Using change in predicted adult height during GnRH agonist treatment for individualized treatment decisions in girls with central precocious puberty.
J Pediatr Endocrinol Metab
; 36(3): 299-308, 2023 Mar 28.
Article
em En
| MEDLINE
| ID: mdl-36473097
ABSTRACT
OBJECTIVES:
It is important to understand what variables influence change in predicted adult height (PAH) throughout GnRHa treatment for central precocious puberty (CPP) to individualize treatment decisions and optimize care.METHODS:
Changes in PAH, chronological age (CA), bone age (BA), BA/CA, and height velocity (HV) were evaluated in girls with CPP throughout treatment with leuprolide acetate (n=77). A second analysis focused on changes in the 3 years preceding the first observed BA of ≥12 years. Relationships were characterized using plot inspection and linear mixed-effects analyses. Association between treatment duration and last assessed PAH was examined using multiple linear regression models.RESULTS:
BA/CA and HV showed a nonlinear change during treatment, with the largest changes and improvement in PAH observed in the first 6-18 months. Rate of BA advancement tended to decrease more slowly in girls initiating treatment at a younger BA. On-treatment change in PAH was predicted by concurrent BA/CA change, HV, and BA, as well as CA at treatment initiation. Last assessed PAH was positively associated with longer treatment durations (primary/exploratory models cut-offs of ≥33/≥55 months).CONCLUSIONS:
These findings support individualized monitoring during GnRHa treatment. Initial response should be interpreted with caution until 6-18 months after treatment initiation and failure should not be assumed based on continued bone maturation in girls starting therapy at a younger age. Treatment cessation should not be automatically based on a diminishing change in PAH or HV, as ongoing treatment may result in continued increase or maintenance of PAH.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Puberdade Precoce
/
Estatura
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Hormônio Liberador de Gonadotropina
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Leuprolida
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article