Brian Hoyle

May 05, 2011

May 5, 2011 (Denver, Colorado) — An analysis of the records of more than 7400 children treated with growth hormone (GH) has refuted the notion that children receiving medication for attention-deficit hyperactivity disorder (ADHD) differ in 3-year growth outcome from those receiving GH therapy but not medication for ADHD.

"Medications used to treat ADHD in children do not appear to have a negative impact on the linear growth response to GH therapy in children. The data are consistent with previous findings in children with growth-hormone-responsive disorders," Susan R. Rose, MD, professor of pediatrics at Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Ohio, told Medscape Medical News.

The results were presented here at the Pediatric Academic Societies and Asian Society for Pediatric Research 2011 Annual Meeting.

The study was undertaken because previous "reports suggest that children receiving medications for ADHD do not grow as well on growth hormone therapy" as those not on medications for ADHD, according to Dr. Rose.

The American Norditrophin Studies: Web-Enabled Research (ANSWER) registry, which, since 2002, has compiled efficacy and safety data on more than 11,000 pediatric patients, was mined by Dr. Rose's team to evaluate the effect of ADHD medication, including amphetamine and dextroamphetamine (Adderall), amphetamine alone, pemoline, and methylphenidate, on the change in height over 3 years in 1055 patients receiving GH (ADHD-positive group) and 6373 patients receiving GH but no ADHD medication (ADHD-negative group).

The 7428 patients were 18 years of age and younger with GH deficiency, multiple pituitary hormone deficiencies, Turner syndrome, Noonan syndrome, idiopathic short stature, small for gestational age, and other short stature disorders.

Baseline characteristics of the ADHD-positive and ADHD-negative groups were similar, with the exceptions of percentage of males (83% vs 65.6%), mean age at baseline (11.6 vs 10.2 years), and the marginally higher proportion of patients with GH deficiency and multiple pituitary hormone deficiencies in the ADHD-positive group.

In the ADHD-positive group, the average percent change in body weight at 1, 2, and 3 years was 18%, 40%, and 62%; in the ADHD-negative group, it was 20%, 41%, and 63% (P = .133, P = .776, and P = .219, respectively). The body mass index was comparable in the 2 groups throughout the study.

The mean change in height was less in the ADHD-positive group than in the ADHD-negative group at 4 months and at 1, 2, and 3 years. But, by year 3, the proportion of patients who had achieved a height of 2 standard deviations or more (in reality, about 0.2 inches) was comparable in both groups (83% vs 85%).

"This is an important study that addresses a problem physicians face when treating children with short stature and ADHD," Susan Scott, MD, professor emeritus of pediatrics, University of New Mexico, Albuquerque, told Medscape Medical News.

The study was funded by Novo Nordisk. Dr. Rose reports financial relationships with Novo Nordisk. Dr. Scott has disclosed no relevant financial relationships.

Pediatric Academic Societies (PAS) and Asian Society for Pediatric Research 2011 Annual Meeting: Abstract 1402.24. Presented April 30, 2011.


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