Time to Menarche and Final Height after Histrelin Implant Treatment for Central Precocious Puberty

Gillis, David; Karavani, Gilad; Hirsch, Harry J.; Strich, David

doi:10.1016/j.jpeds.2013.01.021

Cited by 24 publications

(25 citation statements)

References 19 publications

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“…The efficacy of the various GnRHa in terms of HG appeared similar (24,27,31), except for a study (32) showing a higher adult height SDS in patients treated with leuprolide depot compared to triptorelin depot.…”

Section: Adult Heightmentioning

confidence: 84%

“…According to two independent studies (33,37) analyzing normal-weight and overweight children separately, BMI-SDS during treatment increased in normalweight children, whereas it remained stable in overweight subjects. The majority of long-term studies showed an increased prevalence of overweight and obesity in patients with CPP at diagnosis (22,38), but no significant mean or individual BMI-SDS changes were shown at the end of treatment, irrespective of sex, age at puberty onset and at the start and discontinuation of treatment (15,17,22,23,24,25,30,32,39), and type of GnRHa (31). Recently, a study by Colmenares et al (39) evaluated the effects of GnRHa in treated (nZ29) and untreated (nZ8) CPP patients and in treated (nZ14) and untreated (nZ20) rapidly progressing early puberty (EP), during a 3-year follow-up period.…”

Section: Bmi and Correlates Of Metabolic Syndromementioning

confidence: 99%

“…Few reports of follow-up after histrelin implant treatment were published. Gillis et al (31), evaluating a group of CPP patients treated with the monthly GnRHa and one with the histrelin implant showed that the mean time between the removal of the implant or last injection and menarche was shorter in the histrelin implant group. Fisher et al (41) reported the resumption of puberty in 26 of the 30 girls treated with the histrelin implant, with occurrence of menarche 2-36 months after explantation in treatment-naïve and -nonnaïve CPP girls, with an older age at explantation correlating with earlier menarche.…”

Section: Reproductive Function and Risk Of Polycystic Ovarian Syndromementioning

confidence: 99%

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MANAGEMENT OF ENDOCRINE DISEASE: Long-term outcomes of the treatment of central precocious puberty

Guaraldi

Beccuti

Gori

et al. 2016

European Journal of Endocrinology

113

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GnRH analogues (GnRHa) are the treatment of choice for central precocious puberty (CPP), with the main objective to recover the height potential compromised by the premature fusion of growth cartilages. The aim of this review was to analyze longterm effects of GnRHa on height, body weight, reproductive function, and bone mineral density (BMD) in patients with CPP, as well as the potential predictors of outcome. Because randomized controlled trials on the effectiveness and long-term outcomes of treatment are not available, only qualified conclusions about the efficacy of interventions can be drawn. GnRHa treatment appears to improve adult height in girls with CPP, especially if diagnosed before the age of 6, whereas a real benefit in terms of adult height is still controversial in patients with the onset of puberty between 6 and 8 years of age. No height benefit was shown in patients treated after 8 years. Gonadal function is promptly restored in girls after cessation of treatment, and reproductive potential appears normal in young adulthood. Data are conflicting on the long-term risk of polycystic ovarian syndrome in both treated and untreated women. Fat mass is increased at the start of treatment but normalizes thereafter, and GnRHa itself does not seem to have any long-term effect on BMI. Similarly, analogue treatment does not appear to have a negative impact on BMD. Owing to the paucity of data available, no conclusions can be drawn on the repercussions of CPP and/or its treatment on the timing of menopause and on the health of the offspring.

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Section: Adult Heightmentioning

confidence: 84%

Section: Bmi and Correlates Of Metabolic Syndromementioning

confidence: 99%

Section: Reproductive Function and Risk Of Polycystic Ovarian Syndromementioning

confidence: 99%

See 1 more Smart Citation

MANAGEMENT OF ENDOCRINE DISEASE: Long-term outcomes of the treatment of central precocious puberty

Guaraldi

Beccuti

Gori

et al. 2016

European Journal of Endocrinology

113

View full text Add to dashboard Cite

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“…Recently, Gillis et al [24] compared AH and near-AH of 11 girls with CPP treated with yearly histrelin implants with those of 18 girls treated with monthly triptorelin. Nine of the 11 girls were previously treated with monthly triptorelin [24].…”

Section: Discussionmentioning

confidence: 99%

Central Precocious Puberty: Adult Height in Girls Treated with Quarterly or Monthly Gonadotropin-Releasing Hormone Analog Triptorelin

Bertelloni

Massart²,

Einaudi³

et al. 2015

Horm Res Paediatr

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Background/Aims: Treatment with quarterly gonadotropin-releasing hormone (GnRH) analogs may improve compliance and optimize outcome in girls with central precocious puberty (CPP), but long-term comparative data between the new and the monthly formulations are very scarce. Methods: A group of girls with idiopathic CPP (n = 13; age 7.9 ± 0.6 years) were treated from the beginning with quarterly triptorelin (11.25 mg/90 days) and followed up to the achievement of adult height (AH). A group of girls with idiopathic CPP (n = 12; age 8.0 ± 0.6 years) treated with monthly triptorelin (3.75 mg/28 days) served as controls. Results: The AH (157.1 ± 4.9 cm) of girls treated with quarterly triptorelin was not significantly different from their mid-parental height (159.7 ± 3.8 cm) and significantly increased in comparison with predicted AH (average tables) at the beginning of GnRH analog therapy. The AH of girls treated with quarterly triptorelin was not significantly different in comparison with that of girls treated with the monthly formulation (158.1 ± 6.6 cm; mid-parental height 158.4 ± 5.0 cm). Conclusion: Treatment with quarterly triptorelin formulation permitted to achieve an AH adequate for mid-parental height in girls with CPP. Significant differences of AH between girls with CPP treated with quarterly or monthly formulations were not found.

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“…In one study, time from explantation to menarche was determined in 11 girls, all but 2 of whom were previously treated with depot GnRHa injections, and was compared to 23 girls treated only with depot GnRHa. The average time to menarche was significantly shorter in the histrelin group compared with the injection group (9.3 vs 16 months, p=0.02) [19]. In contrast, a larger study involving 30 girls with CPP found an average interval from implant removal to menarche of 12.75 months, albeit with significant individual variation.…”

Section: Recovery Of the Hpg Axismentioning

confidence: 75%

Experience with the Histrelin Implant in Pediatric Patients

Eugster

2015

Advanced Therapies in Pediatric Endocrinology and Diabetology

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The histrelin implant has emerged as a therapeutic option for the treatment of central precocious puberty (CPP) that has been favorably received by patients and providers. Inserted subcutaneously, the 50 mg implant provides continuous release of the potent gonadotropin releasing hormone analog (GnRHa) histrelin. Profound suppression of the hypothalamic-pituitary-gonadal (HPG) axis occurs within one month of its placement resulting in pubertal arrest, attenuation of skeletal advancement and a progressive increase in predicted adult height. Although marketed for annual use, suppression lasting two years from a single implant has been demonstrated. Placing and removing the device is a minor outpatient procedure easily accomplished by a pediatric surgeon using local anesthesia. The major downside to the implant is a ~25% rate of breakage upon removal. Information about recovery of the HPG axis following histrelin explanation is limited but suggests an average time to menarche comparable with depot-GnRHa formulations albeit with wide individual variation.2

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Time to Menarche and Final Height after Histrelin Implant Treatment for Central Precocious Puberty

Cited by 24 publications

References 19 publications

MANAGEMENT OF ENDOCRINE DISEASE: Long-term outcomes of the treatment of central precocious puberty

MANAGEMENT OF ENDOCRINE DISEASE: Long-term outcomes of the treatment of central precocious puberty

Central Precocious Puberty: Adult Height in Girls Treated with Quarterly or Monthly Gonadotropin-Releasing Hormone Analog Triptorelin

Experience with the Histrelin Implant in Pediatric Patients

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