Real-world data on growth hormone therapy adherence using a connected injection device and catch-up growth in children with growth disorders in Serbia

Vera Zdravkovic; Ivana Vorgucin; Sandra Stankovic; Tatjana Milenkovic; Zoran Cvetkovic; Ekaterina Koledova; Dommelen Paula van

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ESPE Abstracts (2024) 98 P2-150

ESPE2024 Poster Category 2 GH and IGFs (22 abstracts)

Real-world data on growth hormone therapy adherence using a connected injection device and catch-up growth in children with growth disorders in Serbia

Vera Zdravkovic ^1,2 , Ivana Vorgucin ^3,4 , Sandra Stankovic ^5,6 , Tatjana Milenkovic ⁷ , Zoran Cvetkovic ⁸ , Ekaterina Koledova ⁹ & Paula van Dommelen ¹⁰

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Author affiliations

¹Pediatric Endocrinology Department, University Children’s Hospital Tirsova, Belgrade, Serbia. ²University of Belgrade, Medical Faculty, Belgrade, Serbia. ³Pediatric Endocrinology Department, Institute for Healthcare of Children and Youth, Novi Sad, Serbia. ⁴University of Novi Sad, Medical Faculty, Novi Sad, Serbia. ⁵Pediatric Endocrinology Department, Pediatric Clinic at University Clinical Center, Nis, Serbia. ⁶University of Nis, Medical Faculty, Nis, Serbia. ⁷Pediatric Endocrinology Department, Institute for Healthcare of Mother and Child in Serbia ‘Dr Vukan Cupic’, Belgrade, Serbia. ⁸Global Research and Development, Fertility and Cardiometabolic and Endocrinology, Merck d.o.o., (an affiliate of Merck Healthcare KGaA, Darmstadt, Germany), Novi Beograd, Serbia. ⁹Global Medical Affairs, Cardiometabolic and Endocrinology, Merck Healthcare KGaA, Darmstadt, Germany. ¹⁰The Netherlands Organization for Applied Scientific Research TNO, Leiden, Netherlands

Background: Recombinant human growth hormone (r-hGH) therapy is an effective treatment strategy for children experiencing growth disorders. However, poor adherence to long-term r-hGH therapy can lead to suboptimal catch-up growth. Digital health solutions, such as easypod® connect ecosystem, can facilitate adherence to r-hGH therapy in these patients.

Aim: To investigate the adherence to r-hGH therapy administered via easypod® connected injection device and catch-up growth in a cohort of Serbian patients diagnosed with growth disorders.

Methods: Patients from 4 tertiary pediatric endocrinology clinics in Serbia, aged 2–17 years at treatment initiation and <18 years were included in this study. Adherence data (up to 48 months) and height data (up to 18 months) were extracted from easypod® connect ecosystem for a period between December 2015─2023. Adherence was categorised as optimal (≥85%) or suboptimal (<85%) and catch-up growth (Δ height standard deviation score [HSDS]) was estimated.

Results: The analysis included data from 404 patients with adherence information and 330 patients with 939 height measurements. Healthcare professionals (HCPs) documented 784 measurements, while patients or caregivers recorded the remaining 155 measurements using the Growzen™ Buddy smartphone app. Mean (SD) age at treatment initiation was 10.6 (3.6) years and mean (SD) baseline HSDS was −1.8 (0.6). Proportion of patients with optimal adherence was 90.1% in the first year (n = 364/404), 85.5% in the second year (n = 219/256), 85.6% in the third year (n = 161/188) and 82.5% in the fourth year (n = 94/114). Overall, proportion of optimal adherence was slightly higher in females (89.3%) than in males (87.2%), and in patients who initiated treatment before puberty (defined as <10 years for females and <12 years for males) (90.7%) versus those who initiated treatment after puberty (85.2%). However, these sex and pubertal status differences were not statistically significant (P = 0.7 and P = 0.1, respectively). Proportion of optimal adherence was significantly higher in patients who measured their height at home and entered this in the app (96.4%, n = 81/84) versus those who did not (85.3%, n = 210/246) (P = 0.01). Mean ΔHSDS was 0.30 after 6 months and 0.54 after 12 months of treatment.

Conclusion: This study demonstrated high adherence rates to r-hGH therapy delivered via easypod® connected injection device. Remarkably, adherence remained optimal over the first 4 years of treatment. Patients who used the Growzen™ Buddy smartphone app for height measurements at home exhibited the highest adherence rates.