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Aromatase Inhibitors and Growth Disorders

  • Leo Dunkel
  • Matti Hero
Chapter

Abstract

Without estrogen action, the fusion of the growth plates is postponed and height growth continues for exceptionally long period of time. Aromatase inhibitors, blockers of estrogen biosynthesis, have therefore emerged as a new potential option for treatment of children with short stature. Currently three prospective randomised controlled trials using potent third-generation aromatase inhibitors have been published. These reports all show that treatment with the aromatase inhibitor letrozole or anastozole effectively delays bone maturation and increase predicted adult height in boys with constitutional delay of growth and puberty (CDGP) (Wickman and Kajantie, 2003), idiopathic short stature (ISS) (Hero et al., 2005), and GHD (Mauras et al. 2008). Long-term follow-up data of boys with constitutional delay of puberty, treated with letrozole for 1 year during adolescence, suggest that the achieved gain in predicted adult height also results in taller adult height. However, before the safety of the treatment is better established, particularly as regards bone architecture and vertebral morphology, treatment of short stature with aromatase inhibitors must be considered experimental.

Keywords

Aromatase Inhibitor Congenital Adrenal Hyperplasia Adult Height Idiopathic Short Stature Aromatase Inhibitor Therapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Abbreviations

BMD

Bone mineral density

BMAD

Bone mineral apparent density

CDGP

Constitutional delay of growth and puberty

DXA

dual-energy X-ray absorptiometry

GHD

growth hormone deficiency

GnRH

gonadotropin-releasing hormone

HDL

high-density lipoprotein

HOMA

Homeostatic model assessment

ISS

idiopathic short stature

LDL

low-density lipoprotein

SDS

standard deviation score

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Centre for Endocrinology, William Harvey Research Institute, Barts and the London, Queen Mary University of LondonLondonUK
  2. 2.Hospital for Children and Adolescents, University of HelsinkiHelsinkiFinland

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