Combined therapy with GnRH analogue and growth hormone increases adult height in children with short stature and normal pubertal onset

Li, Shuying; Wang, Xi; Zhao, Yaling; Ji, Wen; Mao, Jiangfeng; Nie, Min; Wu, Xueyan

doi:10.1007/s12020-020-02375-5

Cited by 6 publications

(4 citation statements)

References 44 publications

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“…Similar results were observed in a study conducted by Cassio, et al [8]. Furthermore, in a study by Yun, et al [9] on 77 girls with precocious puberty with a mean age of 8.16 ± 0.76 years, the target height and PAH and final height were similar [3]. These investigators, of course, have treated a group of 57 girls with GnRHa who were in relatively early puberty with a mean age of 7.9 ± 0.93 and had a bone age of 10.12 ± 1.08.…”

Section: Relationship Between Predicted Adult Height Changes and Age ...supporting

confidence: 88%

“…If the calculated final height is within the normal range, the child and the parents can be reassured. If the girls have a small final size, interventions such as growth hormone and GnRH agonists may be used to improve final height [3][4][5]. Given that a decision to start on the treatments mentioned earlier or assure the child's parents based on these calculations, their accuracy and stability have always been a concern for pediatric endocrinologists.…”

Section: Introductionmentioning

confidence: 99%

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Changes in Predicted Adult Height over Time in Girls with Early Puberty and Related Factors

Ahadiat¹

2023

AABSc

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Background: One of the most important concerns parents have about their daughters’ precocious puberty is the reduction in final height. This study evaluates the changes in predicted adult height (PAH) over time in girls with early puberty. Materials and Methods: Girls with aged 7 to 9.5 years old with the beginning of puberty after seven years were evaluated. Two non-dominant hand x-ray were taken at 6 to 24 months. The predicted adult height (PAH) was estimated using bone age and the Bayley-Pinneau method. Changes in PAH were determined. The relationship between age, height and weight at birth, target height and puberty stages, and bone age and BMI with PAH changes were investigated. Results: Seventy girls with a mean age of 8.23 years (SD: 0.65) and an average time interval of 0.99 years (SD: 0.47) were studied. At the first evaluation, the average bone age was 8.6 years (p value=0.225 SD: 1.25), and the average predicted adult height was 158.95 cm (SD: 5.66). At the second evaluation, the average bone age was 10.06 years (P-value=0.15 SD: 1.36), and the average predicted adult height was 158 cm (SD: 6.75). The mean difference in predicted adult height is -0.94 ± 4.8 cm. The mean final height predicted in the first and second visits showed a significant relationship with PAH changes and in the group that increased PAH by more than 3 cm, the average growth rate was 69.7 cm per year. In other words, the group growth velocity was higher, the higher their PAH. Two factors associated with expected adult height changes were found: height growth velocity and bone age velocity. Conclusion: Girls with early puberty are not altogether at risk of reduced adult height. However, if there is concern about reducing final height, the expected adult height will still need to be re-estimated at the appropriate interval.

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Section: Relationship Between Predicted Adult Height Changes and Age ...supporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Changes in Predicted Adult Height over Time in Girls with Early Puberty and Related Factors

Ahadiat¹

2023

AABSc

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“…The two uncontrolled studies in set 2 (LoE 4) presented contradictory results. The Italian study ( 68 ) showed no positive effect, while the authors of the Chinese study ( 69 ) concluded that GnRHa/rhGH therapy can effectively improve AH SDS up to TH SDS.…”

Section: The Effect and Safety Of A Gnrh Analogue In Children With A Low Predicted Adult Heightmentioning

confidence: 99%

“…These reports will not further be discussed due to the unavailability of attained AH. The second set contains two uncontrolled studies ( 68 , 69 ). The third set comprises two controlled studies on a short course of rhGH plus GnRHa ( 58 , 70 ).…”

Section: The Effect and Safety Of A Gnrh Analogue In Children With A Low Predicted Adult Heightmentioning

confidence: 99%

Should Skeletal Maturation Be Manipulated for Extra Height Gain?

Wit

2021

Front. Endocrinol.

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Skeletal maturation can be delayed by reducing the exposure to estrogens, either by halting pubertal development through administering a GnRH analogue (GnRHa), or by blocking the conversion of androgens to estrogens through an aromatase inhibitor (AI). These agents have been investigated in children with growth disorders (off-label), either alone or in combination with recombinant human growth hormone (rhGH). GnRHa is effective in attaining a normal adult height (AH) in the treatment of children with central precocious puberty, but its effect in short children with normal timing of puberty is equivocal. If rhGH-treated children with growth hormone deficiency or those who were born small-for-gestational age are still short at pubertal onset, co-treatment with a GnRHa for 2-3 years increases AH. A similar effect was seen by adding rhGH to GnRHa treatment of children with central precocious puberty with a poor AH prediction and by adding rhGH plus GnRHa to children with congenital adrenal hyperplasia with a poor predicted adult height on conventional treatment with gluco- and mineralocorticoids. In girls with idiopathic short stature and relatively early puberty, rhGH plus GnRHa increases AH. Administration of letrozole to boys with constitutional delay of growth puberty may increase AH, and rhGH plus anastrozole may increase AH in boys with growth hormone deficiency or idiopathic short stature, but the lack of data on attained AH and potential selective loss-of-follow-up in several studies precludes firm conclusions. GnRHas appear to have a good overall safety profile, while for aromatase inhibitors conflicting data have been reported.

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A meta-analysis of combination therapy with gonadotrophin-releasing hormone agonist and growth hormone for children with idiopathic short stature and normal timed puberty

et al. 2022

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Combined therapy with GnRH analogue and growth hormone increases adult height in children with short stature and normal pubertal onset

Cited by 6 publications

References 44 publications

Changes in Predicted Adult Height over Time in Girls with Early Puberty and Related Factors

Changes in Predicted Adult Height over Time in Girls with Early Puberty and Related Factors

Should Skeletal Maturation Be Manipulated for Extra Height Gain?

A meta-analysis of combination therapy with gonadotrophin-releasing hormone agonist and growth hormone for children with idiopathic short stature and normal timed puberty

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