A meta-analysis of combination therapy with gonadotrophin-releasing hormone agonist and growth hormone for children with idiopathic short stature and normal timed puberty
- 27 January 2022
- journal article
- research article
- Published by Springer Science and Business Media LLC in Endocrine
- Vol. 75 (3), 698-708
- https://doi.org/10.1007/s12020-021-02970-0
Abstract
Purpose The aim of this meta-analysis is to evaluate whether the combination therapy with gonadotrophin-releasing hormone agonist (GnRHa) and recombinant human growth hormone (rhGH) are effective in the treatment of children with idiopathic short stature (ISS) and normal timed puberty by interrogating data from clinical controlled trials. Methods Literature retrieval, trail selection, data abstraction and quality assessment were completed independently by two authors. STATA software (version 14.1) was used for data analyses. Results This meta-analysis was conducted based on 8 (4 randomized and 4 non-randomized) controlled trials. A total of 245 ISS children with normal timed puberty were financially analyzed. Overall, combination therapy with GnRHa and rhGH can slightly increase final height by 3.70 and 3.43 cm compared with GH treatment alone and no treatment, final height standard deviation score (FHSDS) by 0.10 and 0.22, final height minus predicted adult height (FH-PAH) by 1.5 and 5.32 cm, final height minus predicted adult height (FH-TH) by 7.70 and 4.32 cm, respectively. Subgroup and meta-regression analyses revealed that study type, sample size, GnRHa duration, and percentage of boys were potential sources of between-trial heterogeneity. There was a low probability of publication bias for above comparisons, as indicated by Egger’s tests. Conclusions Our meta-analytical findings indicate that the combination therapy with GnRHa and rhGH can slightly increase the final height of ISS children with normal timed puberty, and the effect was not more obvious than GH alone. We do not recommend the combination therapy as a routine treatment for ISS. Trial registration number CRD42019133438This publication has 45 references indexed in Scilit:
- Review of Growth Hormone Randomized Controlled Trials in Children with Idiopathic Short StatureHormone Research in Paediatrics, 2011
- Treatment of Idiopathic Short Stature: Effects of Gonadotropin-Releasing Hormone Analogs, Aromatase Inhibitors and Anabolic SteroidsHormone Research in Paediatrics, 2011
- Quantifying, displaying and accounting for heterogeneity in the meta-analysis of RCTs using standard and generalised QstatisticsBMC Medical Research Methodology, 2011
- Systematic review and meta-analysis methodologyBlood, 2010
- Management of short stature with GnRH agonist and co-treatment with growth hormone: A controversial issueMolecular and Cellular Endocrinology, 2006
- Towards a Consensus on the Definition of Idiopathic Short StatureHormone Research, 1996
- Combination treatment with growth hormone and gonadotropin-releasing hormone analogs in short normal girlsThe Journal of Pediatrics, 1995
- Failure to improve height prediction in short-stature pubertal adolescents by inhibiting puberty with luteinizing hormone-releasing hormone analogueEuropean Journal of Pediatrics, 1993
- Variations in the Pattern of Pubertal Changes in BoysArchives of Disease in Childhood, 1970
- Variations in pattern of pubertal changes in girls.Archives of Disease in Childhood, 1969