ECEESPE2025 Poster Presentations Growth Axis and Syndromes (91 abstracts)
Prevalence and growth pattern of poor long-term responders to gh therapy in prepubertal short children born small for gestational age: real life data from them belgian-luxembourgish registry BELGROW
Becker Marianne 1 , Beckers Dominique 2 , Elise Nauwynck 3 , Marieke Den Brinker 4 , Cecile Brachet 5 , Claudine Heinrichs 5 , Lysy Philippe 6 , Anne Rochtus 7 , Saskia Van der Straaten 8 , Koen Huysentruyt 3 , Thomas Muriel 9 & Jean De Schepper 3 10 11
1Centre hospitalier de Luxembourg, Luxembourg, Luxembourg; 2UCLouvain, CHU UCL Namur, Yvoir, Belgium; 3University Hospital of Brussels, Brussels, Belgium; 4University Hospital Antwerp, Edegem, Belgium; 5Université libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (H. U. B), Hôpital Universitaire des Enfants Reine Fabiola (HUDERF), Brussels, Belgium; 6UCLouvain, Brussels, Belgium; 7University Hospitals Leuven, KU Leuven, Leuven, Belgium; 8Ghent University Hospital, Ghent, Belgium; 9The BELUX Society for Pediatric Endocrinology and Diabetology (BELSPEED), Brussels, Belgium; 10UZ Brussel, Pediatric Endocrinology, Brussels; 11UZ Brussel, Pediatric Endocrinology, Jette
JOINT1771
Background: GH therapy increases adult height in short small for gestational age (SGA) children, especially when started before puberty, but with high variability in height gain. The aim of this study was to describe the prevalence and the growth pattern of poor long-term responders to GH therapy in a real-life setting.
Methods: SGA (birth weight and/or length for gestational age < - 2 SDS) children, starting GH therapy after the age of 4 years and before onset of puberty with an initial height SDS < -2. 5 and < -1 when adjusted for mid parental height (MPH) SDS, having reached near adult height (NAH) (height velocity increase < 1 cm/6 months) were selected from the BELGROW database.
Results: 182 (100 male) patients were analyzed. Median (Q1;Q3) age at start of GH therapy was younger in females (8. 8 (6. 3; 10. 8) than in males 9. 1 (6. 6;11. 6) years; P = 0. 188), but treatment duration was longer in males (7. 1 (5. 4;9. 7) than in females 6. 1 (4. 7;8. 3) years; P < 0. 05). Median height SDS at start of treatment (-3. 00 (-3. 44;-2. 75)), GH dose (0. 037 (0. 034;0. 042) mg/kg/day), NAH SDS for chronological age (-1. 88 (-2. 40;-1. 35)) and corrected for MPH (-0. 61 (-1. 21;-0. 19)) as well as total SDS height gain (1. 25 (0. 84;1. 76)) were similar in males and females. At NAH, 63% (114; 59 male) of patients remained short (SDS calculated for age 21 years < -2), 49% (89; 50 male) were below target height (NAH SDS corrected for MPH < -1) and 15% (28; 14 male) had a poor total height gain (total height SDS increase < 0. 5). In total, 18% (32; 15 male) of patients had a poor initial growth (height SDS increase < 0. 3 during the first year of therapy), while 22% (40; 19 male) had a poor growth during puberty (height SDS decrease during puberty > 0. 3). Of the 28 patients with a poor total height gain SDS, 7 (25 %) had a poor initial growth and 10 (36 %) had a poor pubertal height gain.
Conclusion: Despite prepubertal start of GH therapy, 63% of short SGA patients did not reach an adult height >-2SDS. Either a poor initial growth response or an impaired pubertal growth spurt were observed in more than half of SGA patients with a poor long-term height gain. These findings highlight the need for a more rigorous diagnostic re-evaluation, a swifter GH dose adaptation and a regular assessment of non-adherence.
Volume 110
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Endocrine Abstracts
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