Introduction: Growth prediction algorithms (i.e. iGRO), provide an estimate of a patients likely growth in the first year, and subsequent years, of GH treatment at a given dose, taking into account the patients combination of physical characteristics. Comparing a patients actual growth with their predicted growth after the first year of GH treatment, it is possible to determine whether the patient is responding to GH as expected (Index of responsiveness; IoR) and hence any appropriate action may be taken.
Objective: The aim of this study is to analyze the frequency and type of discrepancies between predicted and observed growth responses with IGRO in children treated with GH in Spain during the first year of treatment.
Methods: Cross-sectional descriptive study including prepubertal patients (children with growth hormone deficiency (GHD), Turner Syndrome or Small for gestational age (SGA) patients) who started GH treatment between 2011 and 2016 and received the treatment during 12 months. Eighty patients data were analyzed.
Results: 80 patients have been included in the study. 59.2% were SGA, 32% had GHD and 8.6% had Turner Syndrome. 86.5% of patients had an IoR above −1.28 SDS (ranging between −1.25 to 3.81 SDS), reason why they were considered good responders at standard doses of GH. The eleven patients who did not respond (IoR range between −4.00 and −1.35 SDS) were all compliant except one (less than a dose missed per week). Nine had other concomitant pathologies (CNS tumor in full remission, a midline malformation, Steinerts dystrophy, two patients had malnutrition and three patients had pituitary hypoplasia associated to other pituitary deficits). The suboptimal response of the remainder patient could be related to the administration of an infraterapeutical dose.
Conclusions: Variations in responsiveness to GH may be influenced by multiple factors such as inappropriate diagnosis, the presence of other systemic disorders, and lack of compliance with treatment or impaired sensitivity to GH. The discrepancies between predicted height by iGRO and observed growth after a year of GH treatment were low in our series.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology