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Topic:

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Issue:

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Category:

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Title:

The Effect of Human Growth Hormone Treatment on the Development of Slipped Capital Femoral Epiphysis: A Cohort Analysis With 6 Years of Follow-up

Author:

Mittal, Mehul BBA; Momtaz, David BS, MPH; Gonuguntla, Rishi BA; Singh, Aaron BA; Dave, Dhyan BS; Mohseni, Mahshid MD; Torres-Izquierdo, Beltran MD; Schaibley, Claire BS; Hosseinzadeh, Pooya MD

Journal:

Journal of Pediatric Orthopaedics

Date:

April 2024

Reference:

44(4):p e344-e350, DOI: 10.1097/BPO.0000000000002618

Level Of Evidence:

III

# of Patients:

HGH cohort: 36,791 patients under 18 years receiving HGH therapy
Control group: Matched 1:1 cohort of patients not receiving HGH therapy

Study Type:

Therapeutic retrospective cohort study

Location:

Multicenter database analysis using the TriNetX research database

Summary:

This study investigated the association between human growth hormone (HGH) therapy and the risk of developing slipped capital femoral epiphysis (SCFE) in children. Using a large dataset and propensity score matching, the researchers analyzed the incidence of SCFE in children receiving HGH therapy compared to those who did not receive it.

Methods:

Retrospective review of patient records from January 2003 to December 2022. Propensity score matching was employed to compare HGH and no-HGH cohorts. SCFE development was identified using International Classification of Diseases (ICD) codes. Risk ratios (RR) and hazard ratios were calculated to evaluate associations.

Exclusions:

Not specified

Results:

HGH cohort showed a significantly increased risk of SCFE compared to the no-HGH cohort (RR: 3.5, 95% CI: 2.073, 5.909, P<0.001). Patients with >10 HGH prescriptions had a higher risk of SCFE than those with ≤10 prescriptions (RR: 1.914, 95% CI: 1.160, 3.159, P=0.010). Increased hazard of SCFE development was identified with HGH therapy (hazard ratio: 2.627, 95% CI: 1.555, 4.437, P<0.001).

Conclusions:

This study provides robust evidence that HGH therapy is associated with an increased risk of SCFE in children, with a dose-dependent relationship. Enhanced monitoring for SCFE should be considered in patients receiving HGH therapy.

Relevance:

Limitations:

Perspective:

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