Efficacy and safety of growth hormone therapy in children with systemic lupus erythematosus: A systematic review

Abstract

Introduction Childhood-onset systemic lupus erythematosus (cSLE) is a chronic autoimmune disease with long-term consequences, including growth failure and short stature. Growth hormone (GH) therapy is a potential treatment for short stature in cSLE. Objective The aim of the study was to evaluate the current evidence on the efficacy and safety of GH therapy in cSLE. Methods A systematic review was conducted through PubMed, Cochrane, and Web of Science databases to identify relevant publications from January 1988 to October 2023. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Articles focusing on GH therapy in cSLE were included after an initial screening of their titles and abstracts. The articles were extracted and analyzed by two independent reviewers, with a third reviewer addressing any discrepancies that arose to reach an agreement. Results Among the 6364 screened citations, only two case reports fulfilled the inclusion criteria. Both were for males with cSLE who had short stature due to the disease and corticosteroids. Both case reports demonstrated improved linear growth; however, GH therapy was discounted because of a lupus flare concurrent with GH use, with one case necessitating treatment escalation to control disease activity. Conclusion GH therapy has shown favorable effects on growth in cSLE; however, it may increase the risk of disease flare. Limited evidence precludes a definitive conclusion, highlighting the need for further studies to fill the knowledge gap on the safety and efficacy of GH therapy in cSLE patients.