TY - JOUR TI - Long-term mortality after recombinant growth hormone treatment for isolated growth hormone deficiency or childhood short stature: preliminary report of the French SAGhE study AU - Carel, Jean-Claude AU - Ecosse, Emmanuel AU - Landier, Fabienne AU - Meguellati-Hakkas, Djamila AU - Kaguelidou, Florentia AU - Rey, Grégoire AU - Coste, Joël T2 - The Journal of clinical endocrinology and metabolism AB - CONTEXT: Little is known about the long-term health of subjects treated with GH in childhood, and Safety and Appropriateness of Growth hormone treatments in Europe (SAGhE) is a study addressing this question. OBJECTIVE: The objective of the study was to evaluate the long-term mortality of patients treated with recombinant GH in childhood in France. DESIGN: This was a population-based cohort study. SETTING: The setting of the study was a French population-based register. PARTICIPANTS: A total of 6928 children with idiopathic isolated GH deficiency (n = 5162), neurosecretory dysfunction (n = 534), idiopathic short stature (n = 871), or born short for gestational age (n = 335) who started treatment between 1985 and 1996 participated in the study. Follow-up data on vital status were available in September 2009 for 94.7% of the patients. MAIN OUTCOME MEASURES: All-cause and cause-specific mortality was measured in the study. RESULTS: All-cause mortality was increased in treated subjects [standardized mortality ratio (SMR) 1.33, 95% confidence interval (CI) 1.08-1.64]. In a multivariate analysis adjusted for height, the use of GH doses greater than 50 μg/kg · d was associated with mortality rates using external and internal references (SMR 2.94, 95% CI 1.22-7.07, hazard ratio 2.79, 95% CI 1.14-6.82). All type cancer-related mortality was not increased. Bone tumor-related mortality was increased (SMR 5.00, 95% CI 1.01-14.63). An increase in mortality due to diseases of the circulatory system (SMR 3.07, 95% CI 1.40-5.83) or subarachnoid or intracerebral hemorrhage (SMR 6.66, 95% CI 1.79-17.05) was observed. CONCLUSIONS: Mortality rates were increased in this population of adults treated as children with recombinant GH, particularly in those who had received the highest doses. Specific effects were detected in terms of death due to bone tumors or cerebral hemorrhage but not for all cancers. These results highlight the need for additional studies of long-term mortality and morbidity after GH treatment in childhood. DA - 2012/02// PY - 2012 DO - 10.1210/jc.2011-1995 DP - NCBI PubMed VL - 97 IS - 2 SP - 416 EP - 425 J2 - J. Clin. Endocrinol. Metab. LA - eng SN - 1945-7197 ST - Long-term mortality after recombinant growth hormone treatment for isolated growth hormone deficiency or childhood short stature KW - Adolescent KW - Adult KW - Age of Onset KW - Aged KW - Algorithms KW - Child KW - Child, Preschool KW - Cohort Studies KW - Female KW - Follow-Up Studies KW - France KW - Growth Disorders KW - Growth Hormone KW - Human Growth Hormone KW - Humans KW - Male KW - Middle Aged KW - Population KW - Recombinant Proteins KW - Time Factors KW - Young Adult ER -