Background: GnRH agonists, leuprolide acetate (LA) and triptorelin acetate (TA), have been widely used in the treatment of central precocious puberty (CPP). But, a comparative data on the effectiveness of these two drugs for CPP treatment is very scarce.
Objective: To compare the efficacies of TA and LA treatments in girls with idiopathic CPP.
Patients and Methods: Sixty girls with rapidly progressive CPP treated with LA (n=30) or TA (n=30) were studied in a retrospective analysis. Inclusion criteria for treatment were breast development before 8 years, pubertal LH level (basal>0.3 IU/l or peak>5 IU/l), accelerated bone age (BA>+2SD) and predicted adult height (PAH) <155 cm or progressive compromise of PAH (at least 3 cm in 6 months). Initial dose of both drugs was 3.75 mg/28 days. A pubertal LH response to GnRH agonist at the third month of treatment was indicative of non-suppression and a need for dose increment. One-year follow-up data of two groups were compared.
Results: Baseline characteristics including age, pubertal stages, BA, PAH, basal and peak gonadotropin levels and drug doses per kg of body weight were similar in two groups. However, GnRHa-stimulated LH levels at the third month were significantly higher in LA group than in TA groups (3.1±2.3 vs 1.4±0.9 IU/l; P<0.001). While an increment in LA dose was required in seven patients (23%), no patient needed a TA dose increase (P=0.011). Nevertheless, at the end of one year, clinical progression (Tanner stages, growth velocity, skeletal maturity, etc.) of two groups were not different, with similar doses of LA and TA (126±66 and 119±25 μg/kg; P=0.59).
Conclusion: Despite similar clinical efficacy with leuprolide, triptorelin provided better LH suppression without a need for dose increment. So it might be more preferred for treatment of girls with CPP because it.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology