Auxological and Biochemical Evaluation of Pubertal Suppression with the GnRH Agonist Leuprolide Acetate in Early and Precocious Puberty

Mul, Dick; Keizer‐Schrama, Sabine M.P.F. de Muinck; Oostdijk, Wilma; Drop, Stenvert L. S.

doi:10.1159/000023413

Cited by 40 publications

(21 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…According to some reports, adult height after the GnRHa treatment increases although there are some different effects in number13,14,15,16). In our study, pretreatment mean BA was 1.9 years advanced compare to mean CA.…”

Section: Discussionsupporting

confidence: 42%

Age of menarche and near adult height after long-term gonadotropin-releasing hormone agonist treatment in girls with central precocious puberty

Baek

Nam

Jin

et al. 2014

Ann Pediatr Endocrinol Metab

View full text Add to dashboard Cite

PurposeGonadotropin-releasing hormone agonist (GnRHa) is known for improving final adult height in patients with central precocious puberty (CPP). This study aimed to investigate the age of menarche and near adult height in girls with CPP who had been treated with GnRHa.MethodsIn this retrospective study, we reviewed the medical records of 71 Korean girls with CPP who had started menarche or reached over 13 years of bone age after long-term GnRHa treatment. We estimated near adult height using the Bayley-Pinneau method and identified the age of menarche in girls with CPP.ResultsMean chronological and bone age at menarche were 11.9±0.7 and 12.8±0.4 years, respectively. The period between menarche and the end of treatment was 14.0±5.6 months. Posttreatment near adult height was 163.8±4.7 cm, which was significantly greater than pretreatment predicted adult height (158.7±4.1 cm).ConclusionGnRHa treatment in girls with CPP could improve final adult height and made the age of menarche close to that of the general population.

show abstract

Section: Discussionsupporting

confidence: 42%

Age of menarche and near adult height after long-term gonadotropin-releasing hormone agonist treatment in girls with central precocious puberty

Baek

Nam

Jin

et al. 2014

Ann Pediatr Endocrinol Metab

View full text Add to dashboard Cite

show abstract

“…Clinical scoring systems have been devised in an attempt to standardize assessment of CPP patients on therapy, 16 but most continue to rely on subjective measures such as change in bone age. 10 Although careful clinical assessment is crucial in follow-up of these patients, an objective and prompt laboratory measure of treatment success or failure is needed.…”

Section: Discussionmentioning

confidence: 99%

Serum Luteinizing Hormone Rises Within Minutes After Depot Leuprolide Injection: Implications for Monitoring Therapy

2002

View full text Add to dashboard Cite

ABSTRACT. Objective. To find the time of the serum gonadotropin peak after depot leuprolide injection in children and to show that depot leuprolide therapy can be monitored by measuring serum luteinizing hormone (LH) immediately after injections.Study Design. We measured concentrations of leuprolide, LH, and follicle-stimulating hormone (FSH) at multiple time points before and after the first dose of depot leuprolide in 14 pubertal children beginning therapy. Gonadotropins and sex steroids were measured again after the fourth dose.Results. Serum leuprolide, LH, and FSH levels rose rapidly after initial injection, reaching sustained elevations at 30 to 120 minutes. The median LH level increased from 2.1 mIU/mL at baseline to a peak of 27.5 mIU/mL at 45 minutes, and FSH increased from 5.2 to 16.5 mIU/mL. After 3 months on therapy, median serum LH after depot leuprolide injection was only 0.83 mIU/mL, similar to levels observed after intravenous or subcutaneous gonadotropin-releasing hormone stimulation in comparable subjects on depot leuprolide.Conclusion. Our pharmacokinetic data demonstrate that free leuprolide present in a depot leuprolide injection is equivalent to gonadotropin-releasing hormone in stimulating a rapid rise in serum gonadotropin concentrations. We propose that a single serum sample for LH obtained 30 to 60 minutes after depot leuprolide injection in children provides a convenient and accurate assessment of treatment efficacy. Pediatrics 2002;109(2). URL: http://www.pediatrics.org/cgi/content/full/109/2/e30; puberty, leuprolide, luteinizing hormone, follicle-stimulating hormone, gonadotropin, gonadotropin-releasing hormone.ABBREVIATIONS. CPP, central precocious puberty; GnRH, gonadotropin-releasing hormone; LH, luteinizing hormone; FSH, follicle-stimulating hormone; IM, intramuscular; IV, intravenous; SQ, subcutaneous. C entral precocious puberty (CPP) is the early onset of pubertal development attributable to premature gonadotropin release by the pituitary. Most commonly idiopathic, CPP can also result from central nervous system trauma or tumors. Untreated, precocious puberty can result in short stature and significant social problems for children undergoing sexual maturation years before their peers. 1,2 Pulsatile secretion of endogenous gonadotropin-releasing hormone (GnRH) results in luteinizing hormone (LH) and follicle-stimulating hormone (FSH) release from the pituitary and progression of puberty, 3 whereas the tonic stimulus of a long-acting GnRH analog causes an initial surge of gonadotropin release, followed by suppression of pituitary gonadotropin production and release. 4,5 Depot leuprolide (Depot-Lupron, TAP Pharmaceuticals, Deerfield, IL), a commonly used long-acting GnRH analog, is given by monthly intramuscular (IM) injection and is slowly released into the circulation to provide such tonic suppressive levels.Depot leuprolide consists of leuprolide encased in microspheres of a glycolic and lactic acid copolymer. Free leuprolide is also present in the preparation 6 and is absorbe...

show abstract

“…The inhibition of gonadotropin secretion was checked the morning after the second overnight profile by a GnRH agonist test, as follows: 0.5 mg (0.5 ml) of leuprorelide acetate was injected subcutaneously, and after 3 h, a blood sample was taken for determination of LH, FSH and testosterone levels [29, 30]. In the 4 boys in whom overnight profiles were not performed, fasting IGF-I and IGFBP-3 levels and a GnRH agonist test were performed during the second visit, after 3 months of GnRHa treatment.…”

Section: Methodsmentioning

confidence: 99%

Overnight Levels of Luteinizing Hormone, Follicle-Stimulating Hormone and Growth Hormone before and during Gonadotropin-Releasing Hormone Analogue Treatment in Short Boys Born Small for Gestational Age

et al. 2009

View full text Add to dashboard Cite

Aims: To evaluate if 3 months of gonadotropin-releasing hormone analogue (GnRHa) treatment results in sufficient suppression of pubertal luteinizing hormone (LH) and follicle-stimulating hormone (FSH) profile patterns in short pubertal small for gestational age (SGA) boys. To compare growth hormone (GH) profiles and fasting insulin-like growth factor (IGF)-I and IGF-binding protein-3 (IGFBP-3) levels after 3 months of GnRHa treatment with those at baseline. Methods: After measurement of baseline overnight profiles and IGF-I and IGFBP-3 levels, 14 short pubertal SGA boys received leuprorelide acetate depots of 3.75 mg subcutaneously, every 4 weeks. Results: At baseline, mean GH levels were comparable with those of controls, whereas IGF-I and IGFBP-3 standard deviation scores (SDS) were significantly lower than zero SDS. After 3 months of GnRHa treatment, all boys showed clinical arrest of puberty. The area under the curve above zero, mean and maximum LH and FSH had significantly decreased to prepubertal levels. Peak LH during the GnRH agonist test, however, indicated insufficient pubertal suppression in 43% of boys. Overnight GH profile characteristics and IGF-I and IGFBP-3 levels did not significantly change. Conclusions: Puberty was sufficiently suppressed by GnRHa treatment, as shown by the prepubertal LH and FSH profiles. After 3 months of GnRHa treatment, overnight GH profile characteristics had not significantly changed, reflecting that GH levels are comparable for prepubertal and early pubertal boys.

show abstract

Auxological and Biochemical Evaluation of Pubertal Suppression with the GnRH Agonist Leuprolide Acetate in Early and Precocious Puberty

Cited by 40 publications

References 27 publications

Age of menarche and near adult height after long-term gonadotropin-releasing hormone agonist treatment in girls with central precocious puberty

Age of menarche and near adult height after long-term gonadotropin-releasing hormone agonist treatment in girls with central precocious puberty

Serum Luteinizing Hormone Rises Within Minutes After Depot Leuprolide Injection: Implications for Monitoring Therapy

Overnight Levels of Luteinizing Hormone, Follicle-Stimulating Hormone and Growth Hormone before and during Gonadotropin-Releasing Hormone Analogue Treatment in Short Boys Born Small for Gestational Age

Contact Info

Product

Resources

About