Safety of growth hormone treatment in children with juvenile idiopathic arthritis.

BACKGROUND: Available data on growth hormone (GH) therapy in glucocorticoid-treated children with juvenile idiopathic arthritis (JIA) suggest a satisfactory safety profile. There have been few reports of adverse effects on the course of the joint disease (e.g., inflammatory flare-ups or osteoarticular complications). Despite strong concern that combined glucocorticoid and GH therapy might impair glucose tolerance, this has been uncommon in clinical trials. This article briefly reviews the published data and offers recommendations for monitoring patients with JIA who are receiving GH replacement therapy.

CONCLUSIONS: The safety of GH therapy in children receiving glucocorticoid therapy for JIA seems satisfactory with few serious adverse events reported to date; however, given the small number of treated patients and the short periods of follow-up in each individual patient, the decision to initiate GH therapy in patients receiving glucocorticoids should be made cautiously.