Adherence to growth hormone treatment in the transition age: A prospective observational multicenter study

Adherence can be an issue in patients taking growth hormone (GH).

To evaluate adherence to GH treatment during the transition age in patients with permanent childhood-onset GH deficiency (COGHD).

This is a prospective, multicenter, observational study conducted across 9 European centers. Fifty-one patients aged 15 to 25 years with permanent COGHD, who had reached final height and continued recombinant human GH (0.003-0.02 mg/kg/day), were monitored for 12 months using the Easypod™ device, which provides objective adherence data. Anthropometry, total cholesterol, low- and high-density lipoprotein cholesterol, and insulin-like growth factor 1 (IGF-1) standard deviation score (SDS) were measured at baseline and after 1 year. Patients with ≥9 months of adherence data (n = 41) were analyzed.

Twenty-six patients (63%, 16 males) had optimal adherence (≥85%, median, 98%; interquartile range, 91-99%), and 15 (37%, 11 males) had suboptimal adherence (<85%, median, 70%; interquartile range, 47-80%). At baseline, suboptimal adherent patients had greater mean waist circumference (89.2 vs 78.2 cm) and lower mean IGF-1 SDS (-2.2 vs -1.5). After 1 year mean waist circumference (84.8 vs 76.7 cm), mean total cholesterol (185.1 vs 167.0 mg/dL), and mean LDL (111.6 vs 98.5) were higher in the suboptimal adherent group, whereas mean IGF-1 SDS was lower (-1.1 vs -0.2). The mean change in IGF-1 SDS after 1 year was +1.4 vs +0.9 in the 2 groups.

Over 1/3 of patients with permanent COGHD during transition show suboptimal adherence to GH therapy, associated with adverse metabolic markers and persistently lower IGF-1 levels. These findings highlight the importance of adherence monitoring and support targeted interventions to optimize long-term outcomes.