Evaluation of central precocious puberty treatment with GnRH analogue at the Triangulo Mineiro Federal University (UFTM)

Abstract

Objective: To report our experience of treating central precocious puberty (CPP) with a GnRH analogue with respect to the final heights (FH) attained in patients who completed treatment. Subjects and methods: Among 105 records of children diagnosed with precocious puberty, 62 cases (54 girls and 8 boys), who were treated with leuprolide acetate/3.75 mg/monthly, were selected, and divided into 4 groups: group 1 (G1), 25 girls who attained FH; group 2 (G2), 18 girls who completed treatment but did not reach FH; group 3 (G3), 11 girls still under treatment; and group 4 (G4), 8 boys, 5 of which attained FH. Treatment was concluded at a bone age of 12 years, and follow-up continued until FH was achieved. Results: In both G1 and G2 groups, height standard deviation score (SDS), weight-SDS and percentile of body mass index (PBMI) did not show intra/intergroup differences at the beginning and at interruption of treatment, but when added, G1+G2, height-SDS and weight-SDS differed significantly (p = 0.002 and 0.0001, respectively). In G1, 19 of 25 cases attained TH, and average height gain was 16.7 cm (7.7-27.1); there was significant difference between FH and prediction of FH at the start (PFH at start) (p = 0.0001), as well as between PFH at interruption vs TH and vs FH (p = 0.007) with FH higher than TH (p = 0.004). Significant correlation was identified between FH and height gain after treatment. Conclusion: As shown by some studies, GnRH analogue treatment was effective in children with CPP reaching FH near the genetic target. Arch Endocrinol Metab. 2015;59(6):515-22

Puberty-Defining Normal and Understanding Abnormal

“…Continuous dosing of GnRH agonists, most commonly leuprolide, causes suppression of the pulsatile GnRH signals from the hypothalamus and promotes children reaching their full heights based on genetics [14]. Giabicani et al have established formulas to predict adult height to determine if and when treatment with GnRHa is needed [15].…”

Clinical and Laboratory Parameters of Gonadotropin-Releasing Hormone Analog Treatment Effectiveness in Children with Precocious Puberty

“…The current treatment of choice for CPP consists of the administration of depot GnRH analogs (GnRHa). These analogs’ clinical effectiveness has been demonstrated by several authors and includes final height improvement, regression of sexual characteristics according to Marshall and Tanner’s classification, decrease in growth velocity, and decrease in bone age (BA) advancement (3,4,12-17), as well as delaying the age of menarche (18-20). Thus, treated children develop puberty at a similar time as their peers.…”

Long‐term efficacy and safety of gonadotropin‐releasing hormone analog treatment in children with idiopathic central precocious puberty: A systematic review and meta‐analysis

“…Several studies have reported that GnRHa may improve FAH in girls with CPP 3,23–26 ; this is particularly true if they were diagnosed before the age of 6 years and treated with GnRHa from Tanner stage 2–3 to chronological age 11–12 years and bone age 12–12.5 years 27 . However, the effects of GnRHa treatment are unknown in girls diagnosed between 6 and 8 years of age 3 .…”