title: Early cessation and non-response are important and possibly related problems in growth hormone therapy: An OZGROW analysis.
abstract: 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).
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Mater Research, University of Queensland Institute, OZGROW - APEG, South Brisbane, QLD, Australia. Electronic address: i.hughes@uq.edu.au.
authors.forename: Ian P
authors.initials: IP
authors.lastname: Hughes
authors.affiliation: Princess Margaret Hospital for Children, Endocrinology, Subiaco, WA, Australia; The University of Western Australia, School of Paediatrics and Child Health Crawley, WA, Australia.
authors.forename: Catherine
authors.initials: C
authors.lastname: Choong
authors.affiliation: The University of Western Australia, School of Paediatrics and Child Health Crawley, WA, Australia.
authors.forename: Shoshana
authors.initials: S
authors.lastname: Rath
authors.affiliation: The University of Western Australia, School of Paediatrics and Child Health Crawley, WA, Australia.
authors.forename: Helen
authors.initials: H
authors.lastname: Atkinson
authors.affiliation: Lady Cilento Children's Hospital, Endocrinology, South Brisbane, QLD, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Cotterill
authors.affiliation: Liggins Institute, University of Auckland, Auckland, New Zealand.
authors.forename: Wayne
authors.initials: W
authors.lastname: Cutfield
authors.affiliation: Liggins Institute, University of Auckland, Auckland, New Zealand.
authors.forename: Paul
authors.initials: P
authors.lastname: Hofman
authors.affiliation: Lady Cilento Children's Hospital, Endocrinology, South Brisbane, QLD, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Harris
mesh_terms: D000293:Adolescent; D001315:Australia; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D006130:Growth Disorders / Q000188:drug therapy*; D019382:Human Growth Hormone / Q000172:deficiency / Q000627:therapeutic use*; D006801:Humans; D007018:Hypopituitarism / Q000188:drug therapy*; D008297:Male; D055118:Medication Adherence; D012923:Social Class; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome; D014424:Turner Syndrome / Q000188:drug therapy*
chemical_list: D019382:Human Growth Hormone
keywords: Growth disorders; Growth hormone treatment cessation; Growth hormone treatment persistence; Growth hormone treatment response