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生长激素治疗的 SHOX 缺乏儿童的安全结局及接近成人身高增长:一项观察性研究和一项临床试验的数据

Safety Outcomes and Near-Adult Height Gain of Growth Hormone-Treated Children with SHOX Deficiency: Data from an Observational Study and a Clinical Trial.

作者信息

Benabbad Imane, Rosilio Myriam, Child Christopher J, Carel Jean-Claude, Ross Judith L, Deal Cheri L, Drop Stenvert L S, Zimmermann Alan G, Jia Nan, Quigley Charmian A, Blum Werner F

机构信息

Endocrinology and Diabetes Unit, Eli Lilly, Neuilly-sur-Seine, France.

出版信息

Horm Res Paediatr. 2017;87(1):42-50. doi: 10.1159/000452973. Epub 2016 Dec 22.

Abstract

BACKGROUND/AIMS: To assess auxological and safety data for growth hormone (GH)-treated children with SHOX deficiency.

METHODS

Data were examined for GH-treated SHOX-deficient children (n = 521) from the observational Genetics and Neuroendocrinology of Short Stature International Study (GeNeSIS). For patients with near-adult height information, GeNeSIS results (n = 90) were compared with a clinical trial (n = 28) of SHOX-deficient patients. Near-adult height was expressed as standard deviation score (SDS) for chronological age, potentially increasing the observed effect of treatment.

RESULTS

Most SHOX-deficient patients in GeNeSIS had diagnoses of Leri-Weill syndrome (n = 292) or non-syndromic short stature (n = 228). For GeNeSIS patients with near-adult height data, mean age at GH treatment start was 11.0 years, treatment duration 4.4 years, and height SDS gain 0.83 (95% confidence interval 0.49-1.17). Respective ages, GH treatment durations and height SDS gains for GeNeSIS patients prepubertal at baseline (n = 42) were 9.2 years, 6.0 years and 1.19 (0.76-1.62), and for the clinical trial cohort they were 9.2 years, 6.0 years and 1.25 (0.92-1.58). No new GH-related safety concerns were identified.

CONCLUSION

Patients with SHOX deficiency who had started GH treatment before puberty in routine clinical practice had a similar height gain to that of patients in the clinical trial on which approval for the indication was based, with no new safety concerns.

摘要

背景/目的:评估生长激素(GH)治疗的 SHOX 缺乏症儿童的生长学和安全性数据。

方法

对来自国际矮小身材遗传学和神经内分泌学观察性研究(GeNeSIS)中接受 GH 治疗的 SHOX 缺乏症儿童(n = 521)的数据进行检查。对于有接近成人身高信息的患者,将 GeNeSIS 的结果(n = 90)与一项 SHOX 缺乏症患者的临床试验(n = 28)进行比较。接近成人身高以实足年龄的标准差得分(SDS)表示,这可能会增加观察到的治疗效果。

结果

GeNeSIS 中大多数 SHOX 缺乏症患者被诊断为勒里-韦伊综合征(n = 292)或非综合征性矮小身材(n = 228)。对于有接近成人身高数据的 GeNeSIS 患者,开始 GH 治疗时的平均年龄为 11.0 岁,治疗持续时间为 4.4 年,身高 SDS 增加 0.83(95%置信区间 0.49 - 1.17)。基线时青春期前的 GeNeSIS 患者(n = 42)的相应年龄、GH 治疗持续时间和身高 SDS 增加分别为 9.2 岁、6.0 年和 1.19(0.76 - 1.62),而临床试验队列中的相应数据为 9.2 岁、6.0 年和 1.25(0.92 - 1.58)。未发现新的与 GH 相关的安全问题。

结论

在常规临床实践中青春期前开始 GH 治疗的 SHOX 缺乏症患者的身高增长与该适应症获批所基于的临床试验中的患者相似,且无新的安全问题。

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