Purpose: To investigate the outcomes of GH therapy combined with GnRH agonist for short girls who diagnosed with idiopathic CPP compared to whom treated with GnRH agonist alone.
Methods: We performed retrospective reviews, among 1636 patients managed for CPP, collected data of the 166 girls with CPP treated with GnRHa for 36 months or more from January 2002 to December 2016. We divided groups of patients received GnRHa alone (Group A, n=135) or GnRHa combined GH (Group B, n=31). Height, predicted adult height (PAH), bone age(BA) were recorded at the times of initial treatment with GnRHa, 1, 2, 3 years after initial GnRHa, the cessation of GnRHa, and the final adult height. We assessed the yearly changes in PAH SDS, MPH SDS and final height gain SDS. The menarchal ages of 166 girls were recorded.
Results: The mean age of patients at initial treatment was 7.89 years-old. The duration of GnRHa in group B was longer than group A (44.25±7.33mo in Gr. A vs 49.58±11.35mo in Gr. B, P=0.017). MPH (target height) were 159.25±3.51 cm in group A and 156.61±3.39 cm in group B. The height at the initiation of treatment were 129.34±5.18 cm and 123.12±5.13 cm in group A and B. PAH before treatment was significantly higher in group A (150.76±3.69 cm vs 146.44±3.56 cm, P<0.001). The duration of GH treatment was 39.23±16.94 months. The timing of initiation of GH therapy was 19.19 months after start of GnRHa. Height at the end of treatment were 148.99±4.27 cm and 148.61±3.67 cm in group A and B. BA at the end of therapy were 11.83±0.51 and 11.71±0.52 in group A and B. The annual increment of PAH SDS was higher in the group B than group A (0.63±0.52 vs 0.88±0.57 at first year, P=0.02; 0.52±0.34 vs 0.79±0.51 at second year, P=0.008). The height gain SDS that is the difference between NFH SDS and initial PAH SDS was significantly higher in group B (2.5±0.75 vs 2.92±1.02, P=0.048). The mean menarchal age were 13.1±0.99 vs 13.18±0.58 (P=0.755). The interval time to menarche were not significantly different between two groups.
Conclusions: The patients who were treated combined GH with GnRHa showed faster growth and had more additional height gain.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology