One Year of GH Treatment for Growth Failure in Children with Anorexia Nervosa: A Randomized Placebo-Controlled Trial

Abstract

Context: Children with anorexia nervosa (AN) are at risk of adult height deficit due to prolonged low height velocity (HV). Objective: To investigate the effects of human growth hormone (GH) injections on HV in children with AN and severe growth impairment. Design and participants: In this prospective, randomized, double-blind, single-center, proof-of-concept trial, children with AN and low HV (≤2 cm/year) for at least 18 months, and a bone age ≤12 years for girls and ≤14 years for boys, were randomized to receive daily subcutaneous injections of human GH (0.050 mg/kg/day) or placebo for 12 months. Main outcome measures: Change in HV after 12 months. Results: In total, 8 patients were assigned to the GH group and 6 to the placebo group. Patients had a median (25th-75th percentile) HV of 1.0 (0.5;1.5) cm/year. The effect of GH treatment increased strongly after 6 months, with a height gain after 12 months of 9.65 (8.0;11.6) cm for the GH group vs 3.85 (1.7;7.3) cm for the placebo group, with an absolute median (2.5th-97.5th percentile) difference between the groups of 5.8 (-1.85;9.68) cm after bootstrapping. The percentage of patients with a HV > 5 cm/year during the study period was higher in the GH group than in the placebo group (100% vs 50%, P = 0.05). Adverse events occurred in similar numbers in the 2 groups, were mild or nonfatal, and did not lead to treatment being stopped. Conclusion: GH administration to improve HV is a potentially valid option for increasing HV in children with AN and prolonged severe growth failure.