Clinical Effects of Eutropin(Recombinant Human Growth Hormone) in Patients with Turner Syndrome

Kim, Duk Hee; Lee, Byung Chul; Yang, Sae Yon; Chung, Yoo Yong

Abstract

Background
Eutropin is a recombinant human growth hormone preparation and has been used in patients with growth hormone deficiency. Short stature is a characteristic feature of Turner syndrome, which is caused by sexual chromosomal anomalies. Growth hormone therapy would increase growth velocity and increase the ultimate final height in patients with Turner syndrome. The purpose of this study was to evaluate the clinical effects and safety in patients with Turner syndrome with Eutropin treatment.
Subjects and METHODS
60 patients with Turner syndrome,who were diagnosed by chromosome study,were treated with Eutropin 1IU/kg/week for 12 months and followed up every 3 month. The height and weight were evaluate at 0, 3, 6, 9, 12 months. A complete blood count, ESR, urinary analysis and chemistry studies were done every 3 month. IGF- I , T4, TSH & anti-GH antibody were measured at 6 months and 12 months. Chest X-ray was checked at 0, 6 ,12 months.
RESULTS
60 patients were enrolled but 10 patients were lost or treated irregularly and excluded in the study of growth effect. but included all cases in safety analysis. At the onset of Eutropin therapy,their mean age was 10.8+/-2.9 years old(range 4.2- 14.9yr)and the height was 121.1+/-13.7cm(-3.1+/-0.9 SDS) and yearly growth velociy was 3.4+/-1.5cm. Their weight was 30.5+/-10.6kg and bone age 9.1+/-3.0 yrs. After Eutropin treatment, mean height was increased to 123.2+/-13.5cm at 3 months, 125.2+/-13.1cm at 6 months, 127.5+/-12.4cm at 9 months, 128.3+/-12.8cm at 12 months. Height velocity were increased to 8.3+/-3.1cm at 3 months, 8.1+/-2.6cm at 6 months, 7.6+/-1.9cm at 9 months and 7.1+/-1.9cm at 12 months(P<0.001). Height SDS at 0, 3, 6, 9, 12 months were -3.1+/-0.9, -2.9+/-1.0, -2.7+/-0.9, -2.7+/-0.9 respectively(P>0.001).Their bone age were 9.1+/-3.0yr, 9.6+/-2.9yr, 10.2+/-2.7yr before and 6 & 12 months after treatment respectively. HA/BA were 0.84+/-0.15, 0.87+/-0.13, 0.88+/-0.12 at before and 6 & 12 months after treatment respectively(P<0.05). Growth velocity of 4-8 yrs group was most prominent compared to other groups. Serum IGF- I concentration was increased from 167.4+/-85.8ng/ml to 368.4+/-158.1ng/ml at 6 months and 423.2+/-181.0ng/ml at 12 month(P<0.001) after treatment. No significant changes were observed in thyroid function, CBC, ESR, Blood chemistry and urinalysis. Anti-hGH antibody were positive in 2 patients, but these didnot attenualte the growth velocity.
CONCLUSION
Treatment with Eutropin increased significantly height velocity in patients with Turner syndrome. No specific adverse events were observed during Eutropin therapy.