{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T18:11:47Z","timestamp":1793643107048,"version":"4.5.1"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,11,3]],"date-time":"2022-11-03T00:00:00Z","timestamp":1667433600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Children with growth hormone deficiency (GHD) are treated with daily somatropin injections; however, poor treatment persistence and adherence have been recognized previously and have been shown to negatively impact growth outcomes. A recent real-world study of a US pediatric GHD population found that a substantial proportion of children discontinued somatropin therapy, but similar data for a real-world UK population are lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To describe the discontinuation of, and persistence with, daily somatropin treatment among children with GHD in the UK.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective cohort study of children (\u22653 and &amp;lt;16\u00a0years old) with \u22651 medication prescription for daily injectable somatropin from 1 July 2000 to 31 December 2020 in the IQVIA Medical Research DATA (IMRD) database. Early persistence was defined as the proportion of children prescribed \u22651 somatropin refill (\u22652 prescriptions). Discontinuation was defined as the first date at which a medication gap for somatropin (of &amp;gt;60 or &amp;gt;90\u00a0days between prescriptions) occurred. Kaplan\u2013Meier methods were used to evaluate persistence (non-discontinuation) over time to assess time to first discontinuation event. Cox proportional hazards models were used to evaluate the relationship between patient characteristics and time to medication discontinuation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the cohort identified in this study (<jats:italic>n<\/jats:italic>\u00a0=\u00a0117), the majority (<jats:italic>n<\/jats:italic>\u00a0=\u00a084, 71.8%) had 48\u00a0months of available follow-up; 56.4% were boys and the mean (median) age was 8.6 (8.0) years. About 98% exhibited early persistence, but persistence over the follow-up period decreased with follow-up duration. Using the conservative 90-day gap definition of persistence, an estimated 72.4%, 52.8%, and 43.3% were persistent at 12, 36, and 48\u00a0months. Lower persistence rates were observed using the 60-day definition. No significant patient predictors of time to discontinuation were identified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite high early persistence with somatropin, a high percentage of children with GHD were increasingly non-persistent over time. More than 1 in 4 were non-persistent at 12\u00a0months and more than 1 in 2 were non-persistent at 48\u00a0months of follow-up. These results suggest that strategies to support improved medication-taking behavior among children with GHD in the UK are warranted.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2022.1014743","type":"journal-article","created":{"date-parts":[[2022,11,3]],"date-time":"2022-11-03T17:58:07Z","timestamp":1667498287000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Persistence with daily growth hormone among children and adolescents with growth hormone deficiency in the UK"],"prefix":"10.3389","volume":"13","author":[{"given":"Jane","family":"Loftus","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jen","family":"Wogen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Oliveri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darrin","family":"Benjumea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priti","family":"Jhingran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"Alvir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Rivero-Sanz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack C.","family":"Kowalik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael P.","family":"Wajnrajch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,11,3]]},"reference":[{"key":"B1","volume-title":"[TA188] human growth hormone (somatropin) for the treatment of growth failure in children","year":"2010"},{"key":"B2","volume-title":"Growth hormone deficiency in children","year":"2022"},{"key":"B3","volume-title":"Shared care guidelines: Paediatric use of recombinant human growth hormone (r-hGH, somatropin)","year":"2015"},{"key":"B4","doi-asserted-by":"publisher","first-page":"46","DOI":"10.4158\/EP13194.OR","article-title":"Adherence to growth hormone therapy: results of a multicenter study","volume":"20","author":"Aydin","year":"2014","journal-title":"Endocr Pract"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e16223","DOI":"10.1371\/journal.pone.0016223","article-title":"Non-compliance with growth hormone treatment in children is common and impairs linear growth","volume":"6","author":"Cutfield","year":"2011","journal-title":"PloS One"},{"key":"B6","doi-asserted-by":"crossref","DOI":"10.1016\/j.eprac.2022.02.013","volume-title":"Association of daily growth hormone injection adherence and height among children with growth hormone deficiency","author":"Loftus","year":"2022"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2006.114249","article-title":"Monitoring of concordance in growth hormone therapy","volume":"93","author":"Kapoor","year":"2008","journal-title":"Arch Dis Child"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1515\/jpem-2018-0067","article-title":"Improved adherence and growth outcomes with jet-delivered growth hormone","volume":"32","author":"Michaelidou","year":"2019","journal-title":"J Pediatr Endocrinol Metab"},{"key":"B9","article-title":"Persistence with growth hormone therapy in pediatric patients","volume":"6","author":"Miller","year":"2014","journal-title":"Am J Pharm Benefits"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.4158\/EP.14.2.143","article-title":"Compliance and persistence in pediatric and adult patients receiving growth hormone therapy","volume":"14","author":"Rosenfeld","year":"2008","journal-title":"Endocr Pract"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1210\/jendso\/bvab048.1389","article-title":"Persistence of use in children receiving growth hormone therapy","volume":"5","author":"Spataru","year":"2021","journal-title":"J Endocrine Soc"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2021.711979","article-title":"Real-world treatment patterns and outcomes of growth hormone treatment among children in Israel over the past decade (2004-2015)","volume":"9","author":"Ben-Ari","year":"2021","journal-title":"Front Pediatr"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1080\/03007995.2021.1982682","article-title":"Suboptimal adherence to daily growth hormone in a US real-world study: an unmet need in the treatment of pediatric growth hormone deficiency","volume":"37","author":"Loftus","year":"2021","journal-title":"Curr Med Res Opin"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2008.02.017","article-title":"Observations of nonadherence to recombinant human growth hormone therapy in clinical practice","volume":"30","author":"Haverkamp","year":"2008","journal-title":"Clin Ther"},{"key":"B15","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1515\/jpem-2017-0157","article-title":"Adherence to growth hormone therapy in children and its potential barriers","volume":"31","author":"Mohseni","year":"2018","journal-title":"J Pediatr Endocrinol Metab"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.ghir.2018.10.004","article-title":"Long-term adherence to growth hormone therapy in a large health maintenance organization cohort","volume":"44","author":"Farfel","year":"2019","journal-title":"Growth Horm IGF Res"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.17458\/per.vol16.2018.lh.longactingghpreparation","article-title":"Long-acting growth hormone preparations in the treatment of children","volume":"16","author":"Lal","year":"2018","journal-title":"Pediatr Endocrinol Rev"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.2147\/DDDT.S336285","article-title":"Spotlight on lonapegsomatropin once-weekly injection and its potential in the treatment of growth hormone deficiency in pediatric patients","volume":"16","author":"Miller","year":"2022","journal-title":"Drug Des Devel Ther"},{"key":"B19","doi-asserted-by":"publisher","first-page":"bvac117","DOI":"10.1210\/jendso\/bvac117","article-title":"Treatment burden of weekly somatrogon vs daily somatropin in children with growth hormone deficiency: A randomized study","volume":"6","author":"Maniatis","year":"2022","journal-title":"J Endocr Soc"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1159\/000524003","article-title":"Switching to weekly lonapegsomatropin from daily somatropin in children with growth hormone deficiency: The fliGHt trial","volume":"95","author":"Maniatis","year":"2022","journal-title":"Horm Res Paediatr"},{"key":"B21","article-title":"Pfizer registry of outcomes in growth hormone RESearch (PROGRES): a multi-country, non-interventional, prospective, cohort study of patients receiving human growth hormone treatments under routine clinical care","volume":"6","author":"Gettner","year":"2022","journal-title":"Journal of the Endocrine Society"},{"key":"B22","volume-title":"Assessment of adherence, quality of life, clinical response and safety of daily and long-acting growth hormone therapy (LAuGH TRACK) [NCT04938266]","year":"2021"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2022.1014743\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,3]],"date-time":"2022-11-03T17:58:19Z","timestamp":1667498299000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2022.1014743\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,3]]},"references-count":22,"alternative-id":["10.3389\/fendo.2022.1014743"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2022.1014743","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,3]]},"article-number":"1014743"}}