Objectives: Aim of this study was to assess the reliability and the usefulness of a web-hosted software based on a growth prediction model (iGRO) as tool of treatment modulation and compliance evaluation in GH deficient children treated with human recombinant GH. Methods: Target height, birth weight, height, weight, pubertal stage, maximum GH response, bone age and GH dose of 32 children (23 boys) aged 9.34(5.9) years with GH deficiency, were recorded on iGRO before and during GH treatment. We perform the statistical evaluation through single and multiple regression analysis. The data are reported as median (IQR). Results: First year height velocity was positively correlated to body weight (p<0.05), GH dose (p<0.02) and growth response in the second (p<0.01) and in the third year (p-value <0.01) of therapy. Thanks to the software, height velocity prediction (HVP) during the years of therapy, and the index of responsiveness (IoR) were obtained only in 16 pre-pubertal patients. In the other 16 patients HVP and IoR was not available because they start puberty during the first year of treatment. Growth response matched the predicted in most of the patients (p<0.002). Only two children had a IoR outside the normal range (-1.28;+1.28). In the first case a IoR of +1,88 suggested a patient high responder to GH, in the second a IoR of -1.61 was suspicious of non-compliance. Conclusions: Since there is a high individual variability in the response to GH treatment, clinicians need to use prediction models in daily clinical practice. The experience conducted in our clinic shows that iGRO is a simple, useful, easy available device that allows to correctly start, monitor and improve GH treatment with a better outcome on final height.
IGRO A NEW MEDICAL SOFTWARE TO IMPROVE GH TREATMENT IN CHILDREN WITH GH DEFICIENCY: A STUDY BASED ON ITS DAILY USE IN CLINICAL PRACTICE
Simoncini DInvestigation
;FUMAGALLI, LETIZIA ANGELAInvestigation
;Deiana MMethodology
;Cardani RMethodology
;BIASOLI, ROBERTAMethodology
;Salvatoni AConceptualization
2017-01-01
Abstract
Objectives: Aim of this study was to assess the reliability and the usefulness of a web-hosted software based on a growth prediction model (iGRO) as tool of treatment modulation and compliance evaluation in GH deficient children treated with human recombinant GH. Methods: Target height, birth weight, height, weight, pubertal stage, maximum GH response, bone age and GH dose of 32 children (23 boys) aged 9.34(5.9) years with GH deficiency, were recorded on iGRO before and during GH treatment. We perform the statistical evaluation through single and multiple regression analysis. The data are reported as median (IQR). Results: First year height velocity was positively correlated to body weight (p<0.05), GH dose (p<0.02) and growth response in the second (p<0.01) and in the third year (p-value <0.01) of therapy. Thanks to the software, height velocity prediction (HVP) during the years of therapy, and the index of responsiveness (IoR) were obtained only in 16 pre-pubertal patients. In the other 16 patients HVP and IoR was not available because they start puberty during the first year of treatment. Growth response matched the predicted in most of the patients (p<0.002). Only two children had a IoR outside the normal range (-1.28;+1.28). In the first case a IoR of +1,88 suggested a patient high responder to GH, in the second a IoR of -1.61 was suspicious of non-compliance. Conclusions: Since there is a high individual variability in the response to GH treatment, clinicians need to use prediction models in daily clinical practice. The experience conducted in our clinic shows that iGRO is a simple, useful, easy available device that allows to correctly start, monitor and improve GH treatment with a better outcome on final height.
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