A Preliminary Study of Growth Hormone Therapy for Crohn's Disease
Alfred E. Slonim, M.D., Linda Bulone, R.N., Mary B. Damore, M.D., Teresia Goldberg, M.S., R.D., Mark A. Wingertzahn, Ph.D., and Matthew J. McKinley, M.D.
Background Crohn's disease is a chronic inflammatory disorderof the bowel. In a preliminary study, we evaluated whether theadministration of growth hormone (somatropin) as well as a high-proteindiet would ameliorate the symptoms of the disease.
Methods We randomly assigned 37 adults with moderate-to-severeactive Crohn's disease to four months of self-administered injectionsof growth hormone (loading dose, 5 mg per day subcutaneouslyfor one week, followed by a maintenance dose of 1.5 mg per day)or placebo. We instructed all patients to increase their proteinintake to at least 2 g per kilogram of body weight per day.Patients continued to be treated by their usual physicians andto receive other medications for Crohn's disease. The primaryend point was the change in scores on the Crohn's Disease ActivityIndex from base line to month 4. Scores can range from 0 to600, with higher scores indicating more disease activity.
Results At base line, the mean (±SD) score on the Crohn'sDisease Activity Index was somewhat higher among the 19 patientsin the growth hormone group than among the 18 patients in theplacebo group (287±134 vs. 213±120, P=0.09). Threepatients in the placebo group withdrew before their first follow-upvisit and were not included in the data analysis. At four months,the Crohn's Disease Activity Index score had decreased by amean of 143±144 points in the growth hormone group, ascompared with a decrease of 19±63 points in the placebogroup (P=0.004). Side effects in the growth hormone group includededema (in 10 patients) and headache (in 5) and usually resolvedwithin the first month of treatment.
Conclusions Our preliminary study suggests that growth hormonemay be a beneficial treatment for patients with Crohn's disease.
Source Information
From the Departments of Pediatrics (A.E.S., L.B., M.B.D., T.G., M.A.W.) and Medicine (M.J.M.), North Shore University Hospital and New York University School of Medicine, Manhasset. Presented at the 81st annual meeting of the Endocrine Society, San Diego, Calif., June 1215, 1999.
Address reprint requests to Dr. Slonim at the Department of Pediatrics, North Shore University Hospital, 300 Community Dr., Manhasset, NY 11030, or at slonim{at}nshs.edu.
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