ESPE Abstracts

Background: GnRHa is the treatment for CPP, it arrests puberty progression, slows bone age (BA) maturation, and increases pubertal height. In the last decades, the use of GnRHa has demonstrated its favorable effects on linear growth, although the net height gain and predictors of long-term outcomes remains debated. Concerns raised on thepotential negative effects of treatment on weight and reproductive function.

Methods: We reviewed EMR of children with idiopathic CPP treated with GnRHa at the Endocrine clinic (2014 – 2022). The study aimed to evaluate the effects of GnRHa on height preservation measured by improvement in height SDS, along with changes in BA an AH. We analyzed the effects on BMI and determined the time of menarche and the growth pattern after cessation of GnRHa treatment.

Results: A total of 91 subjects; 84.6% were females (n=77) and 15.4% (n=14) were males. For females, median chronological age (CA) at the start of GnRHa thrapy were 8.5 years (7.8-9.2). For males, median CA at the start of therapy were 11.1 years (9.7-11.9). Comparing to CA, BA at start of therapy was advanced by 1.2 years (0.0-1.8) in females and 1.35 years (0.0-2.17) for males. The mean durations of therapy were 20.5 months (±9.8) for females and 21 months (±4.6) for boys. At the end of the second year of treatment, the difference between BA and CA was 0.6 years (0.0-1.6) in females and 0.4 years (0.1-3.2) (P<0.001). Of those who acived AH, all girls (n=9) and boys (n=3) height fall within thier MPH 2SDS. AH was positively correlated with height SDS and negatively with CA and BA at the start of treatment. The mean CA at menarche was 10.9 year (± 1.5), and median time interval from the cessation of GnRHa to menarche was 12 months (9-16). BMI SDS increased significantly during treatment and persisted at the end of treatment. DISCUSSION AND CONCLUSIONS: Mof our patients were females. Treatment with GnRHa resulted in a marked reduction in bone age advancements. BMI SDS increased. The majority of our patients achieved final heights close to the MPH. Our study showed that FAH was correlated negatively with CA, BA, and BA-CA at the start of treatment. The suppression of the HPG axis was recovered after the discontinuation of GnRHa. The average time from the end of treatment to menarche was 10.9 years, which is comparable to the general population.