Does the risk of arterial hypertension increase in the course of triptorelin treatment?

Palma, Laura; Gaudino, Rossella; Cavarzere, Paolo; Antoniazzi, Franco

doi:10.1515/jpem-2018-0210

Cited by 8 publications

(5 citation statements)

References 11 publications

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“…This was also previously reported in 2016 [23]. Additionally, two cases of arterial hypertension following treatment with triptorelin, which resolved after discontinuation of GnRHa, were reported in 2020 and 2019 [24,25]. A recent study of blood pressure changes following induction of GnRHa therapy in 15 transgender male patients [26 ] found a significant but not hypertensive rise of diastolic blood pressure.…”

Section: Safety/adverse Events Associated With Gonadotropin-releasing...supporting

confidence: 71%

Use of gonadotropin-releasing hormone analogs in children

Allen

Krishna

Lee

2021

Current Opinion in Pediatrics

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Purpose of review In this review, we outline the usage and formulations of gonadotropin-releasing hormone analogs (GnRHas) in central precocious puberty (CPP), short stature, and gender diverse individuals, as well as adverse effects, long-term outcomes, and monitoring of therapy. There is a particular focus on citing references published within the last 24 months. Recent findings Long-acting formulations of GnRHa now include Federal Drug Administration approval for subcutaneous injections. Significant adverse events continue to be rarely reported; extremely rare events include arterial hypertension and pseudotumor cerebri. There continue to be no significant long-term consequences including the impact upon body mass index and bone mineral density, which appear to be transient. GnRHas have been used in differences of sexual development (DSD) and increasingly in the treatment of adolescent transgender individuals. Summary GnRHas remain as the only fully efficacious therapy for CPP and effectively suppress pubertal hormones in other situations. The use of GnRHa therapy in gender incongruent individuals has proven beneficial and has become a standard of care, whereas use in those with DSDs should still be considered experimental. Video abstract http://links.lww.com/MOP/A62.

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Section: Safety/adverse Events Associated With Gonadotropin-releasing...supporting

confidence: 71%

Use of gonadotropin-releasing hormone analogs in children

Allen

Krishna

Lee

2021

Current Opinion in Pediatrics

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“…In both cases, re-exposition to the offending drug was not performed. Finally, Palma et al also very recently report a girl with CPP and arterial HTN during treatment with Triptorelin, HTN that subsided once Triptorelin was interrupted (6).…”

Section: Discussionmentioning

confidence: 98%

“…Triptorelin is a widely used drug with few reported adverse effects, such as erythema, bruising, pain, sterile abscesses, menopausal-like symptoms, and anaphylaxis (2, 3). So far secondary arterial hypertension (HTN) has been reported in only 3 patients with CPP (4–6).…”

Section: Introductionmentioning

confidence: 99%

Transient Arterial Hypertension Induced by Gonadotropin-Releasing Hormone Agonist Treatment for Central Precocious Puberty

Sifaki

Cachat

Theintz³

et al. 2019

Front. Pediatr.

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Background: Gonadotropin-releasing hormone agonists (GnRHa) are a safe and effective treatment for precocious puberty. Triptorelin is one of the long lasting GnRHa, which reversibly suppresses the pituitary-gonadal axis. Triptorelin-induced hypertension (HTN) has rarely been reported in the literature.Clinical Case/Methods: We report a 10-year-old girl with central precocious puberty who, during treatment with triptorelin, developed an asymptomatic stage II HTN. Initial workup showed no renal, thyroid, or electrolytes abnormalities. The renal ultrasound showed no parenchymal disease and no increased renal resistance index suggestive of a renal artery stenosis. Echocardiography and ocular fundoscopy were normal. HTN (stage II) was confirmed with ambulatory blood pressure monitoring (ABPM). After extensive literature review, we found 3 other cases of HTN secondary to GnRHa, improving with endocrine treatment cessation. Therefore, antihypertensive treatment was not started immediately in our patient. Indeed, after completion of her treatment with triptorelin, we observed a complete normalization of her blood pressure (confirmed with ABPM) without any medication.Conclusion: Concomitantly to GnRHa treatment, our patient developed HTN, which completely subsided after stopping triptorelin. The complete normalization of her blood pressure, together with a negative workup for HTN strongly speaks for a causal effect of her endocrine treatment. In this setting, estrogen depletion might play a role, although this remains debated.

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“…High blood pressure was only present in 3 participants of the GnRHa/ GH group, which was similar in the GH-only and AGA groups. Two case reports have described transient arterial hypertension during GnRHa treatment (31,32). Both cases showed that blood pressure returned to normal values after cessation of GnRHa treatment.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal Study on Metabolic Health in Adults SGA During 5 Years After GH With or Without 2 Years of GnRHa Treatment

Goedegebuure

Steen

Kerkhof³

et al. 2020

The Journal of Clinical Endocrinology &Amp; Metabolism

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Background In children born small for gestational age (SGA) with persistent short stature, 2 years of gonadotropin-releasing hormone analogue (GnRHa), in addition to long-term growth hormone (GH) treatment, can improve adult height. We assessed safety on metabolic and bone health of GnRHa/GH treatment during 5 years after cessation of GH. Methods A total of 363 young adults born SGA, previously treated with combined GnRHa/GH or GH-only, were followed for 5 years after attainment of adult height at GH cessation and 2 and 5 years thereafter. Data at 5 years after GH cessation, at age 21 years, were also compared with 145 age-matched adults born appropriate for gestational age (AGA). Frequently sampled intravenous glucose tolerance (FSIGT) tests were used to assess insulin sensitivity, acute insulin response, and β-cell function. Body composition and bone mineral density (BMD) was determined by dual-energy x-ray absorptiometry (DXA) scans. Findings In the GnRHa/GH and GH-only groups, fat mass increased during the 5 years after GH cessation, but the changes in FSIGT results, body composition, blood pressure, serum lipid levels, and BMD were similar in both groups. At age 21 years, the GnRHa/GH group had similar fat mass, FSIGT results, blood pressure, serum lipid levels and BMD-total body as the GH-only group and the AGA control group, a higher BMD-lumbar spine and lower lean body mass than the AGA control group. Interpretation This study during 5 years after GH cessation shows that addition of 2 years of GnRHa treatment to long-term GH treatment of children short in stature born SGA has no unfavorable effects on metabolic and bone health in early adulthood. Clinical trial registration ISRCTN96883876, ISRCTN65230311 and ISRCTN18062389.

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Does the risk of arterial hypertension increase in the course of triptorelin treatment?

Cited by 8 publications

References 11 publications

Use of gonadotropin-releasing hormone analogs in children

Use of gonadotropin-releasing hormone analogs in children

Transient Arterial Hypertension Induced by Gonadotropin-Releasing Hormone Agonist Treatment for Central Precocious Puberty

Longitudinal Study on Metabolic Health in Adults SGA During 5 Years After GH With or Without 2 Years of GnRHa Treatment

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