Desrosiers Paul, O'Brien Fanny, Blethen Sandra
Department of Pediatric Endocrinology, Nemours Children's Clinic, Orlando, 32806, and Department of Pediatric Endocrinology, University of Florida, Gainesville, FL, USA.
Pediatr Endocrinol Rev. 2005 Feb;2 Suppl 3:327-31.
To determine the effect of method of growth hormone (GH) administration on patient outcomes, we studied data from the GHMonitor, an electronic database registry of North American children treated with Saizen GH (somatropin [rDNA origin] for injection). Data from 631 children, 305 treated with needle and syringe and 326 treated with cool.click needle-free device, were analyzed. The groups were balanced for factors known to affect GH treatment response. There was no difference in response to GH over 2 years of treatment whether assessed by growth rate, change in height SD score, or change in height age. Although the majority of patients were compliant with GH therapy (84.6% of needle-free delivery system [NFDS] and 76.3% of needle and syringe patients missed <3 doses per month), significantly more patients using needle and syringe missed over one-half of their prescribed GH dose (13.4% needle and syringe patients versus 6% of NFDS patients, P=.002). In this group of poorly compliant patients, growth rates were significantly lower than in patients who missed fewer doses. Thus in patients where compliance is an issue, use of the NFDS may result in better outcomes.
为确定生长激素（GH）给药方法对患者预后的影响，我们研究了来自GHMonitor的数据，这是一个北美接受赛增GH（注射用重组人生长激素）治疗儿童的电子数据库登记处。分析了631名儿童的数据，其中305名采用针头注射器治疗，326名采用cool.click无针装置治疗。两组在已知影响GH治疗反应的因素方面保持平衡。在2年的治疗期间，无论通过生长速率、身高标准差评分变化还是身高年龄变化来评估，对GH的反应均无差异。尽管大多数患者依从GH治疗（无针给药系统[NFDS]组84.6%以及针头注射器组76.3%的患者每月漏用剂量<3剂），但使用针头注射器的患者中，显著更多的患者漏用了超过一半的规定GH剂量（针头注射器组患者为13.4%，而NFDS组患者为6%，P = 0.002）。在这组依从性差的患者中，生长速率显著低于漏用剂量较少的患者。因此，在依从性成为问题的患者中，使用NFDS可能会带来更好的预后。
