Background: Long-term monitoring of GH treatment in children is very important.
Objective and hypotheses: To describe patterns of GH dosing in clinical practice in children with isolated GH deficiency (IGHD) and multiple pituitary hormone deficiency (MPHD).
Method: We analysed 7 years of GH treatment data from NordiNet® International Outcome Study (IOS) (NCT00960128), an observational study evaluating the long-term effectiveness and safety of Norditropin®. Dosing analysis was performed by gender, diagnosis (MPHD/IGHD), age, baseline height S.D. score (SDS) and BMI SDS. GH dose was categorised by mean dose in the full treatment period (μg/kg/day): low (025), medium (>2540) and high (>40≤70).
Results: At baseline, (mean±S.D.) patients with IGHD (n=5 503) were younger (9.1±4.0 years) and shorter (height SDS, −2.6±0.9) than patients with MPHD (n=794; 9.8±4.3 years, height SDS, −2.2±1.3). Mean GH dose (μg/kg/day) during the 7-year period (IGHD, 32.0±6.6; MPHD 29.1±8.6) was similar between sexes (Table 1). Proportionally more patients with MPHD than with IGHD were in the low-dose group (Table 1). During year 1, GH dose was unchanged for most patients (IGHD 82.0%; MPHD 82.7%). During year 2, GH dose increased for 24.7 and 20.1%, and decreased for 10.4 and 15.8% of patients with IGHD and MPHD respectively. Baseline BMI SDS was significantly inversely correlated with average GH dose in the full treatment period (IGHD and MPHD, P<0.0001). GH doses tended to decrease at age ~14 years (girls) and ~15 years (boys).
|Low, %||Medium, %||High, %||Mean±S.D. dose, μg/kg per day|
Conclusion: Patients with MPHD received lower mean GH doses than patients with IGHD. Over 75% of patients with IGHD and >50% with MPHD were in the medium-dose group.
Conflict of interest: M Šnajderová and O Blankenstein are members of the NordiNet® IOS International Study Committee. E Pournara and B Tønnes Pedersen are employees of Novo Nordisk.
Funding: This study was sponsored by Novo Nordisk Health Care AG.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology