SUN-260 The Severity of GH Deficiency (GHD) Does Not Affect Adherence to Treatment in GHD Prepubertal Children Taking rh-GH via the Easypod Device

Abstract

Introduction: The success of GH therapy, as in other chronic conditions, depends on the patient’s ability to maximally adhere to their treatment regimen. Low adherence to GH therapy has been reported in several studies, and shown to be correlated with age, socioeconomic status, treatment duration, the use of an injection device among others, although data are controversial. Recent studies have shown that GH deficient (GHD) patients naïve to treatment have better adherence rates than non-naïve ones, while no data exist on the effect of the severity of GHD on adherence to treatment. The Easypod Connect Observational Study (ECOS) is a prospective long-term observational study involving 24 countries aimed at evaluating the level of adherence in patients receiving growth hormone via the Easypod device. The Easypod device allows an automatic objective measure of adherence over time. The ECOS database provides adherence rates of a large number of patients receiving growth hormone via the Easypod device. Objective: to compare adherence to GH treatment in patients with high likelihood of being severe GHD (SGHD) with a group of non-severe GHD (NSGHD). Patients and methods: The group of SGHD included 17 naïve GHD prepubertal (aged 2 to 10 y in girls and 2 to 12 y in boys) patients (13 boys and 4 girls) with organic or genetic or congenital GHD. All had height-SDS <-2.5 at start of treatment and/or first year change in height >0.5 standard deviation score (SDS). The group of NSGHD included 49 naïve to treatment prepubertal (35 boys and 14 girls) with idiopathic GHD, and height SDS ≥-2.5 at start of treatment. After 2 and 3 y of treatment, respectively 15 and 12 patients were available in the SGHD group, and 37 and 22 in the NSGHD group. Differences in adherence rates between the groups were tested with the unpaired two-samples Wilcoxon test. Results: Mean (SD) height SDS at start was -2.7 (1.4) in SGHD and -2.1 (0.3) in NSGHD, and mean (SD) first year change in height SDS was 0.9 (0.5) in SGHD and 0.6 (0.3) in NSGHD. Adherence rates in the first three years of treatment were not significantly different (p>.1) between the two groups with medians of 92%, 88%, and 95% respectively in SGHD, and 93%, 90%, and 92% respectively in NSGHD. Conclusions: Our data confirm that naïve GHD children receiving GH treatment with the Easypod device have a good adherence to treatment up to three years. Our findings also show that the severity of GHD does not seem to affect adherence to treatment in prepubertal children.