Novel treatment of short stature with aromatase inhibitors

Dunkel, Leo; Wickman, Sanna

doi:10.1016/s0960-0760(03)00344-3

Cited by 21 publications

(24 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In a group of adolescents treated with letrozole, after 5 months of treatment, HDL levels decreased, but then remained stable despite the continuation of treatment. 22 In a group of 31 adolescents treated for 2 years, HDL cholesterol and relative fat mass also decreased, without affecting insulin sensitivity. 25 The levels of LDL-cholesterol and triglycerides do not seem to be affected by AI.…”

Section: Side Effectsmentioning

confidence: 97%

“…Nevertheless, it is important to monitor BMD and lipid metabolism. 22 In regard to the potential role of estrogen suppression on spermatogenesis, in vitro studies showed that estradiol acts as a germ cell survival factor; 23 patients with a mutation in the gene for In regard to bone density, after a period of 1 year of treatment, there was no evidence of decreased BMD. As patients with androgen insensitivity present a reduced BMD even before reaching the peak bone mass, endogenous androgens are important for the acquisition of bone mass.…”

Section: Side Effectsmentioning

confidence: 99%

See 1 more Smart Citation

Manejo farmacológico da baixa estatura: o papel dos inibidores da aromatase

Damiani

2007

J. Pediatr. (Rio J.)

View full text Add to dashboard Cite

Objective: To review the use of aromatase inhibitors, a novel treatment strategy for patients with short stature, which aims at delaying bone age advancement. Skeletal maturation is estrogen-dependent even in male children. Sources:We performed a MEDLINE search of studies published in the last 10 years, including aromatase, short stature, and early puberty as keywords. The most informative articles on indications, dosages, treatment schedules, and side effects of aromatase inhibitors were included in the review. Summary of the findings:It has become increasingly clear that bone age advancement depends on the production of estrogen and its effect on the growth plate. In boys, testosterone is converted to estradiol by the cytochrome P450 enzyme aromatase. The use of aromatase inhibitors has been shown to be effective in prolonging the length of the growth phase in children with idiopathic short stature, constitutional growth delay, delayed puberty, as well as in children with growth hormone deficiency, in which bone age advancement jeopardizes the results of hormonal replacement therapy with growth hormones. As yet, significant adverse effects have not been reported, and results are encouraging in terms of effective increase in height, whenever the indication for the drug is appropriate. Conclusions:Among the pharmacological treatments for short stature, aromatase inhibitors are indicated in cases in which bone age advancement may constitute an obstacle for reaching a final height that is in keeping with the family's target height.J Pediatr (Rio J). 2007;83(5 Suppl):S172-177: Short stature, aromatase inhibitors, bone age, estrogens, androgens, puberty.

show abstract

Section: Side Effectsmentioning

confidence: 97%

Section: Side Effectsmentioning

confidence: 99%

Manejo farmacológico da baixa estatura: o papel dos inibidores da aromatase

Damiani

2007

J. Pediatr. (Rio J.)

View full text Add to dashboard Cite

show abstract

“…Aromatase inhibition [44,58,59,60,61] may be a more effective regimen for enhancing growth, with growth stimulated by the continued presence of androgen and bone age advancement slowed by elimination of the presence of estrogen. In a double-blind, placebo-controlled trial by Dunkel et al, the potent aromatase inhibitor letrozole was used to slow the rate of skeletal maturation in boys with short stature and delayed puberty who were also receiving testosterone [58, 62].…”

Section: Other Attempts At Growth Modulationmentioning

confidence: 99%

“…In a double-blind, placebo-controlled trial by Dunkel et al, the potent aromatase inhibitor letrozole was used to slow the rate of skeletal maturation in boys with short stature and delayed puberty who were also receiving testosterone [58, 62]. Predicted adult heights were significantly enhanced by this regimen (mean, 182.1 cm in treated boys vs. 175.2 cm in placebo-treated boys).…”

Section: Other Attempts At Growth Modulationmentioning

confidence: 99%

Hormonal Treatment of Idiopathic Short Stature

Reiter¹

2007

Horm Res Paediatr

View full text Add to dashboard Cite

Background and Objective: The classification idiopathic short stature (ISS) represents a heterogeneous group of children who, as a group, are similar in height to patients with growth hormone (GH) deficiency, Turner syndrome, and short stature as a consequence of being born small for gestational age. GH therapy has been an effective treatment for enhancing height in children with ISS. Methods: A large body of literature – including data from KIGS (Pfizer International Growth Study Database) and the National Cooperative Growth Study database – shows that non-placebo-controlled GH treatment programs generally, though not uniformly, are associated with substantial increments in height gain. Placebo-controlled trials conducted in several countries report significant gains of 5 to 8 cm in final height. Conclusions: Long-term data are needed to assess the behavioral consequences, if any, of GH treatment for children with ISS. As the pool of children with ISS is potentially large, it would be highly desirable if clinical trials enabled accurate prediction of likely height gain and could result in greater individualization of treatment. The use of aromatase inhibitors to slow estrogen-mediated skeletal maturation is a new treatment modality, but it has only been minimally tested. The lower cost and ease of oral administration are attractive considerations, but long-term safety data are needed.

show abstract

“…So far, these treatments have only been used in pediatric endocrinology in rare patients with gonadotropin-independent precocious puberty (52,53). This approach has recently been reviewed elsewhere (54) and awaits further efficacy and safety data.…”

Section: Other Approaches To Increase Adolescent Growthmentioning

confidence: 99%

Can we increase adolescent growth?

Carel

2004

European Journal of Endocrinology

View full text Add to dashboard Cite

Adolescent growth represents 15-20% of adult height and has been the focus of several treatment interventions, aiming at increasing the amplitude of the adolescent spurt. Importantly, pre-and early puberty are times when patients and families seek medical help and when estimates of adult height are more accurate than in younger children. We review the current approaches aimed at increasing pubertal growth in short children and knowledge about their results and risks. GnRH agonists, when used outside the context of precocious puberty, induce a modest gain (4 cm) when they are used for more than 3 years. Their effects on bone mass, body composition and possibly on psychosocial parameters limit their use. Several trials have now shown that GH can increase adult height of short adolescents with idiopathic short stature or born small for gestational age. However, the amplitude of the effect is modest and of dubious clinical significance. Lastly, the association of both approaches is rather popular among pediatric endocrinologists but still lacks a definite demonstration of its efficacy. In conclusion, we have gained insight in the median effects of some of these treatments and overoptimistic initial expectations are now refocused. However, we still have a long way to go before we truly evaluate the factors affecting the variable individual responses to these treatments, their clinical significance and their cost -benefit balance.European Journal of Endocrinology 151 U101-U108

show abstract

Novel treatment of short stature with aromatase inhibitors

Cited by 21 publications

References 60 publications

Manejo farmacológico da baixa estatura: o papel dos inibidores da aromatase

Manejo farmacológico da baixa estatura: o papel dos inibidores da aromatase

Hormonal Treatment of Idiopathic Short Stature

Can we increase adolescent growth?

Contact Info

Product

Resources

About