ESPE Abstracts

Introduction: The wide aromatization of androgens during puberty is responsible for the rapid bone maturation at this age. In this context, the use of aromatase inhibitors (AIs) has been justified by the potential to slow down the advancement of bone age and thus improve growth. For more than two decades, studies have pointed out the validity of AIs to improve the predicted final height (PFH). However, data on near-final height (NFH) of children treated with AIs are scarce.

Objective: This study aimed to evaluate the PFH and NFH of boys treated with anastrozole (ANZ) either as monotherapy or in combination with Growth Hormone (GH).

Methodology: Seventy-five boys presenting with PFH below the family target height (TH) between 11 and 18 years old received either ANZ as monotherapy or in combination with GH for at least 12 months. Measurements were made on the same height meter by the same examiner. The follow-up included clinical examination performed by the same examiner, laboratory tests (general blood count, glucose, lipid chart, LH, FSH, testosterone, estradiol), and bone X-ray. The calculation of the Final Height Prediction (PEF) was performed using the Bayley Pinneau method.

Results: Among the adolescents, 29 used ANZ regularly for 1 year, 30 used it for 2 years and 16 used it for 3 years of treatment. Fifty-seven boys used ANZ+GH, and 18 received ANZ as isolated therapy. The correlation between TH, PFH at 1,2, and 3 years of treatment and NFH demonstrated P <0.001, regardless of the use or not of GH. Regarding the initial PFH, in those who did not use GH, there was an average increase of 5.73 cm, 7.60 cm, and 7.15 cm in predicted height after 1, 2, and 3 years of ANZ, respectively, and 2.67 cm when compared to NFH. In the ANZ+GH group, this increase was 6.82 cm, 10.27 cm, 7.44 cm, and 6.26 cm, respectively. The increment in final height compared to the basal PFH was 0.82 cm in the ANZ group and 5.55 cm in the ANZ+GH group. The whole group of adolescents who reached NFH exceeded TH by 1.22 cm.

Conclusion: Anastrozole therapy was safe and effective in improving the PFH and NFH in boys with poor height prediction, either as monotherapy or in combination with growth hormone.

Keywords: adolescents, aromatase inhibitors, anastrozole, short stature.