Abstract
Background
Gonadotropin-releasing hormone analog (GnRHa) is the standard treatment for children with central precocious puberty (CPP). We assessed efficacy and safety of GnRHa treatment in girls with CPP and early fast puberty (EFP).
Methods
This retrospective observational study included anthropometric, clinical and laboratory data retrieved from medical files of girls with CPP or EFP, treated with GnRHa and followed at a tertiary endocrine clinic during 2007–2021.
Results
For both CPP (n = 144) and EFP (n = 231) groups, mean height-SDS at GnRHa initiation and termination and at the last follow-up visit was greater than mid-parental height-SDS (P < 0.001). Only among girls with EFP, mean BMI-SDS was higher at treatment termination than initiation (P = 0.025). Median ages at menarche of the CPP and EFP groups were 11.8 and 12.0 years. Menstrual irregularities were reported in 20.3% of girls with CPP and in 18.7% of those with EFP. Adverse effects to treatment were reported in 3.5% and 3.9% of girls with CPP and EFP, respectively.
Conclusions
In this large cohort, GnRHa treatment in girls with EFP was effective without significant adverse effects as in those with CPP. A randomized controlled trial is required to examine the psychological impact of GnRHa treatment of variant early puberty.
Impact statement
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Gonadotropin-releasing hormone analog (GnRHa) is the standard treatment for central precocious puberty (CPP).
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We assessed efficacy and safety of GnRHa treatment in girls with early fast puberty (EFP), characterized by pubertal signs between ages 8–9 years with fast pubertal signs advancement and accelerated growth and bone maturation and in girls with CPP.
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We found in this large cohort that GnRHa treatment in girls with EFP was effective and safe as in those with CPP. A prospective randomized controlled trial is required to examine the psychological impact of GnRHa treatment of variant early puberty.
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Data availability
The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
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Research reported in this publication was supported by a research grant from Debiopharm Biopharmaceutical Company. The content is solely the responsibility of the authors.
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L.L.—Substantial contributions to acquisition of data, analysis and interpretation of data, drafting the article, and final approval of the version to be published. M.Y.G.—Substantial contributions to analysis and interpretation of data, revising the article critically for important intellectual content, and final approval of the version to be published. M.P.—Substantial contributions to acquisition of data, revising the article critically for important intellectual content, and final approval of the version to be published. S.S.—Substantial contributions to conception and design, acquisition of data, analysis and interpretation of data, revising it critically for important intellectual content, and final approval of the version to be published.
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Lerman, L., Yackobovitch-Gavan, M., Phillip, M. et al. Gonadotropin-releasing hormone analogs treatment in girls with central precocious puberty and early fast puberty. Pediatr Res 95, 1051–1059 (2024). https://doi.org/10.1038/s41390-023-02879-6
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DOI: https://doi.org/10.1038/s41390-023-02879-6
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