ESPE Abstracts (2018) 89 P-P3-194

Growth Hormone Treatment: Does Timing Matter?

Bernardo Marquesa, Sónia Madeira Gomesb, Joana Serra Caetanoc, Rita Cardosoc, Isabel Dinisc, Alice Mirantec, Ana Laura Fitasb, Catarina Diamantinob, Catarina Limbertb, Rosa Pinab & Lurdes Lopesb


aInstituto Português de Oncologia de Coimbra FG, EPE, Coimbra, Portugal; bCentro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal; cCentro Hospitalar e Universitário de Coimbra, EPE, Coimbra, Portugal


Introduction: Treatment with recombinant growth hormone (rGH) is safe and has greatly improved the approach of children and adolescents with growth hormone deficiency (GHD) and other growth disorders. Some studies show that most of the height gain associated with GH treatment occurs in prepubertal years. The aim of our study was to evaluate the effect of age at start of the treatment on final height in children with isolated or GHD in a Portuguese cohort.

Methods/design: We performed a retrospective and comparative study of 92 patients who completed treatment with rGH. The parameters evaluated included sex, diagnosis, mid-parental height (MPH), height at the beginning and end of treatment and duration of treatment during pre-puberty/early puberty. Girls with <10 years and boys with <11 years (group 1; n=50 patients) were compared to girls with ≥10 years and boys with ≥11 (group 2, n=42 patients). Statistical analysis was performed using paired and independent t-test samples; results are presented as mean±S.D.

Results: Most patients had isolated GHD (n=66; 72%) and were male (n=60; 65%). Mean age at the start of treatment was 9.8±3.5 years and mean duration of treatment was 6.2±3.9 years (group 1–9.3±3.9 vs group 2–3.69.3±1.4; P<0.001). Patients in group 1 had more pre-pubertal years of treatment (6.2±3.1 vs 0.97±0.4 years; P<0.001). At the start of treatment, mean height standard deviation score (HSDS) was higher in group 1 [−2.7±1.7 SDS versus −2.9±0.8 SDS); P<0.001]. Final HSDS was also greater in group 1 (−1±1.2 SDS vs −1.5±0.7 SDS; P=0.001], as was DHSDS (+2.1±1.7 SDS vs +1.38±0.8 SDS; P=0.015). The majority of patients attained MPH, although there was a non-statistically difference between the two groups (−1.1±9 cm in group 1 vs −5.6±7 cm in group 2). Eighty percent of patients achieved a final height between −2 and +2 S.D.S.

Discussion: Our results show that in this cohort of treated Portuguese children with GHD, younger age at the start of treatment was associated with improved final height and underscores the need for early diagnosis and therapy.