The effect of cyproterone acetate on the growth of children with central precocious puberty

Stanhope, R; Huen, Kwai-Fun; Buzi, Fabio; Preece, M A; Grant, D B

doi:10.1007/bf00441603

Cited by 12 publications

(5 citation statements)

References 30 publications

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“…Before the development of the GnRHan, children with CPP had a significantly compromised final height prognosis because of rapid epiphyseal maturation and fusion. Various medications to suppress the secretion of the sex steroids in CPP such as medroxyprogesterone and cyproterone acetate were tried over the years, but they did not alter the height prognosis of children with CPP 23–25. Although the physical signs of CPP are suppressed with these medications, no difference in growth and bone age advancement was noted between children treated with medroxyprogester‐one and cypoterone acetate and those left untreated.…”

Section: Predicted Height (Ph) In Children With Central Precocious Pumentioning

confidence: 99%

Gonadotropin‐Releasing Hormone Analogues in the Management of Precocious Puberty

Spiliotis

2000

Annals of the New York Academy of Sciences

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Gonadotropin-releasing hormone (GnRH) analogues have successfully been used to treat central precocious puberty (CPP) for 20 years. [1][2][3][4][5][6] By inducing long-term suppression of the pituitary-gonadal axis, these potent agonist analogues of GnRH (GnRHan) have been able to play a major role in allowing the child to return to a prepubertal state "physiologically" and psychologically. Although the success of GnRHan treatment is physically apparent, there have always been concerns regarding two issues: (1) After the cessation of therapy, can the central nervous system mechanisms and the gonads pick up where they left off with reactivation of the process of pubertal maturation? and (2) Can final adult height be improved with the use of GnRHan? These two questions took several years to be answered, but good evidence now available can positively confirm a successful outcome on both counts.First, preliminary studies in the past showed that the effects of GnRH analogues on sexual maturation in girls are fully reversible, 6 as confirmed by subsequent studies. [7][8][9] Recently it was shown that menarche occurs 1.2 ± 0.8 years after the cessation of GnRHan therapy with a range of 0.1-4.3 years and that menstrual cycle lengths become increasingly regular, with cycles of 25-35 days' duration reported by 4% of the girls in the first year postmenarche and 65% of the girls studied 3 years postmenarche 7 (FIG. 1). Ovulation was demonstrated in 50% of the girls within 1 year of menarche and 90% of the girls studied 2 years or more postmenarche 7 (FIG. 2). The timing of menarche in girls treated with GnRHan is determined primarily by the decision of when to stop therapy. This decision is usually based on assessment of the young girl for psychologic "readiness" for menarche based on her psycholgic development and the projected height posttherapy based on bone age. Psychologic readiness for menarche is purely subjective and is derived from the parents and the physician's assessment of the child and the child's ability to relate with her peers.The natural history of CPP includes normal expectations of adult reproductive function, 10 and this was also confirmed in GnRHan-treated patients by the normal pregnancies observed after therapy. 7 As for the final adult height achieved by the children post-GnRHan therapy, the results of multiple studies show the positive outcome of improved adult height of GnRHan-treated children with CPP. [11][12][13][14][15][16][17][18][19] To understand the mechanism involved in a Phone: 0030-61-993 948; fax: 0030-061-994 533. MOC-BERA@med.upatras.gr

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Section: Predicted Height (Ph) In Children With Central Precocious Pumentioning

confidence: 99%

Gonadotropin‐Releasing Hormone Analogues in the Management of Precocious Puberty

Spiliotis

2000

Annals of the New York Academy of Sciences

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“…The natural history of the growth prognosis of central precocious puberty was described in 1974 (18). In this section, the discussion will be confined to girls, as central precocious puberty is more common in girls and also because the older literature on untreated boys with (19,20), though it was appreciated in North America that medroxyprogesterone did not affect height prognosis. When treatment with G n R H analogues, which have a specific action on the gonadotroph, was introduced, it was hoped that they would improve height prognosis.…”

Section: Gnrh Analogues and Growth In Central Precocious Pubertymentioning

confidence: 99%

“…This naturally led to the proposal that such analogues could be used in treatment to retard precocious puberty. Indeed, such trials have been reported in various publications (19)(20)(21)(22). However, although these publications note the spectacular results in the control of gonadal or gonadotrophin secretion, the effect on growth and bone maturation remains unclear because of the lack of follow-up of this type of treatment.…”

Section: Effect Of Growth Retarding Treatmentsmentioning

confidence: 99%

PUBERTY AND GROWTH: Chairman: P. Sizonenko

1988

Acta Paediatrica

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“…It is generally accepted that CPA is effective for the arrest of the development of secondary sexual characteristics. However, there has been considerable controversy about the effect on improvement in stature [11,17,18,201 .…”

Section: Introductionmentioning

confidence: 99%

The long-term effect of cyproterone acetate on growth in girls with idiopathic precocious puberty

Kato¹,

Fujimoto

Hibi

et al. 1993

Eur J Pediatr

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To define the effect of cyproterone acetate (CPA) on statural growth, 25 girls with idiopathic precocious puberty who had been treated with CPA were studied retrospectively. The final height SDS was -1.12 +/- 1.16 (mean +/- SD). The daily CPA dose was negatively related to the final height SDS. We divided our subjects into two groups according to the daily CPA dose [low dose, 84.9 +/- 15.4 mg/m2 (n = 19) vs high dose, 135.8 +/- 17.1 mg/m2 (n = 6)]. In the low dose group, the difference of the final height SDS minus height SDS for bone age at the initiation of CPA treatment was 0.55 +/- 1.16 and final height SDS was -0.82 +/- 1.05. The final height was not significantly different from the target height in the low dose group subjects whose target heights were obtained. Since the increment of height age to the increment of bone age during the treatment was significantly less in the group needing and treated with high dose CPA, high doses of CPA may reduce growth velocity more than its suppressive effect on bone maturation. These results suggest that CPA has an effect on statural growth in girls whose clinical symptoms can be controlled with a low dose of CPA, although they have not been compared with final height in untreated Japanese girls.

show abstract

The effect of cyproterone acetate on the growth of children with central precocious puberty

Cited by 12 publications

References 30 publications

Gonadotropin‐Releasing Hormone Analogues in the Management of Precocious Puberty

Gonadotropin‐Releasing Hormone Analogues in the Management of Precocious Puberty

PUBERTY AND GROWTH: Chairman: P. Sizonenko

The long-term effect of cyproterone acetate on growth in girls with idiopathic precocious puberty

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