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The Easypod\u2122 connect device delivers pre-set doses of recombinant human GH (r-hGH) and stores a digital record of adherence that can be shared with healthcare provider. We assessed adherence to r-hGH delivered with Easypod\u2122 according to the approved pediatric indications for r-hGH: growth hormone deficiency (GHD), born small for gestational age (SGA) who failed to show catch-up growth and Turner syndrome (TS).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>ECOS (NCT01555528) was a multicenter (24 countries), 5-year, longitudinal, observational study, which aimed to evaluate country-specific adherence to r-hGH therapy prescribed via the Easypod\u2122 electronic injection device. The primary endpoint was yearly adherence. Secondary endpoints were height velocity, height velocity standard deviation scores (SDS), height, height SDS and IGF-1 concentrations. Clinical and auxological data were obtained from medical records and adherence from Easypod\u2122 logs.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>This study included 147 Easypod\u2122-na\u00efve Mexican children assessed during 3\u00a0years (mean age: 9.96\u2009\u00b1\u20093.41\u00a0years, 56.8% boys, mean height SDS at baseline: \u2212\u00a02.17\u2009\u00b1\u20090.97): 118 with GHD, 24 SGA and 5 with TS. A total of 105 (71.4%) patients were GH na\u00efve. Overall median adherence was\u2009&gt;\u200990% over the first year of treatment and\u2009&gt;\u200980% at 3\u00a0years. Adherence was not different by r-hGH indication or between GH-na\u00efve or experienced patients. At 1-year follow-up, mean change in height SDS was 0.57\u2009\u00b1\u20090.34, whereas mean height velocity SDS was 2.85\u2009\u00b1\u20092.51. In all, 84.7% patients had normal IGF-1 concentrations at 1-year follow-up. Adherence was associated with change in height SDS (<jats:italic>r<\/jats:italic>\u2009=\u20090.239, <jats:italic>p<\/jats:italic>\u2009=\u20090.005) and height velocity SDS (<jats:italic>r<\/jats:italic>\u2009=\u20090.194, <jats:italic>p<\/jats:italic>\u2009=\u20090.027).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Adherence rates with the Easypod\u2122 device are high and maintained over time in GHD, SGA and TS Easypod\u2122-na\u00efve Mexican patients. High adherence is associated with better outcomes. Easypod\u2122 assists physicians in monitoring adherence to r-hGH.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s40618-020-01218-4","type":"journal-article","created":{"date-parts":[[2020,4,1]],"date-time":"2020-04-01T13:03:22Z","timestamp":1585746202000},"page":"1447-1452","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Adherence to treatment in children with growth hormone deficiency, small for gestational age and Turner syndrome in Mexico: results of the Easypod\u2122 connect observational study (ECOS)"],"prefix":"10.1007","volume":"43","author":[{"given":"A.","family":"Blanco-L\u00f3pez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Antill\u00f3n-Ferreira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Saavedra-Castillo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Barrientos-P\u00e9rez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Rivero-Escalante","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O.","family":"Flores-Caloca","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Calzada-Le\u00f3n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. 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Armando Blanco-L\u00f3pez, Ra\u00fal Calzada-Le\u00f3n and Arturo Ayala-Estrada have received research support and lecture fees from Merck S.A. de C.V., Mexico. Authors of this paper declare that the paper is original and has not been published or submitted for publication elsewhere, and that there is no any affiliation with any organization with a direct or indirect financial interest in the subject matter discussed in the manuscript that may affect the reporting of the work submitted.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The local ethical committees of each participating center in Mexico approved the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Written informed consent was obtained from the patients and\/or from their legal guardians prior to enrollment.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}