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Adherence and Growth Outcomes in a Large Cohort of Children Treated With Recombinant GH Using a Connected

Michel Polak1,2, Natacha Bouhours-Nouet3, Paula van Dommelen4

  • 1Department of Pediatric Endocrinology, Diabetology and Gynecology, Hôpital Universitaire Necker Enfants Malades, Centre des Maladies Endocriniennes Rares de la Croissance et du Développement, Assistance Publique Hôpitaux de Paris, Paris 75015, France.

Journal of the Endocrine Society
|November 13, 2025
PubMed

Insights

High adherence to recombinant growth hormone (GH) treatment in children using auto-injectors is linked to better growth outcomes. Early treatment initiation significantly improves adherence and catch-up growth, highlighting the importance of timely intervention.

Area of Science:

  • Pediatric Endocrinology
  • Growth Hormone Therapy
  • Patient Adherence

Background:

  • Recombinant growth hormone (GH) treatment is vital for achieving optimal adult height in children with growth disorders.
  • Limited data exist on factors influencing adherence and growth outcomes across different countries.

Purpose of the Study:

  • To evaluate treatment adherence and catch-up growth in pediatric patients receiving GH therapy via Easypod® auto-injectors.
  • To identify factors affecting adherence and growth in children undergoing GH treatment.

Main Methods:

  • Retrospective cohort analysis of 481 children (55% boys) from 19 French centers (mid-2018 to end-2023) using the Growzen® Connect database.
  • Adherence classified as high (≥85% injections) or medium/low (<85%).
  • Height standard deviation score (HSDS) gain evaluated after 1 and 2 years of GH treatment.

Main Results:

  • 85% of patients maintained high adherence throughout the study period.
  • Children initiating GH treatment at a younger age (mean 6.3 years) showed significantly higher adherence (91%) compared to older starters (13.1 years, 83%; P=.039).
  • Two-year HSDS gain was significantly greater in children with high adherence (+0.8) versus lower adherence (+0.5; P=.030), and more pronounced in younger starters for GH deficiency and SGA children (+1.1/+1.0 vs +0.6/+0.6).

Conclusions:

  • The Easypod® auto-injector facilitates high adherence in children receiving GH treatment, supporting clinical decisions and patient engagement.
  • Adherence and subsequent catch-up growth diminish with increasing age at treatment initiation.
  • While the indication for GH treatment had minimal impact, high adherence consistently correlated with significantly greater catch-up growth.
Abstract

Keywords:
adherencecatch-up growthconnected auto-injectorgrowth hormone deficiencysmall for gestational age

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