ESPE Abstracts (2018) 89 P-P3-211

Study of the Effectiveness of GH in Children Born Small for Gestational Age in an Area of Northwestern Spain and its Associated Factors

Paloma Cabanas Rodrígueza, Lourdes Rey Cordob, Antonio Bello Fernándezc, Jose Luis Chamorro Martínd, Ana Prado Carroc, Ruben Regoa, Lidia Castro-Feijóoa, Alicia Cepedano Danse & Jesús Barreiro Condea


aClinic University Hospital of Santiago de Compostela, USC, Santiago de Compostela, Spain; bÁlvaro Cunqueiro Hospital, Vigo, Spain; cClinic University Hospital of Coruña, A Coruña, Spain; dHospital Álvaro Cunqueiro, Vigo, Spain; eCinical University Lucus Augusti Hospital, Lugo, Spain


Introduction: Recombinant GH is an effective treatment for short children who are born small for gestational age(SGA). Short children SGA who fail catch-up growth by 4 years of age are candidates for GH treatment, at a dose of 35–70 μg/kg per day. Factors associated with response to GH treatment during the initial 2–3 years of therapy include age and height standard deviation scores at the start of therapy, midparental height, and GH dose. It is important to know the effectiveness of the treatment in our geographical area and compare the clinical and analytical results with those of other populations.

Objective: The aim is to study the predisposing factors of good response in SGA children treated with rhGH in our community, as well as its possible adverse effects.

Methods: Information from the application protocols for GH treatment has been collected of our geographical area (Northwest Spain) for a period of 10 years. It has been made a descriptive and analytical statistical study using SPSS 20.0. Tests used T-Student and Pearson correlation.

Results: Valid data of 180 patients (52.2% males; 47.8% females) have been obtained. All of them met the standars required by the European Medicines Agency. Background: 12.8% multiple pregnancy; 18.3% associated perinatal pathology; 10.6% associated non-perinatal pathology. Birth information: weight −1.88 SDS; length −2.83 SDS. Information at the beginning of treatment: age 7.39±2.6 years; height −3.16 SDS; growth rate at start −1.74 SDS. 96.1% started treatment before the onset of puberty. Information at one year of treatment: height −2.34 SDS; rate of growth +3.03 SDS. Information at second year of treatment: growth rate +1.48 SDS. The average treatment dose was 0.036 mg/kg per day. No adverse events were reported.

Conclusions: Our results agree with other published series and these are representative of our population. We observe an age of late onset of treatment, however, with an adequate response in growth correlated with the genetic height, the height at the beginning, the age of onset and the growth rate at the beginning of the treatment. Its important to optimize the treatment to achieve catch-up growth to a normal height in early childhood, maintain a normal height gain, and achieve an adult height within the normal target range. Although a high dose of up to 0.067 mg/kg per day is relatively safe, adequate response to lower doses should be considered in the light of long-term comorbidities in these patients.