This SR highlights the lack of long-term RCTs reporting final height data and other important qualitative outcomes , such as quality of life .
ABSTRACT Genotropin ( somatropin ) is licensed for the treatment of children with growth hormone deficiency , Prader-Willi syndrome , Turner syndrome , chronic renal insufficiency and in children born small for gestational age .
This systematic review ( SR ) evaluated the clinical efficacy and effectiveness of Genotropin in these conditions to inform a NICE Technology Appraisal of growth hormone for the treatment of growth failure in children .
Increased Adrenal Androgen Levels in Patients with Prader-Willi Syndrome Are Associated with Insulin, IGF-I, and Leptin, but Not with Measures of Obesity
Background / Aim : Since hyper and rogenism in simple obesity is assumed to arise from hyperinsulinism and /or increased insulin-like growth factor I ( IGF-I ) or leptin levels , we examined how in patients with Prader-Willi syndrome ( PWS ) , the most frequent form of syndromal obesity , the accelerated adrenarche can be explained despite hypothalamic-pituitary insufficiency with low levels of insulin and IGF-I. Methods : In 23 children with PWS and a mean age of 5.6 years , height , weight , fat mass , fasting insulin concentration , insulin resistance ( by HOMA-R ; see text ) , and leptin and IGF-I levels were determined to test whether they explain the variance of the levels of dehydroepi and rosterone ( DHEA ) and its sulfate ( DHEAS ) , of and rostenedione , and of cortisol before and during 42 months of therapy with growth hormone . Results : The baseline DHEAS , DHEA , and and rostenedione concentrations were increased as compared with age-related reference values , whereas the cortisol level was always normal . During growth hormone treatment , the DHEA concentration further rose , and the cortisol level decreased significantly . The insulin and IGF-I concentrations were low before therapy , while fat mass and leptin level were elevated . The hormonal covariates provided alone or together between 24 and 60 % of the explanation for the variance of adrenal and rogen levels , but the anthropometric variables did not correlate with them . Conclusions : In children with PWS , elevated and rogen levels correlate with hormones that are usually associated with adiposity . However , the lack of direct correlations between disturbed body composition and and rogen levels as well as the increased sensitivity to insulin and IGF-I are abnormalities specific to PWS , potentially caused by the underlying hypothalamic defect
This SR highlights the lack of long-term RCTs reporting final height data and other important qualitative outcomes , such as quality of life .
ABSTRACT Genotropin ( somatropin ) is licensed for the treatment of children with growth hormone deficiency , Prader-Willi syndrome , Turner syndrome , chronic renal insufficiency and in children born small for gestational age .
This systematic review ( SR ) evaluated the clinical efficacy and effectiveness of Genotropin in these conditions to inform a NICE Technology Appraisal of growth hormone for the treatment of growth failure in children .