Endocrine Abstracts

The majority of adult GH replaced patients reach target IGF1 levels using established injection devices. However, a small but significant cohort of these patients fail to achieve these intended goals. This can be manifested as either a failure to improve (biochemically or symptomatically) despite escalating GH doses, or large variations in IGF1 measurements despite steady GH dosing.

The Easypod^® device has a memory chip which allows recording of time, number and dose of GH injections given.

Ten patients from the cohort described above were invited to trial the Easypod device, and were standardly trained and followed up by a dedicated nurse. IGF1 levels were monitored as per usual clinical practice both before and after commencing the novel device.

The device was well tolerated, with 8/10 patients remaining on the device at the time of submission. Mean duration for use of the device was 191 days (19–397d). Two patients discontinued use of the device due to mechanical failure and difficulty preparing the injection respectively.

Three patients were identified with compliance issues missing over 20% of doses, with a mean compliance of 89% (range 68–99%).

Adequate compliance as evidenced by the administration history in the other patients formed the basis for further dose adaptation to reach target levels which were achieved in 9/10 patients.

Particularly with current uncertainties around IGF1 measurements the downloadable injection history enables clinicians to draw more accurate conclusions regarding the validity of the IGF1 result. This may have potential benefits in reducing unnecessary dose escalations and allowing to identify non-compliance at an early stage.