database was established to monitor the efficacy and safety of growth hormone (GH) treatment in PWS. This study aims to compare response to GH based on eligibility criteria.Methods Comparative study: 72 children received GH on the basis of short stature or evidence of GH deficiency (pre‐2009: PWS‐SS ) and 94 on a genetic diagnosis (post‐2009: PWS ‐ Dx ). We report on mandatory patient data for GH prescription: median and standard deviation score (SDS) for height and body mass index (BMI), waist/height ratio, bone age/chronological age ratio and adverse events. Comparisons were made using non‐parametric tests. Results At baseline, the PWS‐SS cohort was shorter (height SDS : –2.6 vs. –1.1, P < 0.001), had a lower BMI (0.6 vs. 1.5 SDS , P < 0.05) and greater bone age delay (bone age/chronological age: 0.7 vs. 0.9, P < 0.05) than the PWS‐Dx cohort. PWS‐SS parents were shorter (mid‐parental height SDS : −0.13 vs. 0.28, P < 0.005). Mean change in height over 2 years was 0.9 SDS and in BMI using PWS reference standards –0.3 SDS PWS ( n = 106) (year 2, height SDS: PWS‐SS = –1.7, PWS‐Dx = 0.1; BMI SDS PWS : PWS‐SS = –1.0, PWS‐Dx = –0.6). The waist/height ratio reduced (PWS‐Dx: 0.60 vs. 0.56, P < 0.05) and bone age delay was unchanged over this period. No serious adverse events were reported. Conclusions The PWS‐SS cohort represents a subgroup of the wider PWS‐Dx population; however both cohorts improved height SDS with normalisation of height in the PWS ‐ Dx cohort and lowering of BMI relative to PWS standards supporting the efficacy of treatment under the current A ustralian GH programme.