Adult height comparison between boys and girls with precocious puberty after long-term gonadotrophin-releasing hormone analogue therapy

Galluzzi, F.; Salti, R; Bindi, Giuseppe; Pasquini, Elisabetta; Cauza, C. La

doi:10.1080/08035259850158227

Cited by 23 publications

(21 citation statements)

References 30 publications

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“…Their FH, in fact, was on average 2.8 cm higher with respect to PH1, but 1.8 cm lower than PH2; consequently almost half of the gain in PH during treatment was lost between the time therapy was stopped and the time adult height was reached. A similar trend has been described by other authors (11,(16)(17)(18)(19) and is probably due to the significant increase of DBA:DCA ratio which has been reported to follow therapy cessation (16,19).…”

Section: Discussionsupporting

confidence: 89%

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Analysis of the factors affecting auxological response to GnRH agonist treatment and final height outcome in girls with idiopathic central precocious puberty

Arrigo

Cisternino

Galluzzi

et al. 1999

European Journal of Endocrinology

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The aim of this retrospective study was to analyze the factors which affected the auxological response to GnRH agonist treatment and the final height (FH) outcome in 71 girls with idiopathic and truly precocious (onset before 8 years) central puberty (CTPP) who had been treated with the same therapy protocol (Decapeptyl Depot, 60 mg/kg i.m. every 28 days) for at least 2 years (since 7.0 Ϯ 1.3 (S.D.) years of age) and followed until puberty was completed and FH was reached.During the entire treatment period we observed: (a) a decrease of height standard deviation scores (SDS) (from 1.5 Ϯ 1.7 to 0.9 Ϯ 1.3 SDS, P < 0.01); (b) a striking deceleration of bone age (BA), revealed by the subnormal DBA:Dchronological age (CA) ratio (0.2 Ϯ 0.1); (c) an increase of predicted adult height (from 155.6 Ϯ 7.0 to 160.7 Ϯ 6.7 cm, P < 0.0005). Treatment interruption was followed by an important catch-down growth, with an FH (158.4 Ϯ 5.8 cm) lower (P < 0.025) than that predicted at the end of therapy. However, FH fell within the population norm and the target range in respectively 87.3 and 90% of the patients. The tallest FH was recorded in the patients who started therapy at less than 6 years of age and in those who discontinued treatment at a BA of 12.0-12.5 years. At stepwise regression analysis, FH in the whole study population was positively affected by the following independent factors: (a) height at the end of therapy (F = 45.45, P < 0.0001); (b) pretreatment height (F = 13.91, P < 0.0005); (c) treatment duration (F = 8.51, P < 0.005); (d) target height (TH) (F = 7.70, P < 0.01).We conclude that: (i) most girls with idiopathic CTPP treated by GnRH agonists may achieve an adult height within the population norm and/or their target range; (ii) the height gain from therapy onset until FH attainment, however, is generally rather limited (on average 2.9 cm) and only few patients are able to reach their target percentile; (iii) the most favorable height prognosis with respect to TH is generally observed in the subjects with the tallest height at the end of treatment and the lowest BA2:CA2 ratio, due to the important deterioration of height prognosis which frequently follows therapy interruption; (iv) FH is also significantly conditioned by both TH and treatment duration; (v) in order to strengthen the weak therapeutic effect of GnRH agonists in CTPP this treatment should be started as early as possible and discontinued at a BA of 12.0-12.5 years.

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Section: Discussionsupporting

confidence: 89%

“…The positive change in predicted stature observed in our patients from the start of therapy until the achievement of adult height was similar to the one recorded by other authors (5,16,19,21) in girls treated with s.c. or i.m. GnRH preparations (from 2.4 to 3.5 cm).…”

Section: Discussionsupporting

confidence: 75%

Analysis of the factors affecting auxological response to GnRH agonist treatment and final height outcome in girls with idiopathic central precocious puberty

Arrigo

Cisternino

Galluzzi

et al. 1999

European Journal of Endocrinology

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“…The great majority of patients reached an adult height consistent with the TH (13,14,15,17,18,19,20,21,22,23,24,25), a minority of them did not reach the TH (19,26), and a very small portion of patients remained shorter than the predicted height before treatment (13,27). Discordant results were obtained when comparing the efficacy of treatment in females and males.…”

Section: Adult Heightsupporting

confidence: 61%

“…According to a study by Bajpai et al (21), in patients treated with monthly triptorelin depot, mean HG was similar in females and males (mean HG: 6.4G2.4 cm vs 7.6G1.0 cm respectively). In contrast, Galluzzi et al (13) reported a higher HG in boys (7.3G3.8 cm; nZ11) than in girls (3.3G3.0 cm; nZ22), with an achieved adult height SDS higher in the former than in the latter (0.13G0.91 vs K0.62G0.88; P!0.001). In general, HG was highly variable among studies depending on sample characteristics including the progression of pubertal development.…”

Section: Adult Heightmentioning

confidence: 75%

MANAGEMENT OF ENDOCRINE DISEASE: Long-term outcomes of the treatment of central precocious puberty

Guaraldi

Beccuti

Gori

et al. 2016

European Journal of Endocrinology

114

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GnRH analogues (GnRHa) are the treatment of choice for central precocious puberty (CPP), with the main objective to recover the height potential compromised by the premature fusion of growth cartilages. The aim of this review was to analyze longterm effects of GnRHa on height, body weight, reproductive function, and bone mineral density (BMD) in patients with CPP, as well as the potential predictors of outcome. Because randomized controlled trials on the effectiveness and long-term outcomes of treatment are not available, only qualified conclusions about the efficacy of interventions can be drawn. GnRHa treatment appears to improve adult height in girls with CPP, especially if diagnosed before the age of 6, whereas a real benefit in terms of adult height is still controversial in patients with the onset of puberty between 6 and 8 years of age. No height benefit was shown in patients treated after 8 years. Gonadal function is promptly restored in girls after cessation of treatment, and reproductive potential appears normal in young adulthood. Data are conflicting on the long-term risk of polycystic ovarian syndrome in both treated and untreated women. Fat mass is increased at the start of treatment but normalizes thereafter, and GnRHa itself does not seem to have any long-term effect on BMI. Similarly, analogue treatment does not appear to have a negative impact on BMD. Owing to the paucity of data available, no conclusions can be drawn on the repercussions of CPP and/or its treatment on the timing of menopause and on the health of the offspring.

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“…Comparisons between the effects of GnRHa treatment in boys and girls are scarce [6], which is also due to the low incidence of CPP in boys. The number of male patients with an organic aetiology for the development of early puberty is relatively high compared to girls, and more often intracerebral pathology can be observed, further limiting the number of boys with idiopathic CPP [6,7].…”

Section: Introductionmentioning

confidence: 99%

Effect of Gonadotropin-Releasing Hormone Agonist Treatment in Boys with Central Precocious Puberty: Final Height Results

et al. 2002

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Objective: The small number of boys present in most studies on final height (FH) after gonadotropin-releasing hormone agonist (GnRHa) treatment for central precocious puberty (CPP) offers difficulties in the evaluation of the effects of treatment on FH in males. Method: We therefore combined FH data from The Netherlands, Italy and France to study the effect of GnRHa treatment in a large group of 26 boys with CPP. Results: The mean chronological age at the start of treatment was 7.6 ± 2.0 (SD) years, bone age (BA) was 11.0 ± 2.1 years. All boys were treated with depot formulations of the GnRHa triptorelin with established gonadal suppression for a mean treatment period of 4.7 ± 2.1 years. FH was 172.9 ± 6.6 cm. FH standard deviation score (SDS) was –0.66 ± 1.22, not significantly different from the target height SDS of –0.23 ± 0.75. FH-SDS was significantly lower in the subgroup of 12 patients with organic CPP compared to patients with idiopathic CPP (–1.34 ± 1.06 vs. –0.08 ± 1.06, respectively; p = 0.01), but no difference in height gain was observed. The mean estimated height gain, defined as the difference between predicted and actual adult height was 6.2 ± 8.7 cm using the average tables of Bayley and Pinneau, and 0.3 ± 8.6 cm using the BA advance adjusted tables. Regional differences in height gain were observed between the different countries, reflecting different local practices. Conclusion: We conclude that GnRHa treatment in boys results in a FH close to target height.

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Adult height comparison between boys and girls with precocious puberty after long-term gonadotrophin-releasing hormone analogue therapy

Cited by 23 publications

References 30 publications

Analysis of the factors affecting auxological response to GnRH agonist treatment and final height outcome in girls with idiopathic central precocious puberty

Analysis of the factors affecting auxological response to GnRH agonist treatment and final height outcome in girls with idiopathic central precocious puberty

MANAGEMENT OF ENDOCRINE DISEASE: Long-term outcomes of the treatment of central precocious puberty

Effect of Gonadotropin-Releasing Hormone Agonist Treatment in Boys with Central Precocious Puberty: Final Height Results

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