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Adherence to recombinant human growth hormone therapy in children: influencing factors and clinical implications

Wenjing Chang¹, Hua Jin², Qin Zhou²

¹Department of Child Health Care, The Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Nanjing Medical University, Suzhou, China.

Frontiers in Pediatrics

|September 18, 2025

Insights

Adherence to recombinant human growth hormone (rhGH) therapy in children is high overall, especially with long-acting formulations. Factors like age and growth deficit severity influence adherence, with longer treatment potentially decreasing it.

Area of Science:

Pediatric Endocrinology
Pharmacotherapy Adherence
Growth Hormone Therapy

Background:

Adherence to recombinant human growth hormone (rhGH) therapy is critical for children with growth disorders.
Non-adherence poses a significant challenge to treatment efficacy and patient outcomes.
Understanding adherence patterns and influencing factors is essential for optimizing pediatric growth disorder management.

Purpose of the Study:

To evaluate adherence rates to rhGH therapy in pediatric patients.
To identify key factors influencing rhGH therapy adherence.
To explore strategies for improving rhGH therapy adherence in children.

Main Methods:

Retrospective analysis of 8,621 pediatric patients receiving rhGH therapy in China.
Adherence assessed by the proportion of prescribed doses taken (good adherence ≥86%).
Logistic regression used to analyze factors including age, GH formulation, treatment duration, and region.

Main Results:

Overall mean adherence rate was 92%.
Long-acting GH formulations showed higher adherence (94%) than daily injections (91%).
Older children, those with severe growth deficits, and specific regions demonstrated better adherence; longer treatment duration correlated with decreased adherence.

Conclusions:

rhGH therapy adherence is multifactorial, influenced by GH formulation, patient age, growth deficit severity, treatment duration, and regional differences.
Long-acting GH formulations significantly enhance adherence.
Tailored interventions are crucial for sustained adherence and optimal treatment outcomes.

Read full analysis

Abstract

Background:

Adherence to recombinant human growth hormone (rhGH) therapy is crucial for achieving optimal outcomes in children with growth disorders. However, non-adherence remains a significant challenge, affecting treatment efficacy and patient prognosis. This study evaluates adherence rates to rhGH therapy in pediatric patients, identifies key influencing factors, and explores strategies to improve adherence.

Methods:

A retrospective analysis was conducted on 8,621 pediatric patients receiving rhGH therapy in China. Adherence was assessed by the proportion of prescribed doses taken, with good adherence defined as ≥86%. Factors influencing adherence were analyzed using logistic regression models, considering variables such as age, GH formulation type, treatment duration, and regional differences.

Results:

The overall mean adherence rate was 92%, with long-acting GH formulations associated with significantly higher adherence than daily GH injections (94% vs. 91%, p < 0.001). Older children (12-18 years) exhibited better adherence than younger age groups. Patients with severe growth deficits (≤P3 percentile) showed higher adherence than those with moderate deficits. Longer treatment duration was linked to decreased adherence. Regional differences were observed, with patients from Northern Jiangsu demonstrating better adherence than those from Southern Jiangsu.

Conclusion:

Adherence to rhGH therapy is influenced by multiple factors, including GH formulation, age, severity of growth deficit, treatment duration, and regional disparities. Long-acting GH formulations significantly improve adherence. Tailored interventions, such as parental education, digital adherence monitoring, and personalized support programs, are essential to sustain long-term adherence and optimize treatment outcomes.

Keywords:

adherence growth disorders influencing factors pediatric patients recombinant human growth hormone

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