A randomized pilot trial of growth hormone with anastrozole versus growth hormone alone, starting at the very end of puberty in adolescents with idiopathic short stature

Rothenbühler, Anya; Linglart, Agnès; Bougnères, Pierre

doi:10.1186/1687-9856-2015-4

Cited by 27 publications

(19 citation statements)

References 94 publications

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“…In other recent studies the impact of AIs and or GH was also evaluated throughout NF height. Mauras et al [14] studied 25 ISS patients treated with AIs (ANZ or LTZ) and 26 ISS patients treated with AIs plus GH. The authors found after two years of treatment a height SDS increment (for chronological age) of 0.5 and 1.0, respectively for AI alone or combined with GH.…”

Section: Near-final Heightmentioning

confidence: 99%

Height Increment and Laboratory Profile of Boys Treated With Aromatase Inhibitors With or Without Growth Hormone

et al. 2017

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Aromatase inhibitors (AIs) have been used to recover height loss due to their capacity to delay growth plate closure. Long-term studies describing final heights are needed to determine the efficacy and safety profiles of these drugs for the treatment of impaired growth. This study aims to identify the therapeutic efficiency of AIs in improve growth and to describe potential adverse effects during treatment. Retrospective data analysis of 96 adolescents, among which 22 patients already attained near-final height, were followed at outpatient clinics of two referral centers. Patients were all in puberty and present idiopathic decrease in predicted adult height. Patients were treated with Anastrozole (ANZ: 1 mg/day) or Letrozole (LTZ: 2.5 mg/day) with/without recombinant human growth hormone (0.05 mg/kg/day) for 1.0 to 3.5 years (2.1±1.2 years). Height gain, body mass index, lipid, liver enzyme, gonadotropins and testosterone levels were described before and at the end of treatment. Predicted adult height (PAH) and NF height were compared with the TH. The height SDS (adjusted to bone age) significantly increased (p<0.05) in all groups [0.8±0.7 (ANZ), 0.7±0.7 (ANZ+GH), 0.3±0.5 (LTZ), and 1.2±0.8 (LTZ+GH)]; the latter group exhibited the highest increment of PAH and growth recovery to the TH (p<0.004). No significant side effects were observed. AI treatment, especially when used in association with GH was able to improve growth and the attainment of familial target height.

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Section: Near-final Heightmentioning

confidence: 99%

Height Increment and Laboratory Profile of Boys Treated With Aromatase Inhibitors With or Without Growth Hormone

et al. 2017

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“…However, the predicted FAH following a short period of treatment is dynamic and cannot reflect the actual FAH. Owing to the heterogeneity of the treated ISS populations and the individualization of treatment, only a few randomized trials with small sample sizes have observed ISS until FAH [6][7][8][9][10]. A randomized study of FAH typically takes 8 years or more to complete and is often difficult to implement in clinical settings.…”

Section: Introductionmentioning

confidence: 99%

Final adult height of children with idiopathic short stature: a multicenter study on GH therapy alone started during peri-puberty

Chen

et al. 2020

BMC Pediatr

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Background: To evaluate the efficacy of GH in improving FAH in ISS children in a multicenter study. Methods: A real-world observation was carried out. Children with ISS in seven hospitals in China were enrolled. The height gains standard deviation score and the height gain over the target height were evaluated. Results: There were 344 ISS patients (217 boys and 127 girls). The baseline average age of boys and girls was 12.7 and 11.7 years, with bone age of 11.7 and 10.1 years, respectively. The baseline height SDS of boys and girls was − 3.07 and − 2.74, and the FAH SDS was − 1.91 and − 1.38, respectively. Compared with the baseline height SDS, the FAH SDS was significantly increased in both boys and girls (both P = 0.0000). The FAH SDS was the highest (gain by 1.54 SD) in the ≥2y treatment course group. Two hundred eighteen patients (218/344, 63.4%) had a FAH SDS > − 2 SD. Among these patients, girls in the 1-2y treatment course group and ≥ 2y group had a FAH SDS higher than TH SDS. Even in the control group, a spontaneous catch-up growth of 1.16 SD was observed. A multivariate linear regression model was used to analyze the results, with FAH SDS as the dependent variable. It was found that the treatment course and baseline height SDS in the boys' model were statistically significant (P < 0.05), whereas the baseline height SDS and baseline bone age significantly affected the girls' FAH SDS (P < 0.05). Conclusions: Both girls and boys of ISS improved FAH by GH therapy even if treatments begin over 10 years old and majority of them reached TH. Some peri-puberty ISS will have a spontaneous height gain. We recommend the course of GH treatment more than 2 years for girls, and longer courses for boys.

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“…The same subjects were followed until near final height [7] and the boys treated with AI attained a mean NAH 6.7 cm higher compared to the control group. Subsequent studies were done in patients with ISS and GHD [8,10,11]. Hero et al [8] in a prospective doubleblinded, randomized, placebo controlled study showed that subjects with ISS treated with Letrozole have an increased PAH by 5.9 cm and height SD score for bone age increased by 0.7 SD score.…”

Section: Discussionmentioning

confidence: 99%

“…Also Rothenbuhler et al [11] conducted a prospective randomized study to compare GH alone and GH and Anastrozole in 24 adolescent boys with ISS who achieved NAH. Height gain compared to the pretreatment PAH was +4.6 cm greater and height SDS at NAH was +0.7 SD score greater in the subjects treated with GH and Anastrozole compared to the GH alone group.…”

Section: Discussionmentioning

confidence: 99%

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The Efficacy of Anastrozole and Growth Hormone Therapy on Adult Height in Six Adolescent Males with Growth Hormone Deficiency or Idiopathic Short Stature

Uysal

Hodax

Topor

et al. 2017

Advances in Endocrinology

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Background. Data on adult height outcomes of the use of Anastrozole and Growth Hormone (GH) in pubertal males with Growth hormone deficiency (GHD) and Idiopathic short stature (ISS) are limited. Objective. We examined the effect of Anastrozole and GH therapy on near adult height (NAH) with pubertal males with GHD or ISS. Methods. Retrospective review of 419 charts from 2008 to 2015. The primary outcomes are NAH compared to mid-parental target height (MPTH) and predicted adult height (PAH). Results. We identified 23 patients (5 SGA/IUGR, 1 Noonan syndrome, 6 GHD, and 11 ISS). Six patients (4 GHD; 2 ISS) achieved NAH. Prior to Anastrozole treatment, the mean chronological age was 13.9±0.2 years (range 13.7–14.4), bone age was 13.6±0.6 years (range 12.5–14), mean height SDS was -1.5±0.5 (range −0.8 to −2.3), and mean PAH was 162.6±5.9 cm (range 153.5–168.6). MPTH was 173.6 cm ± 7 (range 161.8–181.6). Patients received Anastrozole for an average of 30.5 months (range 19–36 months). At NAH, the mean chronological age was 16.7±0.8 years (range 15.9–18.1 years) and height was 170±1.8 cm (range 168.5–173.4 cm). The mean height SDS improved to +0.81±0.6 (range +0.08 to +1.92, p=0.002). Net height gain was 7.3 cm compared to pretreatment PAH (p<0.01) and overall the mean adult height remained 3.5 cm below MPTH. Conclusion. Anastrozole and GH therapy can be effective in augmenting adult height without significant side effects. However, the long-term safety and efficacy of aromatase inhibitor use in pediatrics remain limited.

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A randomized pilot trial of growth hormone with anastrozole versus growth hormone alone, starting at the very end of puberty in adolescents with idiopathic short stature

Cited by 27 publications

References 94 publications

Height Increment and Laboratory Profile of Boys Treated With Aromatase Inhibitors With or Without Growth Hormone

Height Increment and Laboratory Profile of Boys Treated With Aromatase Inhibitors With or Without Growth Hormone

Final adult height of children with idiopathic short stature: a multicenter study on GH therapy alone started during peri-puberty

The Efficacy of Anastrozole and Growth Hormone Therapy on Adult Height in Six Adolescent Males with Growth Hormone Deficiency or Idiopathic Short Stature

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