title: Final height in girls with central idiopathic precocious puberty treated with gonadotropin-releasing hormone analog and oxandrolone.
abstract: BACKGROUND
  GnRH analogs (GnRHa) are considered the treatment of choice for central precocious puberty (CPP). During GnRHa administration, the suppression of the pituitary-gonadal axis results in decreased rates of linear growth and skeletal maturation and in improved adult height. However, in some patients, the growth deceleration is so marked that the expected improvement in predicted adult height is not achieved.
  
  
  OBJECTIVE
  The objective of this study was to assess whether the addition of oxandrolone (Ox) may affect the height outcome of patients with CPP and growth deceleration during GnRHa treatment.
  
  
  METHODS
  This was an open-label, clinical study.
  
  
  METHODS
  The study was performed at a pediatric endocrinology referral clinic.
  
  
  METHODS
  Twenty patients with CPP and marked growth deceleration during GnRHa treatment were studied.
  
  
  METHODS
  Treatment consisted of GnRHa (Leuprorelina, 3.75 mg im every 28 d) alone (10 patients) or in combination with Ox (0.06 mg/kg.d by mouth) (10 patients).
  
  
  METHODS
  The main outcome measure was the patients' adult height.
  
  
  RESULTS
  The adult height of the patients treated with GnRHa plus Ox was significantly higher than pretreatment predicted adult height (162.6 +/- 2.3 vs. 154.8 +/- 1.7 cm, mean +/- sem; P < 0.05) and target height (162.6 +/- 2.3 vs. 158.0 +/- 1.9; P > 0.05). Patients treated with GnRHa alone reached an adult height similar to the pretreatment predicted adult height (151.9 +/- 1.2 vs. 155.4 +/- 2.1 cm) but significantly lower than target height (151.9 +/- 1.2 vs. 156.6 +/- 1.4 cm; P < 0.005). No side effects were recorded in either group of patients.
  
  
  CONCLUSIONS
  Combined GnRHa and Ox therapy is a viable treatment option for children with CPP and marked growth deceleration during treatment with GnRHa alone.
authors.affiliation: Department of Pediatrics, University of Parma, Via Gramsci 14, 43100 Parma, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Vottero
authors.forename: Simona
authors.initials: S
authors.lastname: Pedori
authors.forename: Marta
authors.initials: M
authors.lastname: Verna
authors.forename: Blandina
authors.initials: B
authors.lastname: Pagano
authors.forename: Marco
authors.initials: M
authors.lastname: Cappa
authors.forename: Sandro
authors.initials: S
authors.lastname: Loche
authors.forename: Sergio
authors.initials: S
authors.lastname: Bernasconi
authors.forename: Lucia
authors.initials: L
authors.lastname: Ghizzoni
mesh_terms: D045930:Anabolic Agents / Q000627:therapeutic use*; D001827:Body Height / Q000187:drug effects*; D001846:Bone Development / Q000502:physiology; D002648:Child; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006128:Growth / Q000187:drug effects; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D016729:Leuprolide / Q000627:therapeutic use; D007986:Luteinizing Hormone / Q000097:blood; D010074:Oxandrolone / Q000627:therapeutic use*; D011629:Puberty, Precocious / Q000188:drug therapy* / Q000473:pathology*
chemical_list: D045930:Anabolic Agents; D007334:Insulin-Like Growth Factor I; D010074:Oxandrolone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D016729:Leuprolide