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Effects of Recombinant Human Growth Hormone for Osteoporosis: Systematic Review and Meta-Analysis

Published online by Cambridge University Press:  10 January 2017

Hayden F. Atkinson ,
Rebecca F. Moyer ,
Daniel Yacoub ,
Dexter Coughlin  and
Trevor B. Birmingham
Hayden F. Atkinson*
Affiliation:
Wolf Orthopaedic Biomechanics Lab, Fowler Kennedy Sport Medicine Clinic, University of Western Ontario School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario
Rebecca F. Moyer
Affiliation:
Wolf Orthopaedic Biomechanics Lab, Fowler Kennedy Sport Medicine Clinic, University of Western Ontario School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario
Daniel Yacoub
Affiliation:
Faculty of Health Sciences, University of Western Ontario
Dexter Coughlin
Affiliation:
School of Occupational Therapy, Dalhousie University
Trevor B. Birmingham
Affiliation:
Wolf Orthopaedic Biomechanics Lab, Fowler Kennedy Sport Medicine Clinic, University of Western Ontario School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario
*
†La correspondance et les demandes de tire-à-part doivent être adressées à : / Correspondence and requests for offprints should be sent to: Hayden Atkinson Faculty of Health Sciences, Wolf Orthopaedic Biomechanics Lab Fowler Kennedy Sport Medicine Clinic Room 1230, 3M Centre University of Western Ontario London, ON N6A 3K7 ([email protected])
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Abstract

Our objective was to evaluate the efficacy of recombinant human growth hormone (GH) on bone mineral density (BMD) in persons age 50 and older, with normal pituitary function, with or at risk for developing osteoporosis. We systematically reviewed randomized clinical trials (RCTs), searching six databases, and conducted meta-analyses to examine GH effects on BMD of the lumbar spine and femoral neck. Data for fracture incidence, bone metabolism biomarkers, and adverse events were also extracted and analysed. Thirteen RCTs met the eligibility criteria. Pooled effect sizes suggested no significant GH effect on BMD. Pooled effect sizes were largest, but nonsignificant, when compared to placebo. GH had a significant effect on several bone metabolism biomarkers. A significantly higher rate of adverse events was observed in the GH groups. Meta-analysis of RCTs suggests that GH treatment for persons with or at risk for developing osteoporosis results in very small, nonsignificant increases in BMD.

Résumé

Notre objectif était d’évaluer l’efficacité de l’hormone de croissance humaine recombinante (HCH) sur la densité minérale osseuse (DMO) chez les personnes âgées de 50 ans et plus, ayant une fonction pituitaire normale, qui risquent de développer l’ostéoporose. Nous avons passé en revue systématiquement les essais cliniques randomisés (ECR), examinant six bases de données, et ont réalisé des méta-analyses pour examiner les effets de la HCH sur la DMO dans la colonne lombaire et le col du fémur. Les données au sujet de l’incidence des fractures, les biomarqueurs du métabolisme osseux et les événements indésirables ont également été extraites et analysées. Treize ECR ont rempli les critères d’admissibilité. Effets de mise en commun de différentes tailles ne suggèrent aucun effet significatif de la HCH sur la DMO. Les valeurs de l’effet de mise en commun étaient plus grandes, mais insignifiantes, comparativement au placebo. La HCH a eu un effet significatif sur plusieurs marqueurs pour le métabolisme osseux. On a observé un taux significativement plus élevé d’évènements indésirables dans les groupes HCH. La méta-analyse des ECR suggère que le traitement par la HCH pour personnes ayant ou à risque de développer l’ostéoporose entraîne des augmentations très petites et insignifiantes de la DMO.

Keywords

agingosteoporosisbone mineral densitygrowth hormonesystematic reviewmeta-analysisvieillissementostéoporosedensité minérale osseusehormone de croissanceexamen systématiqueméta-analyse
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 36 , Issue 1 , March 2017 , pp. 41 - 54
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Copyright
Copyright © Canadian Association on Gerontology 2017 

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Footnotes

* The authors acknowledge Travis Saunders for his assistance and feedback on the original draft of the manuscript and development of the systematic review.
Hayden Atkinson’s work was supported by the Western University Graduate Research Scholarship (Western University), the Collaborative Training Program in Musculoskeletal Health Research (Bone & Joint Institute, Western University), and the Science Undergraduate Research Award (University of Prince Edward Island). Rebecca Moyer’s work was supported by the Western University Faculty of Health Sciences Postdoctoral Fellowship program, and the Collaborative Training Program in Musculoskeletal Health Research (Bone & Joint Institute, Western University). Trevor Birmingham’s work was supported by the Canada Research Chair program, and the Bone & Joint Institute of Western University.

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