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

Abstract

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.

Final Height of Girls with Central Precocious Puberty, Untreated versus Treated with Cyproterone Acetate or GnRH Analogue

“…In contradistinction, CyA suppresses gonadotrophin secretion incompletely [33], and has some undesirable side effects [34,35], Treatment with CyA may also become irregular and inconsistent with time, as noted with any chronic oral therapy in chil dren. This may be an additional reason for the less favor able FHt outcome reported for CyA treatment in CPP [36][37][38]. In this study we included only patients for whom regular and consistent treatment with CyA was registered and its long-term effect on FHt proved to be beneficial.…”

Cirrhosis in a child with hypothalamic syndrome and central precocious puberty treated with cyproterone acetate

“…CPA is used in adults for treatment of prostate and breast cancer, uncontrolled sexual urges, hirsutism and acne. In children, before the introduction of gonadotropin-releasing-hormone (GnRH) analogues, CPA was the most frequently used drug for the treatment of precocious puberty [7,16,13,22]. Moreover, it is still prescribed by some as temporary concomitant treatment to GnRH analogues, to counteract its possible initial stimulatory eect, before gonadotropin secretion ensues [15].…”

Dose of LHRH Analog and Growth Velocity Influence Predicted Final Height in Girls with Central Precocious Puberty

“…The fact that the change in height SDS Table 5 Correlation coefficients for predicted final height (PFH) at the final estimation and various variables in the older group for bone age was greater in the younger group also shows the importance of the effect of growth velocity on final height. Kato et al (4) report that the final height of girls with central precocious puberty was greater in patients who received low-dose cyproterone acetate (CPA) than in patients who received high-dose CPA and speculate that high-dose CPA might cause a greater growth velocity reduction than a suppressive effect on bone age maturation. Our study's findings agree with those of Kato et al The average growth velocity showed a significant negative correlation with the average dose: the higher the dose, the lower the growth velocity.…”

“…ported that gonadal suppressive agents such as cyproterone acetate and LHRH analog can effectively regress or arrest pubertal development, but the results of the effect on improvement of final height are still controversial (1)(2)(3)(4)(5)(6)(7). Final height is thought to be influenced by the rate of deceleration of bone age maturation and growth rate during treatment.…”