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Just taller or more bone? The impact of growth hormone on osteogenesis imperfecta and idiopathic juvenile osteoporosis.

There are scant data to date on the use of GH therapy in osteogenesis imperfecta (OI) or in idiopathic juvenile osteoporosis (IJO). In OI, we review three clinical trials (aggregate study population 46), and 13 patient reports from the NCGS, and two independent patient reports. Based on evidence of increased growth rate versus some reported increased fracture rate, we conclude that GH should probably not be used as first-line therapy in OI, pending further data from clinical trials. There are no published reports of the use of GH therapy in IJO and only one patient with documented IJO enrolled in the NCGS. Since IJO presents in the immediate prepubertal period and appears to improve naturally during puberty, it is difficult to differentiate the effects of GH therapy from those of puberty; therefore, we conclude that GH in IJO should currently be used only for research and not in clinical practice.