ESPE Abstracts

Introduction: Since the 1980s, long-acting gonadotropin-releasing hormone analogues (GnRHa) have been the standard treatment for central precocious puberty (CPP).

Aims: To evaluate the short-term response (at 6 and 12 months) of treatment with GnRHa in female children diagnosed with CPP, regarding growth, bone maturation (Greulich and Pyle method), predicted adult height (PAH) and pubertal development (Tanner stages).

Methods: A retrospective, observational, descriptive and analytical study was conducted in female children diagnosed with CPP, followed at a Pediatric Endocrinology Unit in a tertiary hospital. The sample was divided into 3 groups: group A – 21 children with CPP treated with GnRHa (main study group); group B – 10 children with CPP who did not undergo treatment; group C – 19 children without CPP (control group). Data was collected at baseline (t0), 6 months (t1) and 12 months (t2) of follow-up. In group A, the differences in the studied variables were analyzed between those timings. Later, the same data was compared throughout the follow-up period and between groups.

Results: In group A, there was a decrease in height and corrected height z-scores between t0 and t2 (P=0.007), as well as a decrease in growth rate (GR) between the 3 moments (P<0.001). Bone age z-score decreased while corrected PAH z-score increased, but the results had no statistical significance. There were no differences in Tanner stages for breast development between moments. At t0, group A GR was significantly higher when compared to groups B and C (P=0.003 and P<0.001, respectively). Group A GR at t1 and t2 decreased to values similar to group C, which are pre-pubertal values. Group A GR at t2 was significantly lower than group B (P=0.013). There were differences between groups A and C at all timings, regarding z-score of weight, body mass index and height, which were significantly higher in group A.

Conclusions: Short-term treatment with GnRHa was effective in slowing down linear growth and preventing breast development. However, short-term treatment does not seem to significantly decrease bone maturation and, consequently, to increase PAH significantly, suggesting that a longer treatment may be necessary to achieve these goals. These results allow a better understanding of the short-term effects of GnRHa treatment, which may be useful in the clinical management of pediatric patients with CPP.