ESPE Abstracts

Background: Gonadotropin-releasing hormone analogs (GnRHa) are the standard treatment of central precocious puberty (CPP). Many studies demonstrate the effects of GnRHa on preserved final adult height. However, data compares the efficacy of different GnRHa on growth outcome and gonadotropin suppression in girl with CPP was limit

Objective: Evaluate the effect of 2 different GnRHa on final adult height (FAH) and gonadotropin suppression in girl with CPP

Design: Retrospective study

Method: Reviewed the medical record of girls with idiopathic CPP and had been treated with leuprorelin acetate or triptorelin acetate intramuscular injection every 4 weeks at Phramongkutklao Hospital who are now reach FAH determine by growth velocity during the preceding year was less than 1 cm and/or a bone age of 16 years

Results: Thirty-five girls, 20 treated with leuprorelin acetate (LA group) and 15 with triptorelin acetate (TA group) were enrolled. Mean age at time of treatment was 8.38+0.75 and bone age was 11.09+1.37 years in LA group while mean chronological age at time of treatment was 8.18+0.41 and bone age was 10.72+0.98 years in TA group. There were no different in height SDS, weight SDS, BMI SDS, predicted adult height (PAH), dose of GnRHa at the time of diagnosis and target adult height (TAH) between the groups. However, the duration of treatment in TA group was significantly longer than LA group (3.36+0.57 vs 2.38+0.89 years, P=0.001) and they were discontinued treatment at older age (11.55+0.5 vs 10.76+0.76 years, P=0.002). At 6 month after GnRHa treatment, 16.7% in LA group reveals inadequate gonadotropin suppression and peak LH was significantly higher in LA compare to TA group (2.59+2.44 vs 0.78+0.15 mU/L, P=0.03). In both groups, FAH were comparable with to TAH. The height gain from PAH (FAH-AcPAH) was significantly higher in TA group compare with LA group (5.67+4.20 vs 1.88+4.92 cm, P=0.02) but after using a one-way ANCOVA controlling for duration of treatment and age of discontinue treatment, no significant different in FAH-AcPAH between 2 groups were found (P=0.394)

Conclusion: Girls with idiopathic CPP treated with GnRHa reach their FAH comparable with PAH and TAH. No different in FAH and FH increase over PAH between LA and TA. LH suppression was more pronounced in TA group