Association of Daily Growth Hormone Injection Adherence and Height Among Children With Growth Hormone Deficiency

Jane Loftus; Bradley S. Miller; Craig S. Parzynski; Jose Alvir; Yong Chen; Priti Jhingran; Anu Gupta; Mitch DeKoven; Victoria Divino; Jenny Tse; Jing He; Michael Wajnrajch

doi:10.1016/j.eprac.2022.02.013

Association of Daily Growth Hormone Injection Adherence and Height Among Children With Growth Hormone Deficiency

Jane Loftus, Bradley S. Miller, Craig S. Parzynski, Jose Alvir, Yong Chen, Priti Jhingran, Anu Gupta, Mitch DeKoven, Victoria Divino, Jenny Tse, Jing He, Michael Wajnrajch

Pediatrics - Endocrine and Diabetes

Research output: Contribution to journal › Article › peer-review

11 Scopus citations

Abstract

Objective: Recombinant human growth hormone (somatropin) is recommended for children with growth hormone deficiency (GHD) to normalize adult height. Prior research has indicated an association between adherence to somatropin and height velocity. Further research is needed using real-world data to quantify this relationship; hence the objective of this study was to investigate the association between adherence to somatropin and change in height among children with GHD. Methods: This retrospective cohort study included patients in the IQVIA PharMetrics Plus and Ambulatory Electronic Medical Records databases aged 3 to 15 years, with ≥1 GHD diagnosis code claim and newly initiated on somatropin between January 1, 2007 and November 30, 2019. Adherence was measured over the follow-up using the medication possession ratio (MPR); patients were classified as adherent (MPR ≥ 0.8) or nonadherent (MPR < 0.8). Results: Among 201 patients initiated on somatropin, 74.6% were male, mean age was 11.4 years, and the mean follow-up was 343.3 days. Approximately 76.6% of patients were adherent to somatropin over the follow-up period. Adjusted growth trajectories were similar between adherent and nonadherent patients pre-treatment initiation (P =.15). Growth trajectories post-initiation were significantly different (P =.001). On average, adherent patients gained an additional 1.8 cm over 1 year compared with nonadherent patients, adjusted for covariates. Conclusion: Greater adherence to somatropin therapy is associated with improved height velocity. As suboptimal adherence to daily somatropin therapy is an issue for children with GHD, novel strategies to improve adherence may improve growth outcomes.

Original language	English (US)
Pages (from-to)	565-571
Number of pages	7
Journal	Endocrine Practice
Volume	28
Issue number	6
DOIs	https://doi.org/10.1016/j.eprac.2022.02.013
State	Published - Jun 2022

Bibliographical note

Funding Information:
This study was sponsored by Pfizer .

Funding Information:
This study was sponsored by Pfizer. J.L. J.A. Y.C. A.G. and M.W. are employees of Pfizer and report ownership of Pfizer stock. C.S.P. and P.J. are employees of Genesis Research who were paid consultants to Pfizer in connection with this research and development of this manuscript. M.D. V.D. J.T. and J.H. are employees of IQVIA and were paid consultants to Pfizer in connection with this research and development of this manuscript. B.S.M. is a consultant for Abbvie, Ascendis Pharma, BioMarin, EMD Serono, Novo Nordisk, Orchard Therapeutics, Pfizer, Sandoz, Tolmar and Vertice Pharma and has received research support from Alexion, Abbvie, Amgen, Lumos Pharma, Novo Nordisk, Opko Health, and Pfizer.

Publisher Copyright:
© 2022 AACE

Keywords

adherence
growth
height
pediatric growth hormone deficiency
somatropin

PubMed: MeSH publication types

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title = "Association of Daily Growth Hormone Injection Adherence and Height Among Children With Growth Hormone Deficiency",

abstract = "Objective: Recombinant human growth hormone (somatropin) is recommended for children with growth hormone deficiency (GHD) to normalize adult height. Prior research has indicated an association between adherence to somatropin and height velocity. Further research is needed using real-world data to quantify this relationship; hence the objective of this study was to investigate the association between adherence to somatropin and change in height among children with GHD. Methods: This retrospective cohort study included patients in the IQVIA PharMetrics Plus and Ambulatory Electronic Medical Records databases aged 3 to 15 years, with ≥1 GHD diagnosis code claim and newly initiated on somatropin between January 1, 2007 and November 30, 2019. Adherence was measured over the follow-up using the medication possession ratio (MPR); patients were classified as adherent (MPR ≥ 0.8) or nonadherent (MPR < 0.8). Results: Among 201 patients initiated on somatropin, 74.6% were male, mean age was 11.4 years, and the mean follow-up was 343.3 days. Approximately 76.6% of patients were adherent to somatropin over the follow-up period. Adjusted growth trajectories were similar between adherent and nonadherent patients pre-treatment initiation (P =.15). Growth trajectories post-initiation were significantly different (P =.001). On average, adherent patients gained an additional 1.8 cm over 1 year compared with nonadherent patients, adjusted for covariates. Conclusion: Greater adherence to somatropin therapy is associated with improved height velocity. As suboptimal adherence to daily somatropin therapy is an issue for children with GHD, novel strategies to improve adherence may improve growth outcomes.",

keywords = "adherence, growth, height, pediatric growth hormone deficiency, somatropin",

author = "Jane Loftus and Miller, {Bradley S.} and Parzynski, {Craig S.} and Jose Alvir and Yong Chen and Priti Jhingran and Anu Gupta and Mitch DeKoven and Victoria Divino and Jenny Tse and Jing He and Michael Wajnrajch",

note = "Funding Information: This study was sponsored by Pfizer . Funding Information: This study was sponsored by Pfizer. J.L. J.A. Y.C. A.G. and M.W. are employees of Pfizer and report ownership of Pfizer stock. C.S.P. and P.J. are employees of Genesis Research who were paid consultants to Pfizer in connection with this research and development of this manuscript. M.D. V.D. J.T. and J.H. are employees of IQVIA and were paid consultants to Pfizer in connection with this research and development of this manuscript. B.S.M. is a consultant for Abbvie, Ascendis Pharma, BioMarin, EMD Serono, Novo Nordisk, Orchard Therapeutics, Pfizer, Sandoz, Tolmar and Vertice Pharma and has received research support from Alexion, Abbvie, Amgen, Lumos Pharma, Novo Nordisk, Opko Health, and Pfizer. Publisher Copyright: {\textcopyright} 2022 AACE",

year = "2022",

month = jun,

doi = "10.1016/j.eprac.2022.02.013",

language = "English (US)",

volume = "28",

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journal = "Endocrine Practice",

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T1 - Association of Daily Growth Hormone Injection Adherence and Height Among Children With Growth Hormone Deficiency

AU - Loftus, Jane

AU - Miller, Bradley S.

AU - Parzynski, Craig S.

AU - Alvir, Jose

AU - Chen, Yong

AU - Jhingran, Priti

AU - Gupta, Anu

AU - DeKoven, Mitch

AU - Divino, Victoria

AU - Tse, Jenny

AU - He, Jing

AU - Wajnrajch, Michael

N1 - Funding Information: This study was sponsored by Pfizer . Funding Information: This study was sponsored by Pfizer. J.L. J.A. Y.C. A.G. and M.W. are employees of Pfizer and report ownership of Pfizer stock. C.S.P. and P.J. are employees of Genesis Research who were paid consultants to Pfizer in connection with this research and development of this manuscript. M.D. V.D. J.T. and J.H. are employees of IQVIA and were paid consultants to Pfizer in connection with this research and development of this manuscript. B.S.M. is a consultant for Abbvie, Ascendis Pharma, BioMarin, EMD Serono, Novo Nordisk, Orchard Therapeutics, Pfizer, Sandoz, Tolmar and Vertice Pharma and has received research support from Alexion, Abbvie, Amgen, Lumos Pharma, Novo Nordisk, Opko Health, and Pfizer. Publisher Copyright: © 2022 AACE

PY - 2022/6

Y1 - 2022/6

N2 - Objective: Recombinant human growth hormone (somatropin) is recommended for children with growth hormone deficiency (GHD) to normalize adult height. Prior research has indicated an association between adherence to somatropin and height velocity. Further research is needed using real-world data to quantify this relationship; hence the objective of this study was to investigate the association between adherence to somatropin and change in height among children with GHD. Methods: This retrospective cohort study included patients in the IQVIA PharMetrics Plus and Ambulatory Electronic Medical Records databases aged 3 to 15 years, with ≥1 GHD diagnosis code claim and newly initiated on somatropin between January 1, 2007 and November 30, 2019. Adherence was measured over the follow-up using the medication possession ratio (MPR); patients were classified as adherent (MPR ≥ 0.8) or nonadherent (MPR < 0.8). Results: Among 201 patients initiated on somatropin, 74.6% were male, mean age was 11.4 years, and the mean follow-up was 343.3 days. Approximately 76.6% of patients were adherent to somatropin over the follow-up period. Adjusted growth trajectories were similar between adherent and nonadherent patients pre-treatment initiation (P =.15). Growth trajectories post-initiation were significantly different (P =.001). On average, adherent patients gained an additional 1.8 cm over 1 year compared with nonadherent patients, adjusted for covariates. Conclusion: Greater adherence to somatropin therapy is associated with improved height velocity. As suboptimal adherence to daily somatropin therapy is an issue for children with GHD, novel strategies to improve adherence may improve growth outcomes.

AB - Objective: Recombinant human growth hormone (somatropin) is recommended for children with growth hormone deficiency (GHD) to normalize adult height. Prior research has indicated an association between adherence to somatropin and height velocity. Further research is needed using real-world data to quantify this relationship; hence the objective of this study was to investigate the association between adherence to somatropin and change in height among children with GHD. Methods: This retrospective cohort study included patients in the IQVIA PharMetrics Plus and Ambulatory Electronic Medical Records databases aged 3 to 15 years, with ≥1 GHD diagnosis code claim and newly initiated on somatropin between January 1, 2007 and November 30, 2019. Adherence was measured over the follow-up using the medication possession ratio (MPR); patients were classified as adherent (MPR ≥ 0.8) or nonadherent (MPR < 0.8). Results: Among 201 patients initiated on somatropin, 74.6% were male, mean age was 11.4 years, and the mean follow-up was 343.3 days. Approximately 76.6% of patients were adherent to somatropin over the follow-up period. Adjusted growth trajectories were similar between adherent and nonadherent patients pre-treatment initiation (P =.15). Growth trajectories post-initiation were significantly different (P =.001). On average, adherent patients gained an additional 1.8 cm over 1 year compared with nonadherent patients, adjusted for covariates. Conclusion: Greater adherence to somatropin therapy is associated with improved height velocity. As suboptimal adherence to daily somatropin therapy is an issue for children with GHD, novel strategies to improve adherence may improve growth outcomes.

KW - adherence

KW - growth

KW - height

KW - pediatric growth hormone deficiency

KW - somatropin

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Association of Daily Growth Hormone Injection Adherence and Height Among Children With Growth Hormone Deficiency

Abstract

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Keywords

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