Comparison of three doses of leuprolide acetate in the treatment of central precocious puberty: preliminary results.
OBJECTIVE
Depot luteinizing-hormone releasing hormone (LHRH) agonist have been widely used for the treatment of central precocious puberty (CPP), but the optimal doses to obtain hormonal suppression are still unknown, especially in patients with higher weights. The goal of our study was to compare the efficacy of three leuprolide acetate (LA) preparations, suppressing gonadotropin secretion in patients with CPP.


METHODS
In an open 12-month protocol, we evaluated LA 7.5 mg/month, 11.25 and 22.5 every 3 months.


METHODS
Fourteen girls with CPP and weights over 30 kg.


METHODS
Clinical, radiological and laboratory follow-up: GnRH test plus LH, FSH 40 min post analogue was performed periodically.


RESULTS
Pretreatment basal and LHRH stimulated LH levels between groups were not different. Basal and LHRH stimulated LH levels decreased significantly between baseline and from 3 up to 12 months of therapy in all groups (P = 0.001). GnRH stimulated LH peak <2 IU/l, the main efficacy criterion was met in 80, 75 and 100% of the children at 6 months in the 7.5, 11.25, 22.5 mg doses respectively. By 12 months, 100% of patients had LH suppressed to <2 IU/l.


CONCLUSIONS
These results affirm that 3-month injections may be a satisfactory alternative for the therapy of children with CPP to avoid monthly injections. In addition, suppression of LH occurs sooner in the 3-month 22.5 mg LA dose compared to the 3-month 11.5 mg; therefore, adequate dosing may be important for optimal outcome. Further investigation is needed in more patients over 30 kg, with longer treatment duration, and ultimately final height consideration.
Mericq
Verónica
V
Institute of Maternal and Child Research, Faculty of Medicine, University of Chile, Casilla 226-3, Santiago, Chile. vmericq@med.uchile.cl
Lammoglia
Juan Javier
JJ
Unanue
Nancy
N
Villaroel
Claudio
C
Hernández
María Isabel
MI
Avila
Alejandra
A
Iñiguez
Germán
G
Klein
Karen Oerter
KO
D000365:Age Determination by Skeleton; D002648:Child; D005260:Female; D012739:Gonadal Steroid Hormones / Q000378:metabolism; D006801:Humans; D016729:Leuprolide / Q000008:administration & dosage* / Q000627:therapeutic use; D011629:Puberty, Precocious / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
D012739:Gonadal Steroid Hormones; D016729:Leuprolide