ESPE Abstracts

Background: Triptorelin, a gonadotropin-releasing hormone (GnRH) agonist, is available as 1-, 3-, and 6-month formulation for treatment of central precocious puberty (CPP). The triptorelin 22.5mg as 6-month formulation, which has recently been approved for use in CPP and offers greater convenience to children by reducing the injection frequency, but related research is very limited. The aim of this study was to study on the impact of 6 month formulation on predicted adult height (PAH) and changes in gonadotropin levels including related variables.

Methods: Total 42 patients (33 girls and 9 boys) with idiopathic central precocious puberty who were treated with triptorelin 6-month formulation for more than 12 months were enrolled. Auxological parameters including chronological age (CA), bone age (BA), height (cm and SDS), weight (kg and SDS), taget height (TH), and Tanner stage were evaluated at baseline, 6, 12, 18 and 24 months of treatment. In addition, hormonal parameters including serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol for girls and testosterone for boys were analyzed at the same interval.

Results: The mean age at the initiation of treatment was 8.6 years old (8.3 years for girls, 9.6 years for boys). The mean evoked LH level from GnRH stimulation test at diagnosis was 15.47 ± 9.94 IU/L. No progression of the Tanner stage of the breast was observed during treatment in all females and testis volume remained unchanged in males. Compared to the time at diagnosis, LH, FSH, estradiol, and testosterone were significantly reduced. In particular, the basal LH levels were well suppressed to less than l.0 IU/l and the LH/FSH ratio was less than 0.66. During treatment, the BA/CA ratio was kept steady, and although not statistically significant, it showed a decreasing trend (1.15 at baseline, 1.14 at 18 month, 1.11 at 24 month). PAH SDS increased during the treatment as 0.77±0.79 at baseline, 0.87±0.84 at 6 month, and 1.01±0.93 at 12 month of treatment with a significant increase in PAH-TH SDS (P<0.001). No adverse effect was observed during treatment.

Conclusion: The triptorelin 6-month formulation not only suppressed the pituitary-gonadal axis stably, but also showed improvement in PAH. Considering convenience and effectiveness, a significant shift to long-acting formulations is expected in the future.