Background: Early diagnosis of growth disorders and initiation of GH therapy at a younger age improves clinical outcomes.
Aims and objectives: To analyse time trends in baseline parameters at GH treatment start (2006 2014) in short children with GHD, SGA and TS from Germany and Czech Republic enrolled in NordiNet® IOS (NCT00960128).
Method: Baseline data (chronological age, height, weight, BMI, GH dose) from paediatric patients (<18 years) enrolled in NordiNet® IOS in Germany and Czech Republic were analysed using a multiple regression model including country and year. Standard Deviation Scores (SDS) for height and for BMI were calculated using national and WHO references, respectively.
Results: In Germany (n=2113) significant decreases (2006: 2014) in mean (SD) age at treatment start for GHD (9.96(3.86): 8.31(4.08); P<0.001) and SGA (7.52(3.19): 6.63 (2.40);P=0.025), and a reduction in baseline (SD) GH dose (μg/kg/day) in GHD (29.42(7.41): 26.27(3.70); P=0.029) and SGA (34.67(4.40): 30.89(4.41); P=0.012) were observed over time. In Czech Republic (n=581) significant decreases in mean (SD) age for GHD (11.37(3.57): 6.87(4.09); P<0.001) and mean (SD) GH dose for TS (45.61(3.67): 41.59(3.54); P=0.005) were observed over time. Significant between-country differences in GH dose (GHD P<0.001; SGA P<0.001; TS P=0.006) and HSDS (GHD P=0.013; TS P=0.018) over time were also shown. Increasing proportions of females with GHD (2006: 2014) (16.7%: 32.4%) and SGA (21.4%: 66.7%) were enrolled in Czech Republic during the study bringing proportions closer to overall proportions observed in Germany (GHD 30.4%; SGA 40.9%). BMI SDS did not differ significantly between both countries.
Conclusion: Significantly earlier age at treatment start in both countries and improvements in the proportion of females with GHD and SGA treated with GH in the Czech Republic may indicate raised awareness of diagnosing children with short stature and suggest optimism for improving clinical outcomes with GH therapy.
Conflict of interest: HG Dörr, J Bramswig: none to declare. M Šnajderová: member of NordiNet® IOS International Study Committee. E Pournara, S Meckes-Ferber, B Tønnes Pedersen: employees of Novo Nordisk.
Funding: This study was sponsored by Novo Nordisk Health Care AG.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology