8407 Baseline Clinical Factors Associated with Cessation of Growth Hormone Therapy in Patients with Severe Growth Hormone Deficiency: Real World Evidence

Abstract Disclosure: E. Ssemmondo: None. N. Nadarajah: None. S. Brooks: None. R. Akinyombo JNR: None. K.A. Adeleke: None. H. Deshmukh: None. T. Sathyapalan: None. Introduction: Growth hormone replacement is indicated in adults with severe growth hormone (GH) deficiency, adult growth hormone deficiency assessment (AGHDA) score of at least 11 and are receiving treatment for other pituitary hormone deficiencies. GH is administered as a daily subcutaneous injection. There are no data looking at the cessation of GH replacement in adult patients with severe GH deficiency and the factors that predict the likelihood of patients continuing or stopping growth hormone replacement. Methods: We audited patients on the GH register between January 2006 and January 2023 in Hull Teaching Hospital NHS foundation Trust, a UK tertiary hospital. Baseline characteristics, the cause of GH deficiency, AGHDA score at diagnosis and the reason for stopping GH were collected. Proportions were compared between patients adhering to GH replacement and those who had ceased it using the Fisher exact test. Logistic regression was employed to explore factors correlated with the cessation of GH replacement. Results: The study comprised 141 adult patients with a mean age of 52 years, of which 75 (53%) were female. Notably, 54 (38%) individuals had discontinued GH replacement therapy. Predominant reasons for discontinuation were cited as lack of therapeutic benefit (46%) and a shift in clinical indication (26%). Among patients off GH therapy, the most frequent cause of GH deficiency was idiopathic (57%), while for those on GH replacement, pituitary surgery was the leading cause (53%). Upon adjusting for covariates, gender emerged as significantly associated with the cessation of GH therapy. Females exhibited an 8.8 times higher likelihood of discontinuing GH therapy compared to males (P-value=0.02). However, no other baseline factors displayed a statistically significant correlation with the cessation of GH replacement. Conclusion: In this real-world investigation of patients with severe GH deficiency, over two in five individuals who discontinued GH therapy cited the absence of perceived benefits. Notably, gender is a predictive factor for the cessation of GH replacement, with females displaying a higher tendency to discontinue this therapy. Presentation: 6/1/2024