Identification of factors associated with good response to growth hormone therapy in children with short stature: results from the ANSWER Program®

Abstract

Objective: To identify factors associated with growth in children on growth hormone (GH) therapy using data from the American Norditropin Studies: Web-enabled Research (ANSWER) Program® registry.

Methods: GH-naïve children with GH deficiency, multiple pituitary hormone deficiency, idiopathic short stature, Turner syndrome, or a history of small for gestational age were eligible (N = 1,002). Using a longitudinal statistical approach, predictive factors were identified in patients with GHD for change from baseline in height standard deviation score (ΔHSDS) following 2 years of treatment.

Results: Gradual increases in ΔHSDS over time were observed for all diagnostic categories. Significant predictive factors of ΔHSDS, ranked by significance were: height velocity (HV) at 4 months > baseline age > baseline HSDS > baseline body mass index (BMI) SDS > baseline insulin-like growth factor I (IGF-I) SDS; gender was not significant. HV at 4 months and baseline BMI SDS were positively correlated, whereas baseline age, HSDS, and IGF-I SDS were negatively correlated with ΔHSDS.

Conclusions: These results may help guide GH therapy based on pretreatment characteristics and early growth response.

Figure 1

Height velocity for all diagnostic categories over time.

Figure 2

First-year change from baseline HSDS and height velocity vs baseline age for patients with GHD (A, Change in baseline HSDS in male patients with GHD; B, Change in baseline HSDS in female patients with GHD; C, Change in height velocity in male patients with GHD; D, Change in height velocity in female patients with GHD).