Efetividade do hormônio do crescimento na baixa estatura: uma análise de mundo real

Abstract

Short stature is caused by several factors such as genetics, changes in the endocrine system and nutrition. The main treatment option is recombinant growth hormone (rhGH), which has been widely used in children with idiopathic short stature (ISS) and small for gestational age (SGA). This study characterized the epidemiological profile and evaluated the real-world effectiveness of individuals using rhGH, attended by the state SUS, for the treatment of ISS and SGA. This is a longitudinal study, with data from the administrative processes of the State Department of Health of ES, requesting rhGH for the treatment of ISS and SGA. The period evaluated was from January 2012 to January 2021. Patients with less than one year of treatment and processes with missing information were excluded from the study. The data was analyzed using the software Excel®, software R (R Core Team, 2021) and WHO AnthroPlus. The patients' height data were transformed into Zscore height-for-age, where the evolution of growth was evaluated for the variables, treatment time, sex, age at the start of treatment and diagnosis and to test the relationship between the variables, it was the standard linear regression model was used The work approved by the Comitê de Ética e Pesquisa em Seres Humanos – UFES and was authorized by the Instituto Capixaba de Ensino, Pesquisa e Inovação em Saúde - SESA. 237 ISS and SGA users were included in the study. After 1 year of treatment, patients with ISS had an increase in height Zscore of 0,79, while in the same period SGA patients had a gain of 0,76 (p<0,05). Age at the start of treatment the group aged between and 71 months showed the most favorable results throughout each year of treatment, which was confirmed by logistic regression. In the results of the analysis of the estimated values of the multiple linear regression model to evaluate whether 'treatment time', 'initial Zscore', 'sex' and 'diagnosis' the R² value was 0,4261. Therefore, it is concluded that treatment with growth hormone in children with ISS and SGA is effective and the younger the age at which treatment begins and the lower the Z-score, the better the results.