ESPE Abstracts (2019) 92 P2-194

Growth Hormone Treatment Adherence in Patients from an Emerging Economy Country: 1-Year Real-World Data from the Easypod™ Connect Ehealth Platform

Luis Eduardo Calliari1, Paula Barquero2, Cleber Sato2, Ekaterina Koledova3


1Assistant Professor. Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil. 2Merck Brazil, a business of Merck KGaA, Darmstadt, Germany. 3Merck KGaA, Darmstadt, Germany


Previous studies have shown that poor adherence to recombinant human growth hormone (r-hGH; Saizen®) therapy is associated with decreased efficacy outcomes and increased healthcare costs. Easypod™ is the only electronic injection device that enables continuous monitoring of adherence to treatment. Early recognition of non-adherence is essential in the management of long-term outcomes of r-hGH therapy. This analysis aimed to evaluate adherence to r-hGH therapy administered via easypod™ up to 12 months in Brazilian patients.

Data from the past 48 months were downloaded on 15th February 2019 from easypod™ connect. The period of recorded data varied, according to individual's treatment length. Data were stratified by age, gender and device engagement. Patient adherence was calculated as mg Saizen® injected vs mg Saizen® prescribed and categorised as high [≥85%], intermediate [>56%–84%] or low [≤56%]. Only data after the 10th injection registered were analysed. Puberty cut-off points were 10 years for girls and 12 years for boys.

In total, 984 patients recorded >10 injections. Overall, there were 750 patients (76.2%), 195 (19.8%) and 39 (4.0%) in the high, intermediate and low-adherence categories respectively. Although a slight decrease in adherence was recorded over time, 178 of 246 (72.4%) patients were still in the high-adherence category at month 12. After 12 months there was no difference in high-adherence rates between pre-pubertal (66/92 [71.7%]) and pubertal patients (112/154 [72.7%]). However, more girls had high-adherence rates than boys (78/103 [75.7%] vs 100/143 [69.9%]), and this difference mainly laid in the pre-pubertal group: girls (21/25 [84.0%]) vs boys (45/67 [67.2%]). The proportion of pubertal girls vs boys was comparable (57/78 [73.1%] vs 55/76 [72.4%]). Patients in the high-adherence category had the highest mean number of data transmissions at 12 months (6.4 [SD 8.4]) compared with the intermediate and low adherence categories (4.1 [SD 4.7] and 4.1 [SD 5.1]) respectively.

This is the first analysis of adherence exclusively in Brazilian patients using easypod™ connect in a real-world clinical setting. Overall, the majority of patients were in the high-adherence category. Adherence was higher in pre-pubertal females than males, but comparable in pubertal patients. After 12 months, 28% of patients were in low or intermediate categories, demonstrating that adherence is an issue that continuously needs to be addressed with families and patients. Through our validated method of recording adherence, we can address an unmet need in r-hGH therapy.

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