Prognostic Factors and Long-Term Safety of GnRHa in the Treatment of Idiopathic Central Precocious Puberty in Girls

Wenyong Wu; Ruimin Chen

Objective: To investigate the relevant prognostic factors and long-term safety of gonadotropin-releasing hormone analogs (GnRHa) in the treatment of idiopathic central precocious puberty (ICPP).

Methods: This was a retrospective study. Data analysis included 142 girls with ICPP who reached final adult height (FAH). Among them, 101 girls were treated with GnRHa while 41 girls were untreated. The Pearson and Spearman correlation test were used to analyze the prognostic factors. The Chi-squared test and Fisher's exact test were used to evaluate long-term safety.

Results: The comparisons of general information between the treatment and control group are shown in Table 1. Height SDS for bone age (HtSDS_BA, r= 0.656, P<0.001), height SDS (r= 0.621, P<0.001), and target height (r= 0.596, P<0.001) were the major prognostic factors affecting FAH of ICPP girls with GnRHa treatment. The follow-up data showed all of the characteristics, including dysmenorrhea, polycystic ovary syndrome, facial acne, hirsutism, and alopecia were not found statistically different in two groups.

Table 1 Clinical characteristics of participants in this study
	Treatment Group (n=101)	Control Group (n=41)	MWU-t (P-values)
Before treatment
CA0 (years)	8.15±0.73	7.61±1.06	0.011
Height0 (cm)	130.65±4.84	129.16±10.01	0.669
HeightSDS0	0.31±0.73	0.52±1.17	0.112
Weight0 (kg)	27.85±4.04	27.32±6.37	0.427
BMI0 (kg/m²)	16.27±1.83	16.14±1.83	0.707
Peak LH (IU/L)	18.61±14.19	14.81±8.11	0.331
Peak FSH (IU/L)	14.65±5.73	14.66±5.80	0.937
BA0 (years)	10.29±0.76	9.18±1.83	<0.001
HtSDS_BA0	-1.79±0.61	-1.04±0.88	<0.001
BA0-CA0 (years)	2.14±0.70	1.57±1.11	0.003
PAH0 (cm)	150.93±3.31	154.98±4.74	<0.001
TH (cm)	157.20±3.40	156.90±3.79	0.857
Uterine volume (ml)	2.05±1.41	2.59±3.52	0.761
Larger ovarian volume (ml)	2.44±0.63	2.57±0.79	0.265
After treatment / Follow-up
CA1 (years)	19.89±1.91	20.38±1.95	0.106
FAH (cm)	160.73±3.95	161.13±4.37	0.655
Weight1 (kg)	53.31±6.52	54.35±7.19	0.394
BMI1 (kg/m²)	20.66±2.67	20.90±2.32	0.336
Duration of treatment (years)	2.48±0.52	-	-
Age at first menstruation (years)	12.15±0.86	11.43±1.22	0.001
Menstruation after discontinuing GnRHa (years)	1.51±0.74	-	-
MWU-t: Mann-Whitney U test. CA: chronological age. LH: luteinizing hormone. FSH: follicle-stimulating hormone. BA: bone age. PAH: predicted adult height. TH: target height. The numbers 0 and 1 indicate the data before and after treatment.

Conclusions: This study corroborated the long-term safety of GnRHa treatment for girls with ICPP. HtSDS_BA, height SDS and target height can be valuable indicators for predicting the prognosis.

ESPE Abstracts

P1-377