ESPE Abstracts (2015) 84 P-3-936

Adherence to GH Treatment: Impact of Actual Height, Treatment Duration, and Puberty

Juliane Rothermela, Karl Scheiteb, Nadine Nazaric, Berthold Hauffad & Thomas Reinehra


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).

Table 1 (for abstract P3-936)
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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