Early cessation and non-response are important and possibly related problems in growth hormone therapy: An OZGROW analysis

Objective: To investigate growth hormone (GH) treatment and treatment cessation with respect to efficacy and efficiency. To identify factors that best classify or predict cessation type: completed treatment (CT), early cessation (EC), or non-response (NR). Design: Observational study (1990-2013) of...

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Main Authors: Hughes, I., Choong, C., Rath, S., Atkinson, Helen, Cotterill, A., Cutfield, W., Hofman, P., Harris, M.
Format: Journal Article
Published: 2016
Online Access:http://hdl.handle.net/20.500.11937/68051
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author Hughes, I.
Choong, C.
Rath, S.
Atkinson, Helen
Cotterill, A.
Cutfield, W.
Hofman, P.
Harris, M.
author_facet Hughes, I.
Choong, C.
Rath, S.
Atkinson, Helen
Cotterill, A.
Cutfield, W.
Hofman, P.
Harris, M.
author_sort Hughes, I.
building Curtin Institutional Repository
collection Online Access
description Objective: To investigate growth hormone (GH) treatment and treatment cessation with respect to efficacy and efficiency. To identify factors that best classify or predict cessation type: completed treatment (CT), early cessation (EC), or non-response (NR). Design: Observational study (1990-2013) of the Australian GH Program comparing CT, EC, and NR groups with respect to demographic, clinical, and response criteria. All patients treated for GH deficiency (GHD; 909), short stature and slow growth (SSSG; 2144), and Turner Syndrome (TS; 626) were included. Information was retrieved from the OZGROW database. Results: 51.9% of patients were EC, 40.7% CT and 7.4% NR.Median treatment durations for NR patients were often longer than patients who completed treatment. EC and NR groups were both associated with poor growth response with males overrepresented.Socioeconomic status differentiated NR (higher) and EC (lower) groups. Conclusions: EC was observed at very high rates and appears, generally, to be a little-recognised but frequent problem in GH therapy.EC and delayed recognition of NR may be interrelated being differentiated by the decision to cease or continue treatment following poor response.Poor treatment compliance is likely a major causal factor in EC.Strategies to address poor response and compliance have been developed, however, given the scale of these problems, it may be that long acting GH formulations or individualized treatment need consideration.
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spelling curtin-20.500.11937-680512018-08-07T03:41:03Z Early cessation and non-response are important and possibly related problems in growth hormone therapy: An OZGROW analysis Hughes, I. Choong, C. Rath, S. Atkinson, Helen Cotterill, A. Cutfield, W. Hofman, P. Harris, M. Objective: To investigate growth hormone (GH) treatment and treatment cessation with respect to efficacy and efficiency. To identify factors that best classify or predict cessation type: completed treatment (CT), early cessation (EC), or non-response (NR). Design: Observational study (1990-2013) of the Australian GH Program comparing CT, EC, and NR groups with respect to demographic, clinical, and response criteria. All patients treated for GH deficiency (GHD; 909), short stature and slow growth (SSSG; 2144), and Turner Syndrome (TS; 626) were included. Information was retrieved from the OZGROW database. Results: 51.9% of patients were EC, 40.7% CT and 7.4% NR.Median treatment durations for NR patients were often longer than patients who completed treatment. EC and NR groups were both associated with poor growth response with males overrepresented.Socioeconomic status differentiated NR (higher) and EC (lower) groups. Conclusions: EC was observed at very high rates and appears, generally, to be a little-recognised but frequent problem in GH therapy.EC and delayed recognition of NR may be interrelated being differentiated by the decision to cease or continue treatment following poor response.Poor treatment compliance is likely a major causal factor in EC.Strategies to address poor response and compliance have been developed, however, given the scale of these problems, it may be that long acting GH formulations or individualized treatment need consideration. 2016 Journal Article http://hdl.handle.net/20.500.11937/68051 10.1016/j.ghir.2016.04.006 restricted
spellingShingle Hughes, I.
Choong, C.
Rath, S.
Atkinson, Helen
Cotterill, A.
Cutfield, W.
Hofman, P.
Harris, M.
Early cessation and non-response are important and possibly related problems in growth hormone therapy: An OZGROW analysis
title Early cessation and non-response are important and possibly related problems in growth hormone therapy: An OZGROW analysis
title_full Early cessation and non-response are important and possibly related problems in growth hormone therapy: An OZGROW analysis
title_fullStr Early cessation and non-response are important and possibly related problems in growth hormone therapy: An OZGROW analysis
title_full_unstemmed Early cessation and non-response are important and possibly related problems in growth hormone therapy: An OZGROW analysis
title_short Early cessation and non-response are important and possibly related problems in growth hormone therapy: An OZGROW analysis
title_sort early cessation and non-response are important and possibly related problems in growth hormone therapy: an ozgrow analysis
url http://hdl.handle.net/20.500.11937/68051