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Effects and safety of combination therapy with gonadotropin-releasing hormone analogue and growth hormone in girls with idiopathic central precocious puberty: a meta-analysis

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Abstract

Purpose

This meta-analysis is to evaluate the effects and safety of the combination therapy for girls with idiopathic central precocious puberty (ICPP).

Methods

Electronic databases were searched for randomized controlled trials (RCTs) and clinical controlled trials (CCTs) that adopted gonadotropin-releasing hormone analogue (GnRHa) therapy and GnRHa plus growth hormone (GH) combination therapy to treat ICPP girls.

Results

A total of six RCTs (162 patients) and six CCTs (247 patients) were included. Compared to the GnRHa therapy group, the combination therapy group achieved taller final height (mean difference, MD = 2.81 cm, 95 % CI 1.76–3.87, four CCTs; MD = 4.30 cm, 95 % CI 0.59–8.01, one RCT); greater progression of final height compared with target height (MD = 3.92 cm, 95 % CI 3.12–4.73, four CCTs; MD = 4.00 cm, 95 % CI 1.93–6.07, One RCT) and larger height gains (MD = 3.49 cm, 95 % CI 0.97–6.01, four CCTs; MD = 3.88 cm, 95 % CI 0.15–7.61, one RCT). No severe adverse effects of treatment were reported.

Conclusion

For ICPP girls, the GnRHa and GH combination therapy had advantages over GnRHa alone on final height and no severe adverse effects were reported. We recommend comprehensive assessment of the individual growth rate, patient compliance, the clinical effects, the height expectations of individual patients and the treatment cost to the family in order to identify the best therapy for individual patients.

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Acknowledgments

The research was supported by National Youth Science Fund Project (Grant No: 81502825) and Basic and Frontier Research Project of Chongqing Science and Technology Commission (Grant No. cstc2013jcyjA10001). Special thanks to Ms Kaori Sato of Duke University for the kind edits.

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Authors and Affiliations

  1. School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, No. 1 Yixueyuan Road, Yuzhong District, Chongqing, 400016, China

    S. Liu, Q. Liu, X. Cheng, Y. Luo & Y. Wen

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  1. S. Liu
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Correspondence to Q. Liu.

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Liu, S., Liu, Q., Cheng, X. et al. Effects and safety of combination therapy with gonadotropin-releasing hormone analogue and growth hormone in girls with idiopathic central precocious puberty: a meta-analysis. J Endocrinol Invest 39, 1167–1178 (2016). https://doi.org/10.1007/s40618-016-0486-9

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