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Is insulin-like growth factor-I a good marker for treatment adherence in growth hormone deficiency in adulthood?

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http://pubman.mpdl.mpg.de/cone/persons/resource/persons127670

Auer,  Matthias K.
Clinical Research, Max Planck Institute of Psychiatry, Max Planck Society;

http://pubman.mpdl.mpg.de/cone/persons/resource/persons172989

Stieg,  Mareike R.
Clinical Research, Max Planck Institute of Psychiatry, Max Planck Society;

http://pubman.mpdl.mpg.de/cone/persons/resource/persons80539

Stalla,  Günter K.
Clinical Research, Max Planck Institute of Psychiatry, Max Planck Society;

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Auer, M. K., Stieg, M. R., Hoffmann, J., & Stalla, G. K. (2016). Is insulin-like growth factor-I a good marker for treatment adherence in growth hormone deficiency in adulthood? CLINICAL ENDOCRINOLOGY, 84(6), 862-869. doi:10.1111/cen.13030.


Cite as: http://hdl.handle.net/11858/00-001M-0000-002B-72CE-9
Abstract
ObjectiveThere is a paucity of studies on adherence to growth hormone treatment in growth hormone deficient (GHD) adults. Therefore, this study reports on adherence to GH-replacement therapy in adults with GHD, with a special focus on the course and potential predictors of nonadherence. DesignRetrospective single-centre cohort study. PatientsFrom the local patient database, 179 suitable patients with GHD were identified. MeasurementsThe primary outcome was adherence assessed by calculating the percentage of available prescription data in comparison with recommended GH dosages over a mean follow-up period of 924 months. Patients were categorized into five adherence categories ranging from <20% to >80%. ResultsMean overall adherence was 740%, with 529% of patients falling into the adherence group of >80% and 88% of <20%. There was a significant drop in adherence (98%) between the first and second years of treatment (P < 0001). Patients with childhood-onset GHD were significantly less adherent to GH treatment than patients with adult-onset GHD (620% vs 770%, P = 0012); however, this finding was no longer significant after including age as a covariate. Frequency of IGF-1 levels lying outside the age- and sex-specific reference range was not a good indicator for adherence. ConclusionAlthough overall adherence was relatively high in our study sample, there is a significant amount of patients who should be regarded as nonadherent. This applies in particular to younger patients. Treating physicians should be aware of the fact that IGF-1 levels do not seem to be a good indicator for adherence.