Efficacy of Triptorelin 3-Month Depot Compared to 1-Month Depot for the Treatment of Korean Girls with Central Precocious Puberty in Single Tertiary Center

Abstract

Background Triptorelin depot is largely used to treat central precocious puberty (CPP) in children, and a 3-month depot has been introduced. However, data about the 3-month gonadotropin-releasing hormone use for treatment of CPP in Korean girls are not available. This study was conducted to compare the efficacy of a triptorelin 11.25 mg 3-month depot with that of a 3.75 mg 1-month depot in suppressing pubertal development for the treatment of CPP. Methods A retrospective study, including 106 girls with CPP treated with triptorelin, was conducted. Fifty patients were treated with a triptorelin 3-month depot, and 56 were treated with a triptorelin 1-month depot. Serum luteinizing hormone (LH), follicle-stimulating hormone, and estradiol levels were analysed every 6 months after the visit. The height and bone age of each patient was evaluated at the beginning of treatment, after 6 months, and one year after therapy. Results The baseline characteristics of the girls treated with a 3-month depot were similar to those of the girls treated with a 1-month depot. A suppressed levels of LH to the triptorelin injection (serum LH < 2.5 IU/L) at 6 months was seen in 90.0% and 98.2% of the girls treated with the 3-month and 1-month depots, respectively ( P = 0.160). After 1 year of treatment, a suppressed levels of LH was seen in 93.5% and 100% of the girls treated with the 3-month and 1-month depots, respectively ( P = 0.226). Height velocity showed no significant difference between the two groups. Degree of bone age advancement decreased from 1.22 ± 0.07 and 1.22 ± 0.08 years at baseline ( P = 0.914) to 1.16 ± 0.07 and 1.17 ± 0.08 in the girls treated with the 3-month and 1-month depots after 1 year, respectively ( P = 0.481). Conclusion This study showed that the efficacy of long-acting triptorelin 3-month was comparable to 1-month depot regarding hormonal suppression and inhibition of bone maturation. The triptorelin 11.25 mg 3-month depot is an effective treatment for girls with CPP.

Efficacy of Leuprorelin 3-Month Depot (11.25 mg) Compared to 1-Month Depot (3.75 mg) for Central Precocious Puberty in Chinese Girls: A Prospective Cohort Study

“…Tere is still controversy over the appropriate LH suppression cut-of value with GnRHa stimulation [26][27][28]. In our study, we used LH < 2.5 IU/L as the cut-of value for LH suppression, which is consistent with previous studies [14]. Tere was no signifcant diference in suppression of LH between the two groups, and serum LH and serum E2 concentrations declined approximately 7-10-fold from baseline to 6 months after treatment.…”

“…Our results showed that LA 3-month depots were similarly effective to LA 1-month depots. Although our study is a single center, short-term study, we have seen the report of Chung et al [ 14 ] from Chorea, which is larger and have a longer follow-up period. They found that a suppressed levels of LH was seen in 93.5% and 100% of the girls treated with the 3-month and 1-month depots after 1 year of treatment, respectively ( P =0.226).…”

“…Following triptorelin-stimulated measurement, we determined the serum peak levels of LH and FSH. Additionally, the levels of fasting serum LH < 2.5 IU/L after therapy were considered to suppress the HPG axis [ 14 ].…”

“…In short-term studies, it was shown that the 3-month depot formulation of GnRHa was efective in patients [10][11][12]. However, there has rarely been a comparison of the efectiveness of 3.75 mg versus 11.25 mg depot in suppressing the HPG axis [12][13][14]. In many countries of the world, leuprorelin acetate (LA) has been used in patients sufering from CPP in depot formulations that are injected monthly or every 3 months [7,13].…”

Impact of 6-month triptorelin formulation on predicted adult height and basal gonadotropin levels in patients with central precocious puberty

“…The 6-mo TP formulation recently approved for CPP offers greater convenience to children than other formulations, by reducing the injection frequency; however, related research is very limited (12). The 1-month dose presentation is still the most used, and usage of the 3-month dosage form is increasing (32)(33)(34); however, there is a lack of clinical experience worldwide regarding the use of the 6-month formulation (35). It has not yet been universalized, and doubts about its efficacy and safety persist among guardians and pediatric endocrinologists (1,35).…”