Study Questions Growth Hormones

By BRIGITTE GREENBERG
Associated Press Writer

The first long-term study on the controversial practice of using growth hormones for cosmetic reasons shows the treatment can increase the height of healthy children by about 2 inches. However, the hormones don't offer a guarantee of any gain in stature.

The findings published in today's New England Journal of Medicine led some experts to question whether up to 10 years of daily injections are worth the cost and the trouble, especially since the Food and Drug Administration has not approved the use of hormones for cosmetic purposes.

Dr. Raymond Hintz and colleagues at Stanford University showed that about 80 percent of the children studied over 10 years reached heights greater than would have been expected otherwise.

However, the results in individual children varied; 20 percent saw no height increase. And few of the children reached the target height set by doctors based on the size of the child's parents.

Hintz called the results ``somewhat disappointing.''

``The question is: Do we treat, understanding that it's not a 100 percent guarantee and that it's years of treatment, or do we let nature take its course?'' he said. ``I think different parents are going to give different answers.''

The study was paid for in part by Genentech Inc. of South San Francisco, Calif., which holds 67 percent of the U.S. market for growth hormones. A spokeswoman for Genentech said the company ``does not currently intend to pursue FDA approval'' for short, healthy children based on the study's findings. Eli Lilly and Co. and Pharmacia & UpJohn also make growth hormones.

The American Academy of Pediatrics recommends use of growth hormones only in children who have a deficiency of the hormones; a rare chromosomal abnormality called Turner syndrome that stunts growth in girls; or a chronic kidney disorder that retards growth.

The academy warns that the hormones should not be widely used for cosmetic reasons because they could lead to tumors, diabetes, hip problems or difficulties with self-esteem. This study found no side effects.

Even though the FDA has not approved the drugs for use in short but otherwise healthy children, it is not illegal to do so. About 30,000 children are treated with growth hormones in the United States yearly, and about 20 percent of them don't fit into one of the categories the FDA deems as medically necessary.

One year of growth hormone therapy can cost $10,000 to $25,000.

The researchers examined 121 children who were considered short for no known medical reason and were treated with growth hormones for two to 10 years.

Among 80 children who received treatment and who have reached adulthood, both boys and girls were an average of about 2 inches taller than would have been expected otherwise.

In an accompanying editorial, Dr. Sharon Oberfield of the College of Physicians and Surgeons of Columbia University called the findings inconclusive but was skeptical of hormone use on healthy children.

``Is short stature a disease? If not, should the most severe short stature be considered a disability warranting treatment?'' Oberfield wrote.

Hintz defended the use of the hormones in some cases where a person is ``severely short,'' meaning below 4-foot-11 for a woman or 5-3 for a man.

``When you have trouble interacting with people or in handling kitchen cabinets or driving, then it becomes a significant problem,'' he said. ``Like a lot of `isms,' such as racism or ageism, there is heightism, which can be subtle. Sometimes people judge others, even unconsciously, based on their stature.''

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