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生长激素治疗对日本小于胎龄儿身材矮小儿童的长期安全性和有效性。

The long-term safety and effectiveness of growth hormone treatment in Japanese children with short stature born small for gestational age.

作者信息

Horikawa Reiko, Tanaka Toshiaki, Nishinaga Hiromi, Nishiba Yosuke, Yokoya Susumu

机构信息

Department of Endocrinology and Metabolism, National Center for Child Health and Development, Tokyo, Japan.

Tanaka Growth Clinic, Tokyo, Japan.

出版信息

Clin Pediatr Endocrinol. 2020;29(4):159-171. doi: 10.1297/cpe.29.159. Epub 2020 Oct 3.

Abstract

This study aimed to characterize the safety and effectiveness of GH treatments, in usual clinical practice, in children with short stature born small for gestational age (SGA). This was a multicenter, open-label, non-interventional study (NCT01110928) conducted at 150 sites in Japan (2009-2018). The primary objective was to assess the type and frequency of serious adverse drug reactions (SADRs) associated with long-term GH use. Overall, 452 naïve and 46 non-naïve (previously treated) children were enrolled. GH treatment was well‑tolerated, with SADRs occurring in 1.3% (6/452) and 0% (0/46) of naïve and non-naïve children, respectively. No new safety concerns or notable changes in glucose metabolism were identified during long-term treatment. Altogether, 57 children (32 naïve and 25 non-naïve) reached near adult height (NAH). In naïve and non-naïve children, mean ± standard deviation (SD) height standard deviation score (SDS) at NAH were -2.03 ± 0.77 and -1.53 ± 0.81, respectively, representing a change of +0.85 ± 0.72 and +1.24 ± 0.66 from baseline height SDS, respectively. Mean treatment duration to NAH was 4.29 (naïve) and 7.26 (non-naïve) yr. Thus, long-term GH treatment for short stature in children born SGA was confirmed to have a good safety profile and was effective for improving adult height.

摘要

本研究旨在描述生长激素(GH)治疗对小于胎龄儿(SGA)出生的身材矮小儿童在常规临床实践中的安全性和有效性。这是一项在日本150个地点进行的多中心、开放标签、非干预性研究(NCT01110928,2009 - 2018年)。主要目的是评估与长期使用GH相关的严重药物不良反应(SADR)的类型和频率。总体而言,纳入了452例初治儿童和46例非初治(既往接受过治疗)儿童。GH治疗耐受性良好,初治儿童和非初治儿童中SADR的发生率分别为1.3%(6/452)和0%(0/46)。在长期治疗期间未发现新的安全问题或葡萄糖代谢的显著变化。共有57例儿童(32例初治儿童和25例非初治儿童)达到接近成人身高(NAH)。在初治和非初治儿童中,NAH时的平均±标准差(SD)身高标准差评分(SDS)分别为 - 2.03±0.77和 - 1.53±0.81,相对于基线身高SDS分别变化了 + 0.85±0.72和 + 1.24±0.66。达到NAH的平均治疗持续时间为4.29年(初治儿童)和7.26年(非初治儿童)。因此,证实长期使用GH治疗SGA出生儿童的身材矮小具有良好的安全性,并且对改善成人身高有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc4d/7534526/fe5306ec0fec/cpe-29-159-g001.jpg

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