Comparison of the growth hormone, oxandrolone, letrozole and anastrozole’s impact on the height increase in children and adolescents with idiopathic short stature (ISS): a systematic review and meta-analysis

Shiri , Samira; Ghasemi, Mahmoud; Asadollahi, Khairollah; Deldar , Maryam; Sayehmiri , Kourosh

Volume 79, Issue 9 (December 2021) Tehran Univ Med J 2021, 79(9): 665-673 | Back to browse issues page

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Shiri S, Ghasemi M, Asadollahi K, Deldar M, Sayehmiri K. Comparison of the growth hormone, oxandrolone, letrozole and anastrozole’s impact on the height increase in children and adolescents with idiopathic short stature (ISS): a systematic review and meta-analysis. Tehran Univ Med J 2021; 79 (9) :665-673
URL: http://tumj.tums.ac.ir/article-1-11432-en.html

Comparison of the growth hormone, oxandrolone, letrozole and anastrozole’s impact on the height increase in children and adolescents with idiopathic short stature (ISS): a systematic review and meta-analysis

Samira Shiri¹

, Mahmoud Ghasemi²

, Khairollah Asadollahi³

, Maryam Deldar¹

, Kourosh Sayehmiri ^*

⁴

1- Department of Biostatistics, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran.
2- Clinical Developmental Researches Center, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
3- Department of Social Medicine, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran.
4- Department of Biostatistics, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran. , sayehmiri@razi.tums.ac.ir

Abstract: (14481 Views)

Background: Short children face many problems throughout their lives. Consumption of growth hormone and the drugs such as Letrozole, Oxandrolone, and Anastrozole can increase the growth of children and adolescents. There is not an overall estimate of the effects of Letrozole, Oxandrolone, and Anastrozole on the growth of children and adolescents with Idiopathic Short Stature (ISS). There are different estimates of the effect of growth hormone and the drugs Letrozole, Oxandrolone, and Anastrozole on growth in children and adolescents with Idiopathic Short Stature. Therefore, the aim of this study was to compare the efficacy of growth hormone, Letrozole, Oxandrolone, Anastrozole, and a combination of growth hormone and aromatase inhibitors on height gain in children and adolescents with idiopathic short stature using meta-analysis method.
Methods: Search was done in databases such as; Scopus, Web of Science(ISI), and PubMed using keywords: Idiopathic, Short Stature, Body Height, Aromatase Inhibitors, Growth hormone, Letrozole, Oxandrolone, Anastrozole. Randomized clinical trial studies ,that have investigated the efficacy of growth hormone and aromatase inhibitors on height gain in children and adolescents with short stature, were selected. Height standard deviation score (HSDS) before intervention and after treatment has been used to measure the rate of height increase in various studies. This study was written based on the PRISMA checklist and the heterogeneity of this study was evaluated using the Q statistic and I² index.

Results: Height increase index (HSDS) was obtained with the use of growth hormone combined with one of the aromatase inhibitors (0.38-3.58=95%CI) (SMD=0.98), with the use of growth hormone (0.62-1.14=95%CI) (SMD=0.88), with the use of Letrozole (0.51-16.51=95%CI) (SMD=0.83), with the use of Oxandrolone (0.99-0.99=95%CI) (SMD=0.56), and with the use of Anastrozole (0.00-0.63=95%CI) (SMD=0.31), which shows that all these drugs have a significant effect on height increase. (P<0.05)
Conclusion: Although the effect of growth hormone on height increase was greater than that of aromatase inhibitors, but according to our results, adding an aromatase inhibitor to growth hormone can increase the effectiveness of it.