Long-term treatment with recombinant insulin-like growth factor (IGF)-I in children with severe IGF-I deficiency due to growth hormone insensitivity

J Clin Endocrinol Metab. 2007 Mar;92(3):902-10. doi: 10.1210/jc.2006-1610. Epub 2006 Dec 27.

Abstract

Context: Children with severe IGF-I deficiency due to congenital or acquired defects in GH action have short stature that cannot be remedied by GH treatment.

Objectives: The objective of the study was to examine the long-term efficacy and safety of recombinant human IGF-I (rhIGF-I) therapy for short children with severe IGF-I deficiency.

Design: Seventy-six children with IGF-I deficiency due to GH insensitivity were treated with rhIGF-I for up to 12 yr under a predominantly open-label design.

Setting: The study was conducted at general clinical research centers and with collaborating endocrinologists.

Subjects: Entry criteria included: age older than 2 yr, sd scores for height and circulating IGF-I concentration less than -2 for age and sex, and evidence of resistance to GH.

Intervention: rhIGF-I was administered sc in doses between 60 and 120 microg/kg twice daily.

Main outcome measures: Height velocity, skeletal maturation, and adverse events were measured.

Results: Height velocity increased from 2.8 cm/yr on average at baseline to 8.0 cm/yr during the first year of treatment (P < 0.0001) and was dependent on the dose administered. Height velocities were lower during subsequent years but remained above baseline for up to 8 yr. The most common adverse event was hypoglycemia, which was observed both before and during therapy. It was reported by 49% of treated subjects. The next most common adverse events were injection site lipohypertrophy (32%) and tonsillar/adenoidal hypertrophy (22%).

Conclusions: Treatment with rhIGF-I stimulates linear growth in children with severe IGF-I deficiency due to GH insensitivity. Adverse events are common but are rarely of sufficient severity to interrupt or modify treatment.

Publication types

  • Controlled Clinical Trial
  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Bone Development / drug effects
  • Child
  • Child Development / drug effects
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Insulin-Like Growth Factor I / adverse effects
  • Insulin-Like Growth Factor I / deficiency*
  • Insulin-Like Growth Factor I / therapeutic use*
  • Kidney / drug effects
  • Kidney / growth & development
  • Laron Syndrome / drug therapy*
  • Long-Term Care
  • Male
  • Placebos
  • Recombinant Proteins / therapeutic use

Substances

  • Placebos
  • Recombinant Proteins
  • Insulin-Like Growth Factor I