Evaluation of Efficacy of GnRH Agonist on Predicted Adult Height (PAH) in Patients with Central Precocious Puberty Using Two Different Dosages

Jin, Hye Young; Choi, Jin Ho; Yoo, Han Wook

Abstract

PURPOSE: Depot gonadotropin releasing hormone agonist (GnRHa) has been widely used for the treatment of central precocious puberty (CPP). The effectiveness of GnRHa depends on potency, dosage, route of administration, duration of treatment, and compliance. There is a controversy about optimal doses of GnRHa. This study aimed to compare the efficacy of GnRHa on improvement of PAH in girls with CPP using two different dosages.
METHODS
Seventy-one girls with CPP were included in this study. The patients were categorized into two groups depending on the dosage of GnRHa; group 1 (80 - 100 microgram/kg/4 wk) and group 2 (100 - 110 microgram/kg/4 wk). The clinical parameters such as chronological age (CA), bone age (BA), duration of treatment, height, growth velocity, predicted adult height (PAH), and endocrine assay including GnRH stimulation test, luteinizing hormone, follicle stimulating hormone, and E2 at the start and the end of treatment were obtained to analyze the efficacy of GnRHa according to dosage.
RESULTS
CA and BA at the start of treatment were 8.2 +/- 1.26 yr and 10.7 +/- 0.61 yr, while CA and BA at the end of treatment were 10.7 +/- 0.61 yr and 11.7 +/- 0.50 yr, respectively. CA and BA before and after treatment, and duration of treatment were similar between two groups. BA/CA, Height SDS, growth velocity (cm/r) were decreased while PAH was significantly increased in both groups (P < 0.05). There were no significant differences in DeltaPAH, DeltaBA/CA, DeltaHeight SDS and growth velocity between two groups (P > 0.05).
CONCLUSION
Higher dose (100 - 110 microgram/kg/4 wk) of GnRHa group was not associated with higher PAH in girls with CPP, compared with the group with dose of 80 - 100 microgram/kg/4 wk. Therefore, the results indicates that the dose of 80 - 100 microgram/kg/4 wk is sufficient for treatment of CPP, necessitating further study with lesser dose to identify the optimal dose.