Introduction: In children receiving growth hormone (GH) therapy during puberty, epiphyseal fusion due to sex steroids often limits the height gain. Aromatase inhibitors may seem to help at this point despite the lack of evidence. Herein, it was aimed to investigate the efficacy of anastrozole for add-on treatment in pubertal male patients receiving GH therapy.
Methods: This is a retrospective study comparing two groups of patients treated with GH either with or without anastrozole who achieved final height (FH) between 2006 and 2021: patients who had received only GH (GH-Only) and both GH and anastrozole (GH+A). Chronological age, bone age (BA), pubertal stage, height, height SDS were noted from the files of the patients who received GH+A therapy at 3 different times: at the beginning of GH (TIME1), when anastrozole was added (TIME2), and at the end of the whole therapy (TIME3). FH was noted in all patients (TIME4). Then, GH-Only patients with similar target height and exactly similar auxological parameters indicated above as the GH+A group at TIME1 were selected to create a matched group. Since there was no milestone in which anastrozole was added (TIME2) in the GH-only group, for each patient, the findings were noted at the CORRESPONDING TIME2 (same chronological age of its partner in the GH+A group when anastrozole was added). Comparisons of auxological parameters were made between the groups at TIMES1-4.
Results: A total of 48 cases (24 cases in each group) were included. There was no statistical difference in the matched parameters at TIME1 and FH (TIME4)(P=0.071) between GH+A and GH-Only. However, when the analysis was limited to the patients who received anastrozole ≥2 years, FH was found to be significantly higher with an average of 3.3 cm in GH+A than in GH-Only group (173.1±6.2 vs. 169.8±5.6 cm, respectively, P=0.044). Advancement in BA was slower in the GH+A group than in the GH-only group in the mean anastrozole treatment period of 1.59 years (1.37±0.80/1.81±0.98 years, P=0.001). However, the growth rate in this period and the height reached at TIME3 were similar between GH+A and GH-only groups (P=0.133 and P=0.269, respectively).
Conclusion: It has been apparently shown that although the use of anastrozole for at least 2 years in addition to GH does not affect growth rate, it slows down the advancement in BA, thus, resulting in gain in FH.
15 Sep 2022 - 17 Sep 2022