A systematic review of growth hormone for hip fractures

ObjectiveTo evaluate the clinical effectiveness of growth hormone (GH) for hip fractures.DesignBased on the principles and methods of Cochrane systematic reviews, we searched the Cochrane Library (2011, 3 issue), PubMed (1966 to October 2011), EMBASE (1974 to October 2011), OVID database (1963 to October 2011), Chinese Bio-medicine database (1978 to October 2011), China Journal Full-text Database (1979 to October 2011), and VIP database (1989 to October 2011). Randomized controlled trials (RCTs) of GH treatment for hip fractures were included. We assessed the quality of included trials according to the Cochrane Handbook for Systematic Reviews of Interventions Version. The Cochrane Collaboration's software RevMan 5.0 was used for meta-analysis.Results3 RCTs with a total of 162 hip fractures patients were included. Results of GH compared to placebo treatment showed that IGF-I levels significantly increased in the short term, but no significant differences in the long term. Additionally, there was no statistical difference in adverse events. Only one trial reported the measurement of bone mineral content (BMC), which showed that GH group was unchanged while the placebo group lost BMC at both 4 weeks and 8 weeks. Only one study measuring BMC showed no significant differences in the change of the MBI scores between GH group and placebo group; however, the changes from baseline in the hGH group were less than that in the placebo group among the older than 75 years group. Owing to the difference of measurement indexes in those studies, we could not perform a meta-analysis.ConclusionsWith the low quality of current evidence, GH may be effective in hip fractures. More carefully designed, double-blinded and placebo-controlled randomized trials with large numbers of participants about GH in the treatment of hip fractures are required.