Abstract
Purpose
Persistence and adherence with subcutaneous growth hormone (GH; somatropin) therapy in children is widely acknowledged to be suboptimal. This study aimed to investigate how the use of a jet-delivery device, ZomaJet®, impacts on medication-taking behaviors compared to needle-based devices.
Materials and methods
A retrospective cohort study of children aged ≤18 years was conducted using a UK-based, nationwide database of GH home-delivery schedules. Data were evaluated for the period between January 2010 and December 2012 for 6,061 children receiving either Zomacton® (somatropin) via the ZomaJet jet-delivery device or one of six brands of GH all administered via needle-based devices. Persistence was analyzed for patients with appropriate data, measured as the time interval between first and last home deliveries. An analysis of adherence was conducted only for patients using ZomaJet who had appropriate data, measured by proportion of days covered. Brand switches were identified for all patients.
Results
Persistence with GH therapy was significantly longer in patients using ZomaJet compared to needle-based devices (599 days versus 535 days, respectively, n=4,093; P<0.001); this association was observed in both sexes and across age subgroups (≤10 and 11–16 years). The majority (58%) of patients using ZomaJet were classed as adherent (n=728). Only 297 patients (5%) switched GH brand (n=6,061), and patients tended to use ZomaJet for longer than other devices before switching.
Conclusion
It appears important that the choice of a jet-delivery device is offered to children prescribed daily GH therapy. These devices may represent a much-needed effective strategy for maintaining persistence with subcutaneous GH administration in children, potentially offering better clinical outcomes and greater cost-efficiency.
Acknowledgments
Editorial support was provided by Acumen Healthcare Communications Ltd., funded by Ferring Pharmaceuticals. The authors are grateful to Sue Whitten (Ferring Pharmaceuticals) and Matt Jones (formerly of Sciensus Ltd.) for their assistance with this study and manuscript.
Disclosure
This study was conducted by Sciensus (Brighton, UK), and initiated and funded by Ferring Pharmaceuticals (London, UK). Editorial support was provided by Acumen Healthcare Communications, funded by Ferring Pharmaceuticals. Helen Spoudeas has accepted fees for lecture invitations and received educational grants from Ferring Pharmaceuticals, Novo Nordisk, Pfizer, and Ipsen. Priti Bajaj is an employee of Ferring Pharmaceuticals. Nathan Sommerford is an employee of Sciensus.