ESPE Abstracts

Objectives: - To establish the main factors on which a good response to GH treatment depends. - To study the optimum adherence values. - To study the impact of the loss of adherence in the treatment with GH.

Materials and Methods: This is a non-interventional, retrospective observational study, by reviewing medical records of patients undergoing GH treatment for at least 2years due to GHD or SGA. Patients received treatment with Saizen®, allowing to assess adherence to treatment through the EasyPod Connect platform. Statistical significance has been considered when p≤0.05.

Results: 110patients (51.4%boys, 48.6%girls), 69% GHD, 31% SGA. Patients with the lowest height velocity (HV)SDS are those with the highest adherence (r = -0.230, P = 0.017) and achieve a higher HV gain in the first year (r = -0.499, P = 0.000). At first year, IoR1 is associated with a higher heightSDS (r = 0.573, P = 0.000), HVSDS (r = 0.615, P = 0.000), heightSDS in the 2ºyear (r = 0.581, P = 0.000) and higher HVSDS 2ºyear (r = 0.398, P = 0.000). More adherence during the first year correlates to higher HV during the first year, compared to the previous one at the beginning (HV1-HV0) (r = 0.182, P = 0.04), and a better adherence and IoR2 persist the 2ºyear (r = 0.836, P = 0.000, r = 0.246, P = 0.01, respectively). Patients with an adherence>90% during the first year, have more frequently a HV>1SDS (P = 0.025) and higher heightSDS (P = 0.003) and height-gainSDS (P = 0.000). In the 2ºyear, a higher IoR1 correlates to heightSDS (r = 0.581, P = 0.000) and the HVSDS (r = 0.398, P = 0.000). A higher heightSDS in the first year correlates to higher heightSDS the 2ºyear (r = 0.887, P = 0.000) a higher IoR2, heightSDS (r = 0.201, P = 0.035) and HVSDS (r = 0.401, P = 0.000). Adherence during the 2ºyear is better in those with higher HV1-HV0 (r = 0.201, P = 0.035), better adherence the first year (r = 0.836, P = 0.000), and in those with a higher IoR2 (r = 0.298, P = 0.002). There is a positive correlation between the educational level of the father and mother and adherence the first (r = 0.031, P = 0.006, r = 0.21, P = 0.04, respectively) and the 2ºyear (r = 0.35, P = 0.00, r = 0.24, P = 0.03, respectively). In patients with GHD, every 10% loss of adherence means a loss of HV of 1.1cm/year, being 0.6cm/year for SGA patients. Adherence could explain 33.4% of the response to treatment with GHD, while if we include the total number of patients in the study, it could explain 38.8%.

Conclusions: Adherence is a determining parameter in the response to treatment with GH; a value> 90% is estimated as optimal for a better response the first year of treatment, and >85% the second. The percentage of adherence is higher in those patients with greater growth restriction at the beginning and remains high in those with higher HV.