ESPE2022 Rapid Free Communications Late Breaking (6 abstracts)
Are GnRH agonists beneficial in final adult height after 8 years old? Data from a Portuguese National Digital Platform of idiopathic Central Precocious Puberty
Filipa Espada 1,2,3 , Carolina Castro 4 , Ana Luisa Leite 5,6 , Elisa Galo 7,8 , Ana Antunes 9 , Sofia Castro 10,11 , Brigida Robalo 12,13 , Daniela Amaral 14 , Sofia Ferreira 15,16 & Catarina Limbert 8,17,18
1Hospital Pedro Hispano - ULSM, Matosinhos, Portugal; 2ICUF, Matosinhos, Portugal; 3SEDP - SPP, Matosinhos, Portugal; 4ULSM, Matosinhos, Portugal; 5CHVNGE, Vila Nova de Gaia, Portugal; 6SEDP - SPP, Vila Nova de Gaia, Portugal; 7Hospital da Luz, Lisboa, Portugal; 8SEDP - SPP, Lisboa, Portugal; 9Hospital de Braga, Braga, Portugal; 10CHBM, Barreiro, Portugal; 11EpiDoc Nova Medical School, Lisboa, Portugal; 12Hospital de Santa Maria, Lisboa, Portugal; 13Faculdade de Medicina Universidade de Lisboa, Lisboa, Portugal; 14HospitaLLusiadas, Lisboa, Portugal; 15Hospital Sao João, Porto, Portugal; 16Faculdade de Medicina Universidade do Porto, Porto, Portugal; 17Centro Hospitalar de Lisboa Central, Lisboa, Portugal; 18Nova Medical School, Lisboa, Portugal
Objective: Central precocious puberty (CPP) is a common condition in pediatric endocrinology practice. Gonadotropin-releasing hormone agonists (GnRHa) treatment is safe, but the real effect on final height and the ideal timing for treatment remains controversial. The purpose of the authors was to evaluate a nationwide representative group of CPP Portuguese girls treated with GnRHa, assess the effectiveness of treatment and the growth outcome before and after 8 years of age.
Design and Methods: Nationwide retrospective longitudinal study evaluated data from Portuguese girls with CPP who completed GnRHa treatment, between January 2010 and 2021. Auxological and clinical characteristics were analyzed and compared according to the age at the beginning of treatment.
Results: Of the 400 patients diagnosed with CPP, we assessed 134 girls in this study. Patients were divided into early (<8 years, n=48) and later treatment group (≥ 8 years, n=86). Duration of treatment was higher in the early group (P=0.001). In all patients, height-SDS for chronological age (CA) tended to decrease during the study (P=0.005; P=0.038), while height-SDS for bone age (BA) had a continuous increase (P=0.086; P=0.012). Similar patterns were observed in later treatment group. In early treatment group, both height-SDS for CA and BA increased throughout the study (height-SDS for CA: P=0.828 and P=0.821; height-SDS for BA: P=0.450 and P=0.001). BA advancement decreased since baseline to final treatment (P=0.008) and last visit (P=0.034), and an increase in predicted adult height (PAH) was observed in both groups (early treatment group, P=0.032; later treatment group, P=0.04). Height gain was higher in the early group, but the difference between groups was not statistically significant (P=0.056).
Conclusions: This study showed a benefit of the treatment in terms of growth outcomes demonstrated by an increase of height-SDS for BA and PAH, and a decrease in BA advancement in both groups. Moreover, height at last visit was higher than the initial PAH and GnRHa treatment was still effective even after 8 years of age in girls with CPP.
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