Growth Hormone and GnRH Agonist in Adolescents With Acquired Hypothyroidism
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Purpose
| Condition | Intervention | Phase |
|---|---|---|
| Hypothyroidism | Drug: Growth hormone Drug: Growth hormone treatment and puberty | Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Single Group Assignment Masking: None (Open Label) Primary Purpose: Treatment |
| Official Title: | Concomitant Use of Growth Hormone and GnRH Agonist in Adolescent Patients With Acquired Hypothyroidism |
- final height [ Time Frame: When bones are fused ]
- bone age [ Time Frame: When bones are fused ]
- growth factors [ Time Frame: no time frame ]
| Enrollment: | 21 |
| Study Start Date: | May 2003 |
| Study Completion Date: | November 2011 |
| Primary Completion Date: | September 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
No Intervention: 1
Group 1 will be treated only with Synthroid.
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Experimental: 2
Group 2 will be treated with Growth hormone, synthroid, and lupron.
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Drug: Growth hormone
Growth hormone + Synthroid + Lupron
Other Name: Humatrope
Drug: Growth hormone treatment and puberty
Lupron once a month and growth hormone daily
Other Name: Humatrope
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No Intervention: 3
Group 3 will have acute hypothyroidism and will serve as controls.
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Detailed Description:
Hypothyroidism is often associated with growth failure. It takes several years for slow growth to be noticed. This growth retardation is typically severe and progressive.
Thyroid hormone is necessary for normal growth. Treatment with thyroxine (thyroid hormone) results in rapid catch-up growth, which mostly happens during the first 18 months. Growth is accompanied by increased bone age, which means early fusion (closure of the growing bones) of the bones and reduced growth potential. For example, a patient, who is 10 years old but has bone age of 12 years, has growth potential of a 12 year old and will stop growing 2 years earlier than a 10 year old patient. According to the literature, prolonged juvenile hypothyroidism (low thyroid condition) resulted in a permanent loss in height and only 70% catch-up growth was generally achieved with thyroxine replacement.
Eligibility
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| Ages Eligible for Study: | 8 Years to 17 Years (Child) |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- Patients should have clinical and biochemical evidence of hypothyroidism, T4 less than 5.0 ng /dl , fT4 less than 1.0 mcg/dl and TSH of more than 10. Patients with prolonged hypothyroidism should have growth failure and delayed bone age of at least 2 SD from the mean. Patients with short term hypothyroidism should have normal growth velocity and bone age.
- Females 8 to 16 years old.
- Males 9 to 17 years old.
- Patients without any chronic medical conditions.
- Availability of a parent or guardian to attend study visits with the patient and to be actively involved in the patient treatment plan.
- Give written informed consent prior to any study specific screening procedure with the understanding that the patient has the right to withdraw from the study at any time without penalty.
Exclusion Criteria:
- Taking medications that affect their growth. (eg. Systemic corticosteroids, anabolic steroids)
- Experiencing other health problems/conditions that affect their growth rate such as growth hormone deficiency, Cushing Syndrome, rickets, and chronic diseases.
- Patients with any condition that is a contraindication for GH therapy would include conditions such as an active tumor, impaired glucose tolerance, neurofibromatosis (worsening of neurofibromatosis), and hypertrophy of tonsils and adenoids with sleep apnea. Contraindications for patients for GNRHa therapy would include a severe systemic reaction to GNRHa which is rare, osteopenia, and osteoporosis, because delaying puberty will worsen the condition.
- Moving to a location that the patient will not be able to be followed by a pediatric endocrinologist.
- Patient is not willing to continue with the study. -
Contacts and Locations
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00206375
| United States, Texas | |
| Baylor college of Medicine | |
| Houston, Texas, United States, 77030 | |
| Principal Investigator: | Parvin Yazdani, MD | Baylor College of Medicine |
More Information
| Responsible Party: | Baylor College of Medicine |
| ClinicalTrials.gov Identifier: | NCT00206375 History of Changes |
| Other Study ID Numbers: |
H-13213 |
| First Submitted: | September 13, 2005 |
| First Posted: | September 21, 2005 |
| Last Update Posted: | September 22, 2015 |
| Last Verified: | September 2015 |
Keywords provided by Baylor College of Medicine:
|
Hypothyroidism Growth hormone |
Additional relevant MeSH terms:
|
Hypothyroidism Thyroid Diseases Endocrine System Diseases Hormones Deslorelin |
Hormones, Hormone Substitutes, and Hormone Antagonists Physiological Effects of Drugs Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action |