LONDON (Reuters Health) - More than one in five children treated with growth hormone in Britain are taking it for unlicenced reasons and are unlikely to gain much extra height, the Drug and Therapeutics Bulletin said on Thursday.

The bulletin, an independent review for doctors published by the Consumers' Association, said that short stature was one of the most common chronic problems in paediatric practice and might be regarded as a disability by parents.

It pointed out, however, that synthetic human growth hormone (somatropin) is only licenced for use in children with growth hormone deficiency and children with short stature associated with Turner's syndrome, chronically poor kidney function or Prader-Willi syndrome.

It said that an estimated 22% of children receiving growth hormone were receiving the therapy for unlicenced indications, where growth hormone secretion was within normal levels, such as children with short stature due to intra-uterine growth retardation or skeletal dysplasia.

"While several small randomised controlled trials and observational studies have suggested that some children with idiopathic short stature do have a short-term increase in growth rate when given growth hormone therapy, their overall mean final height gain over predicted adult height is small--about 2.7 cm," according to the report. "Idiopathic" means without known cause.

That compared with a gain of 25 cm to 30 cm in children with growth hormone deficiency.

It was also unclear, the report stated, whether growth hormone therapy in the unlicenced indications led to any improvement in academic achievement, employment prospects, psychological health or quality of life.

It concluded that the therapy should be given only for these unlicenced uses as part of controlled clinical trials.

In England alone in 2000, the bulletin estimated that over 39,000 prescriptions, costing around £27 million, were dispensed for synthetic human growth hormone.

SOURCE: Drug and Therapeutics Bulletin 2002;40:17-20.

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