medwireNews: Real-time data on treatment adherence show its importance for good growth outcomes in patients taking recombinant human growth hormone (GH).

Ekaterina Koledova (Merck Serono SA, Darmstadt, Germany) and colleagues made use of data from 1190 patients in the easypod™ connect observational study (ECOS), a register of patients using the easypod GH injection device (Merck Serono SA) in real-world practice.

“No other large-scale patient registries have provided comparable insights into patient adherence to GH treatment”, the researchers observe in Endocrine Connections.

The easypod device records the date, time and dose every time GH is delivered, providing objective and complete data on patient treatment adherence. The team’s analysis of these data confirms the importance of adherence for good growth outcomes; adherence significantly correlated with change in height and height standard deviation score (SDS) and with height velocity and height velocity SDS.

This supports the concept “that adherence is a necessary contributor to an adequate clinical response to GH treatment,” say the researchers, adding that their findings show “the clinical relevance of monitoring adherence.”

All patients in the study had at least 3 months of easypod data available. They were aged a median of 10 years, and the indication for GH treatment was GH deficiency in 74.6%, being born small for gestational age in 17.2%, Turner syndrome in 6.8% and other indications in the remaining 1.4%.

Baseline height SDS in the cohort overall was –2.23 and this improved by 0.47 during the first year of treatment. Median height velocity was 8.2 cm/year and height velocity SDS was 2.11. Among the 606 patients who were GH-naïve, baseline height SDS was –2.26, which improved by 0.50 during the first year, with the best results seen in patients with organic GH deficiency.

During the first year, the median adherence rate was 93.7%, report the researchers, who stress that “[a]ctive interventions to manage adherence were not a part of this study, owing to its observational design.”

They found that adherence declined in later years, to 87.2% and 70.2% after 3 and 5 years of follow-up, respectively. The proportion of patients with at least 80% adherence was 79.0% during the first year, declining to 28.0% after 5 years.

Eleanor McDermid

Endocr Connect 2018; doi:10.1530/EC-18-0172

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