Background: Quality management of GH treatment in children is important to ensure optimal treatment outcome and to save resources in the health care system. iGRO is a new internet based Medical Device to compare treatment results with predicted results according to published prediction models.
Objective and hypotheses: Growth data were analyzed by iGRO for 1st and 4th year prediction in comparison to treatment results. All eligible patients of our practice treated with GH between 2009 and 2015 were analyzed to compare results with prediction.
Method: Growth data were analyzed by iGRO for 1st year treatment results in 55 IGHD patients (age 6.76±2.19 years; ±S.D.), 22 TS pts (age 7.85±3.31 years), and 56 SGA pts (age 5.4±1.79 years). Eighteen, 6, and 14 pts were available for the analysis of the 4th year.
Results: Of the IGHD, TS, and SGA pts 41.8% (n=23), 12.5% (n=2), and 29% (n=14) did not reach the mean prediction after 1 year of treatment, respectively. Of these low responders, 16, 2, and 5 pts differed more than 1 cm from their individual mean predictions, respectively. The reason for this low treatment response was related to adherence problems in 6, 2, and 5 children and related to a low dose of GH in 3, 0, and 0 children, respectively. Additional reasons for low treatment response were Noonan syndrome (1), undefined syndromal disease (1), and revision of diagnosis to constitutional delay of growth and puberty (2). In the 4th year of GH treatment 33% (n=6), 16.7% (n=1), and 50% (n=7) of patients in IGHD, TS, and SGA groups did not reach the mean prediction.
Conclusion: The analysis of treatment response to GH using iGRO showed a high percentage of good responders and only a low percentage of patients missing their prediction by more than 1 cm. In most cases, reasons for a suboptimal response to GH could be found. Thus, iGRO is a valuable and easy-to-use tool in a Paediatric Endocrine Practice to analyze the response to GH treatment in IGHD, TS, and SGA children. For the future iGRO will be used prospectively to optimize GH treatment from the start onwards.
*iGRO is a CE-certified Medical Device, available in EU countries, provided by Pfizer, Inc.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology