Children with anorexia nervosa (AN) are at risk of adult height deficit due to prolonged low height velocity (HV).To investigate the effects of human growth hormone (GH) injections on HV in children with AN and severe growth impairment.In this prospective, randomized, double-blind, single-center, proof-of-concept trial, children with AN and low HV (≤2 cm/y) for at least 18 months, and a bone age ≤12 years for girls and 14 years for boys, were randomized to receive daily subcutaneous injections of hGH (0.050 mg/kg/d) or placebo for 12 months.Change in HV after 12 months.In total, eight patients were assigned to the GH group and six to the placebo group. Patients had a median (25-75 th percentile) HV of 1.0 (0.5;1.5) cm/year. The effect of GH treatment increased strongly after six months, with a height gain after 12 months of 9.65 (8.0;11.6) cm for the GH group vs.3.85 (1.7;7.3) cm for the placebo group, with an absolute median (2.5 th-97.5 th percentile) difference between the groups of 5.8 (-1.85;9.68) cm after bootstrapping. The percentage of patients with a HV>5 cm/y during the study period was higher in the GH group than in the placebo group (100% vs.50%, p=0.05). Adverse events occurred in similar numbers in the two groups, were mild or non-fatal, and did not lead to treatment being stopped.GH administration to improve HV is a potentially valid option for increasing HV in children with AN and prolonged severe growth failure.
Juliane Léger, Anne Fjellestad-Paulsen, Anne Bargiacchi, Pages Justine, Didier Chevenne, Marianne Alison, Corinne Alberti, Sophie Guilmin-Crepon