Pediatric Turner syndrome: data support combination of oxandrolone and growth hormone

  • Cochrane Database Sys Rev

  • Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

  • Girls with Turner syndrome may benefit in terms of final height acquisition from a combination of oxandrolone and growth hormone, according to this Cochrane analysis.

Why this matters

  • Girls with Turner syndrome reach an adult height of about 8 inches (20 cm) less than the average for unaffected women.
  • The addition of the androgen oxandrolone to growth hormone has been tried, but benefits and harms are not clear.

Key results

  • Level of evidence was downgraded because of the small number of trials and small number of participants.
  • For growth hormone vs combination with oxandrolone, the combination was superior, yielded a final adult height of more than 1 inch (2.7 cm) (P<.001 trials n="270;" evidence quality moderate>
  • Adverse events did not differ between growth hormone alone and the combination.
  • Results were mixed for virilization, such as low voice, and for cognition and psychological status.
  • No data on health-related QoL or mortality.

Study design

  • Analysis of data from 6 randomized controlled trials that included 498 participants (267 taking combination; 231 growth hormone only; n range, 22-133).
  • Funding: Metabolic and Endocrine Group, Cochrane, Germany; King Saud University, Riyadh, Saudi Arabia.

Limitations

  • Few trials are available, and data are limited for some outcomes.