Title

Response to growth hormone treatment in prader-willi syndrome: Auxological criteria versus genetic diagnosis

Date of this Version

1-1-2013

Document Type

Journal Article

Publication Details

Citation only

Scheermeyer, E., Hughes, I., Harris, M., Ambler, G., Crock, P., Verge, C. F.,Craig, M., Bergman, P., Werther, G., Van Driel, M., Davies, P., & Choong, C. S. Y. (2013). Response to growth hormone treatment in prader-willi syndrome: Auxological criteria versus genetic diagnosis. Journal of Paediatrics and Child Health, 49(12), 1045-1051.

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© Copyright, The Authors, 2013

2013 HERDC submission. FoR code: 111400

ISSN

1034-4810

Abstract

Aim The Australian Prader-Willi Syndrome (PWS) database was established to monitor the efficacy and safety of growth hormone (GH) treatment in PWS. This study aims to compare response to GH based on eligibility criteria. Methods Comparative study: 72 children received GH on the basis of short stature or evidence of GH deficiency (pre-2009: PWS-SS) and 94 on a genetic diagnosis (post-2009: PWS-Dx). We report on mandatory patient data for GH prescription: median and standard deviation score (SDS) for height and body mass index (BMI), waist/height ratio, bone age/chronological age ratio and adverse events. Comparisons were made using non-parametric tests. Results At baseline, the PWS-SS cohort was shorter (height SDS: -2.6 vs. -1.1, P < 0.001), had a lower BMI (0.6 vs. 1.5 SDS, P < 0.05) and greater bone age delay (bone age/chronological age: 0.7 vs. 0.9, P < 0.05) than the PWS-Dx cohort. PWS-SS parents were shorter (mid-parental height SDS: -0.13 vs. 0.28, P < 0.005). Mean change in height over 2 years was 0.9 SDS and in BMI using PWS reference standards -0.3 SDSPWS (n = 106) (year 2, height SDS: PWS-SS = -1.7, PWS-Dx = 0.1; BMI SDSPWS: PWS-SS = -1.0, PWS-Dx = -0.6). The waist/height ratio reduced (PWS-Dx: 0.60 vs. 0.56, P < 0.05) and bone age delay was unchanged over this period. No serious adverse events were reported. Conclusions The PWS-SS cohort represents a subgroup of the wider PWS-Dx population; however both cohorts improved height SDS with normalisation of height in the PWS-Dx cohort and lowering of BMI relative to PWS standards supporting the efficacy of treatment under the current Australian GH programme.

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This document has been peer reviewed.