ESPE Abstracts (2015) 84 P-3-940

GH Dosing Patterns in Children with Isolated GH Deficiency and Multiple Pituitary Hormone Deficiency Enrolled in the NordiNet[reg] International Outcome Study

Marta Šnajderováa, Effie Pournarac, Birgitte Tønnes Pedersenb & Oliver Blankensteind


aCharles University and University Hospital Motol, Prague, Czech Republic; bNovo Nordisk A/S, Søborg, Denmark; cNovo Nordisk Health Care AG, Zurich, Switzerland; dCharité – Universitätsmedizin Berlin, Berlin, Germany


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 (0–25), medium (>25–40) 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).

Table 1 (for abstract P3-940)
Low, %Medium, %High, %Mean±S.D. dose, μg/kg per day
IGHDAll11.278.610.232.0±6.6
Boys11.578.79.931.9±6.6
Girls10.778.510.932.4±6.8
MPHDAll28.363.68.129.1±8.6
Boys25.866.97.329.3±8.0
Girls32.258.79.228.7±9.4

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.

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