Long-term treatment of central precocious puberty with a long-acting analogue of luteinizing hormone release hormone (D-Tryp6-GnRH) in monthly injections. Its possible use in normal puberty.
The gonadotropin-releasing-hormone-like agonist D-Tryp6-GnRH (GnRHa) has been shown to induce reversible suppression of gonadotropins and gonadal steroids in patients with central precocious puberty. We examined the effect of a long-acting preparation of GnRHa in biodegradable microcapsules. D-Tryptophane6-GnRH, administered intramuscularly at 1 month intervals, for 12 consecutive months, on growth and skeletal maturation in 3 girls and 4 boys with neurogenic or idiopathic precocious puberty. Suppression of gonadotropin release after GnRH stimulation and gonadal steroids was maintained in all subjects. Growth velocity fell from a mean rate (+/- SEM) or 8.60 +/- 0.75 cm/year before treatment to 5.81 +/- 0.60 cm/year (p < 0.005) after 1 year. Bone age advanced a mean of 8.0 +/- 0.45 months during treatment, suggesting an increase in predicted height from the ratio delta bone age/delta chronological age. Two subjects, one of them with compensated Bartter's syndrome with normal hypothalamic pituitary-gonadal-axis, received the analogue to delay pubertal growth with the hope to improve final height. In the first one, the growth velocity fell from 9.9 cm/year to 8 cm/year and delta bone age/delta chronological age decreased from 1.28 to 1.0 and in the other subject, the growth velocity fell from 12 cm/year to 6.0 cm/year in the last year of treatment and delta bone age/delta chronological age fell from 3.2 to 0.75, indicating an improvement in predicted height.
Marcondes
J A
JA
Endocrine Clinic, Hospital das Clinicas de Sao Paulo, Brazil.
Abujamra
A C
AC
Minanni
S L
SL
Mendonca
B B
BB
Nery
M
M
Lerario
A C
AC
Pereira
M A
MA
Abelin
N
N
Wajchenberg
B L
BL
D001477:Bartter Syndrome / Q000188:drug therapy; D001827:Body Height / Q000187:drug effects; D001846:Bone Development / Q000187:drug effects; D002214:Capsules; D002648:Child; D002675:Child, Preschool; D004343:Drug Implants; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007273:Injections, Intramuscular; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D011629:Puberty, Precocious / Q000188:drug therapy*; D013737:Testis / Q000187:drug effects / Q000254:growth & development; D013739:Testosterone / Q000097:blood; D017329:Triptorelin Pamoate / Q000008:administration & dosage / Q000627:therapeutic use*
D002214:Capsules; D004343:Drug Implants; D017329:Triptorelin Pamoate; D013739:Testosterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone