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

## TL;DR

This study shows that children on growth hormone treatment using a connected auto-injector have better adherence and growth outcomes when they start treatment at a younger age.

## Contribution

The study provides new insights into adherence patterns and growth outcomes in children using a connected auto-injector for GH treatment across different age groups and conditions.

## Key findings

- High adherence was maintained by 85% of patients throughout treatment.
- Younger children (mean age 6.3 years) had significantly higher adherence (91%) compared to older children (mean age 13.1 years, 83%).
- High adherence correlated with greater height SD score gains after two years of treatment.

## Abstract

Adherence to recombinant GH treatment is crucial to achieve optimal adult height in children with growth disorders. Information on factors responsible for differences in adherence and growth in different countries is limited.

To evaluate adherence and catch-up growth in children receiving GH using Easypod® auto-injectors.

Retrospective cohort analysis of adherence and height, from 481 children (55% boys) in 19 centers in France, from the Growzen® Connect database, from mid-2018 to end-2023. Adherence was classified as high (≥85% of injections) or medium/low (<85%). Gain in height SD score (HSDS) was evaluated after 1 and 2 years of GH treatment.

High adherence was maintained throughout for 85% of patients. Among children who started young (mean age 6.3 years), 91% had high adherence over the first 2 years, significantly more than the 83% among those starting older (13.1 years) (P = .039). HSDS gain at 2 years for children with GH deficiency and born small for gestational age was +1.1 and +1.0, respectively, for children who started young and +0.6 and +0.6 for those starting older (P = .001 and.032, respectively), with no difference between disorders (P > .5). For children with high adherence, 2-year HSDS gain was significantly higher than for children with lower adherence (0.8 vs +0.5, P = .030).

Children using Easypod exhibit high adherence, which aids clinical decision-making and patient engagement. Adherence and catch-up growth decrease with age. Indication for GH treatment had little impact, but overall catch-up growth was significantly greater with high adherence.