ESPE Abstracts

Objective: To investigate the clinical efficacy of GnRHa in the treatment of girls with post-menarche in ICPP or rapidly progressive puberty（RPP）. To analyze the effect of GnRHa combined with rhGH on growth velocity (GV) and predicted adult height (PAH) in the process of GnRHa treatment with too low growth velocity.

Methods: Retrospective analysis of the clinical data of 55 post-menarche ICPP/RPP girls within 3 months of menarche, all girls to receive treatment, the 27 girls were treated with GnRHa alone(GnRHa group), another 28 girls received GnRHa+rhGH treatment when GV fell below 4 cm/year. all patients were treated regularly and followed up 1 year, the height, BA, GV, PAH, HtSDSBA, ΔPAH andΔHtSDSBA were compared between the two group after 1 year of treatment, and the changes in GV, height, BA, HtSDSBA and PAH were observed before and after the combination treatment was observed.

Results: Among the 87 girls in GnRHa group, 31 girls chose to discontinue after 1~1.5 years of GnRHa therapy and were followed up to nearly FAH (158.01±2.73 cm), which was slightly higher than the PAH at the start of treatment (157.08±2.70 cm), but the difference was not statistically significant (P>0.05) 55 post-menarche ICPP/RPP girls, the 27 girls were treated with GnRHa alone, another 28girls received GnRHa+rhGH treatment when GV fell below 4 cm/year. after treat for one year, the height were 149.60±2.98 cm and 147.75±3.08 cm, PAH were 157.49±2.78 cm and 155.98±2.47 cm,ΔHtSDSBA were 0.93±0.26 and 0.58±0.24,ΔPAH were 5.08±1.48 cm and 3.10±1.35 cm, the GV were 6.00±1.38 cm/year and 4.71±0.99 cm/year respectively in rhGH+GnRHa group and GnRHa group. There were statistically significant differences in GV, height, PAH,ΔHtSDSBA andΔPAH between the two group (P < 0.05).

Conclusions: ICPP/RPP girls within 3 months after menarche experienced significant growth retardation during the GnRHa treatment, the risk of below normal annual growth velocity was more pronounced in the second half year, especially the girls with older bone age, higher IGF-1 and LH basal value. GnRHa treatment could improve FAH in ICPP/RPP girls within 3 months after menarche, but the effect was limited. If the ICPP/RPP girls after menarche within 3 months showed low growth velocity(GV<4cm/year) during GnRHa treatment, combined rhGH therapy could improve GV and PAH, and no obvious adverse effects occured.