Efficacy and Safety of Domestic Leuprorelin in Girls with Idiopathic Central Precocious Puberty

Abstract

Background:In central precocious puberty (CPP), the pulse secretion and release of gonadotropin-releasing hormone (GnRH) are increased due to early activation of the hypothalamic-pituitary-gonadal axis, resulting in developmental abnormalities with gonadal development and appearance of secondary sexual characteristics. The CPP without organic disease is known as idiopathic CPP (ICPP). The objective of the study was to evaluate the clinical efficacy and safety of domestic leuprorelin (GnRH analog) in girls with ICPP.Methods:A total of 236 girls with ICPP diagnosed from April 2012 to January 2014 were selected and were randomized into two groups. One hundred fifty-seven girls in the test group were treated with domestic leuprorelin acetate, 79 girls in the control group were treated with imported leuprorelin acetate. They all were treated and observed for 6 months. After 6-month treatment, the percentage of children with peak luteinizing hormone (LH) ≤3.3 U/L, the percentage of children with peak LH/peak follicle stimulating hormone (FSH) ratio <0.6, the improvements of secondary sexual characteristics, gonadal development and sex hormone levels, the change of growth rate of bone age (BA) and growth velocity, and drug adverse effects between two groups were compared.Results:After the treatment, the percentage of children with a suppressed LH response to GnRH, defined as a peak LH ≤3.3 U/L, at 6 months in test and control groups were 96.80% and 96.20%, respectively, and the percentage of children with peak LH/FSH ratio ≤0.6 at 6 months in test and control groups were 93.60% and 93.70%, respectively. The sizes of breast, uterus and ovary of children and the levels of estradiol (E2) were significantly reduced, and the growth rate of BA was also reduced. All the differences between pre- and post-treatment in each group were statistically significant (P < 0. 05), but the differences of the parameters between two groups were not significant (P > 0.05).Conclusions:Domestic leuprorelin is effective and safe in the treatment of Chinese girls with ICPP. Its effectiveness and safety are comparable with imported leuprorelin.

The Influence of Gonadotropin-Releasing Hormone Agonist Treatment on Thyroid Function Tests in Children with Central Idiopathic Precocious Puberty

“…This treatment would have reversible changes to BMI, reproductive system and bone density (10); although it would not result in decreasing the bone quality and quantity after menarche (11-12). Patients treated with the GnRH agonist may report vaginal bleeding for 3 to 5 days, especially 2 weeks, after initiating the treatment (5). Moreover, increased appetite was observed in children who were treated with the GnRH agonist (13).…”

“…Treatment with the gonadotropin-releasing hormone agonist (GnRH) agonist is a healthy, relatively old treatment (4). Most of the complications of this treatment are manifested as pseudo-menopausal in children (5). However, thyroid hormones disorders are considered to be the complications of treatment with the GnRH agonist which has been neglected in pediatric studies, and is mostly studied in adults and cases other than precocious puberty (6).…”

Study on the Mechanism of Sarsasapogenin in Treating Precocious Puberty by Regulating the HPG Axis

“…It acts on the pituitary in a continuous nonpulsed form, downregulates its GnRH receptor or reduces its sensitivity to the GnRH receptor, and inhibits the pituitary to secrete luteinizing hormone (LH) and follicle stimulating hormone (FSH), thus inhibiting the development of secondary sex characteristics [ 10 , 11 ], achieving the effect of therapeutic precocious puberty. Although leuprolide plays a significant role in the treatment of precocious puberty, it has been found that it is easy to cause vaginal bleeding when used for the first time, with an incidence of 16%–60% [ 12 ]. Also, it can also increase the incidence of polycystic ovary syndrome [ 13 ].…”

Study on the mechanism of sarsasapogenin in treating precocious puberty by regulating HPG axis

“…It acts on the pituitary in a continuous non-pulsed form, down-regulates its GnRH receptor or reduces its sensitivity to GnRH receptor, and inhibits the pituitary to secrete luteinizing hormone (LH) and follicle stimulating hormone (FSH), thus inhibiting the development of secondary sex characteristics [10,11] , achieving the effect of therapeutic precocious puberty. Although leuprolide plays a significant role in the treatment of precocious puberty, it has been found that it is easy to cause vaginal bleeding when used for the first time, with an incidence of 16%-60% [12] . And it can also increase the incidence of polycystic ovary syndrome [13] .…”