ESPE2015 Poster Category 3 GH & IGF (68 abstracts)
Adherence to GH Treatment: Impact of Actual Height, Treatment Duration, and Puberty
Juliane Rothermel a , Karl Scheite b , Nadine Nazari c , Berthold Hauffa d & Thomas Reinehr a
aVestische Children Hospital, Datteln, Germany; bGKM Gesellschaft fuer Therapieforschung mbH, Munich, Germany; cMerck Serono GmbH, Damrstadt, Germany; dDepartment of Pediatric Endocrinology and Diabetology, University Children’s Hospital, University Duisburg-Essen, Essen, Germany
Background: Adherence to GH treatment is a challenge.
Objective and hypotheses: We analysed the impact of treatment duration, treatment success, treatment indication, age, gender, pubertal stage, and height on treatment adherence (TA) to optimise treatment success.
Method: Based on the easypod autoinjector used in the Saizen-online prospective, multicenter, open-label, noninterventional study we analyzed TA in 6 months periods. TA was evaluated using proposed cut-offs (good adherence: <1 missed dose/week; medium adherence: 1–3 missed doses/week; poor adherence: >3 missed doses/week)1.
Results: 168 children treated with GH (71% GH deficiency, 7% Turner-Syndrome, 2% chronic renal insufficiency, 20% small-for-gestational age) were included (641 6-months observations periods). TA did not differ significantly between treatment indications (P=0.713) or gender (P=0.167). Younger age, prepubertal stage, and lower height-SDS were associated with better TA, while better treatment success and longer treatment duration were related to lower TA (table 1).
| Good adherence | Medium adherence | Poor adherence | P-value | |
| Number of 6-months observation periods | 373 (58.2%) | 135 (21.1%) | 133 (20.7%) | |
| Age (years) | 11.6±3.2 | 13.4±3.1 | 12.0±3.1 | <0.0011,2,4 |
| Actual height-SDS | −1.9±1.1 | −1.7±1.2 | −1.3±1.3 | <0.0011,3; 0.0382; 0.0174 |
| Prepubertal | 57.3% | 32.2% | 48.7% | <0.0011,2; 0.0124 |
| Treatment success (actual height-SDS– height-SDS at onset of GH treatment) | +0.8 (IQR 0.2–1.4) | +0.7 (IQR 0.2–1.3) | +1.0 (IQR 0.5–1.5) | 0.0041; 0.0023; 0.0054 |
| Treatment duration (y) | 1.8 (IQR 0.8–3.6) | 3.0 (IQR 1.5–4.5) | 2.5 (IQR 1.6–3.6) | <0.001 1,2,3 |
| Data as n (%), mean±1 S.D., or median and interquartile range (IQR); P-values: 1) overall; 2) good versus medium; 3) good versus poor; 4) medium vs poor TA, Fisher’s exact, Wilcoxon–Mann–Whitney and Kruskal–Wallis tests were used as adequate. | ||||
Conclusion: Especially in pubertal children with good treatment success so far, TA should be critically reviewed.
Funding: This work was supported by a grant from Merck Serono GmbH, Darmstadt Germany. Study design, data collection and analysis, decision to publish, and preparation of the manuscript are solely the responsibility of the authors.
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