Today we have an increase in patients with early-ahead forecast pubarche with impaired bone carving for advancement but organicidad criteria (HSC) but if dysfunction or adrenal hyperandrogenism and/or ovarian There are several anti-androgen drugs, all without usual pediatric use (use of label). Low-dose flutamide 62.5 mgr/day has been postulated as a treatment in these cases, but its use is restricted due to the risk of side effects (gynecomastia and liver involvement).
Objective: To study the clinical safety and efficacy of flutamide in adrenal hyperandrogenism girls affected with bone age advancement and premenarchal.
Methods: Girls significant over 6 years, early pubarche not thelarche, of course affected adrenal hyperandrogenism (ACTH test compatible with functional hyperandrogenism, no HSC), bone advancement. Use off label drug, informed consent. Control at baseline, 3.6, 9 and 12 months after implantation. voluntary use. Cost for families. Variables blood count, transaminases, basal androgens, EO (G-P), height, weight, Tanner. Comparative study. IBM SPSS 19.0 Stastistics, Nonparametric paired samples n<30.
Results: Twenty girls, mean age 6.8 to (68). previous size +0.8 SDS (0.21.7) for target height SDS 0.2 (−0.5,0.6); EO (G-P) average 19.5 months advance (1530) and prognosis of size (B-Pinau) SDS −0.6 0.8 Difference parental height SDS. Average drug use 13.4 months (1215) at doses of 62.5 mgr/day. After follow-up period event No clinical side effects. No alterations in the blood count, BQ, lipid profile and blood count. Size +0.7 SDS (0.31.5) (P: 0.23), EO (GP) advancement average 12.1 months (1124) (only observer) difference of 7.3 months (P=0.001) and forecast size (B -Pinau) −0.3 0.3 Difference SDS SDS (P: 0.04)
Conclusion: The use of low-dose flutamide and in a limited time does not appear in our series associated with biochemical alteracions, limitarparciaelmente allows the advancement of bone maturation and improve the prognosis of final height. Further studies are required in this regard.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology