Growth Hormone Deficiency Clinical Trial
Official title:
Endocrine Dysfunction and Growth Hormone Deficiency in Children With Optic Nerve Hypoplasia
Hypotheses:
1. The prevalence of endocrinopathies, and growth hormone (GH) deficiency in particular,
among young children diagnosed with optic nerve hypoplasia (ONH) is higher than is
commonly thought.
2. Early treatment of children with ONH and GH-deficiency can prevent adverse outcomes.
Aims:
1. Determine the prevalence and types of endocrinopathies in children diagnosed with ONH.
2. Correlate endocrine outcome with radiographic, ocular, and developmental findings in
children with ONH.
3. Examine the effect of GH treatment on growth and obesity in children with ONH,
GH-deficiency, and either subnormal or normal growth compared to children with ONH that
are not GH-deficient.
4. Compare growth outcomes between children with isolated GH-deficiency and those with
multiple hormone deficiencies.
Subjects for this study will be recruited from active and newly enrolled subjects in our
larger ONH study. The study duration is three years and we anticipate 38 subjects will
enroll. Subjects will be recruited for this study if they present with either growth
deceleration or at least one subnormal result for IGF-1 or IGFBP-3.
Baseline information collected includes: height, weight, head circumference, examinations by
an endocrinologist and ophthalmologist, endocrine laboratory testing, fundus photography,
electrophysiology testing, head MRI, and a developmental assessment. A glucagon stimulation
test will be performed and subjects who are deemed GH-deficient and who have delayed growth
will be assigned to GH treatment, in line with standard clinical practice. Those with normal
growth but determined to be GH-deficient by a glucagon stimulation test will be randomized
to treatment with GH vs control (no intervention; observation only).
Subjects assigned or randomized to treatment with GH will be provided with GH for the
duration of their participation in the study. Enrolled subjects will return every four
months to monitor progress. Subjects will undergo a physical examination at each visit,
including height, weight, head circumference, and body fat. In addition, subjects assigned
or randomized to growth hormone will have laboratory testing of thyroid, IGF-1 and IGFBP-3
hormones, and fasting lipid levels.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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