The effects of cyproterone acetate on statural growth in children with precocious puberty

Abstract

Forty-four patients (42 f, 2 m) with precocious puberty (31 idiopathic, 1 familial, 7 cerebral, 5 McCune-Albright) were treated with cyproterone acetate for periods of 1\p=n-\8.75 years in different (P < 0.05) daily dosages of 117 \m=+-\6.1 mg/m2 per day (\l =x_\\ m=+-\sem, group A, N = 20) and 60.8 \m=+-\ 2.42 mg/m2 per day (group B, N = 24). Thirty-three girls had experienced menarche before therapy at a mean age of 4.89 \m=+-\0.42 years. Treatment was started at a chronologic age of 5.45 \m=+-\0.33 years in the girls and 5.74 \m=+-\1.34 years in the boys. At the time of evaluation, 31 of our patients had reached final height. With respect to the effects of treatment on statural growth, the Standard Deviation Scores were retrospectively determined for height, weight, and growth velocity. The initial Bayley-Pinneau height predictions were compared with final height and target height, and the skeletal maturation was studied.

Growth Analysis up to Final Height and Psychosocial Adjustment of Treated and Untreated Patients with Precocious Puberty

“…Idiopathic precocious puberty may result in a loss of final height [5]. In our patient population of 34 children who had reached final adult height, we observed no dif- ference between treated and untreated patients.…”

“…They suggested that giving a higher dose of cyproterone acetate (> 70 mg/m2) might result in a more pronounced inhibitory effect on bone maturation. Sorgo et al [5] studied dose dependency but found no differ ence in the inhibitory effect of cyproterone acetate on bone maturation between a group treated with high doses (average 126 mg/m2/day) and low doses (average 69 mg/m2/day) of cyproterone acetate. Frequently, growth spurt is the first sign of the onset of puberty, and the larger part of this spurt along with a great deal of bone maturation may already have taken place before the start of treatment.…”

“…In both cases, the hormone production leads to the development of secondary sex characteris tics at an abnormally early age. At the same time, a marked 'pubertal' growth spurt occurs, with a dispro portionate advancement of bone maturation of 1 SDS [5]. Until 1980, in our clinics most patients with preco cious puberty were treated with cyproterone acetate (Androcur®), some were treated with medroxyprogester one acetate.…”

A Dose Finding Study of a Super Long-Acting Luteinizing Hormone-Releasing Hormone Analog (Leuprolide Acetate Depot, TAP-144-SR) in the Treatment of Central Precocious Puberty.

“…A single subcutaneous injection every four weeks is practical and more acceptable for patients than daily injections. It is reported that cyproterone acetate treatment did not obtain sufficient adult heights [18]. The final effect of this treatment remains to be established.…”

Dose of LHRH Analog and Growth Velocity Influence Predicted Final Height in Girls with Central Precocious Puberty

“…ported that gonadal suppressive agents such as cyproterone acetate and LHRH analog can effectively regress or arrest pubertal development, but the results of the effect on improvement of final height are still controversial (1)(2)(3)(4)(5)(6)(7). Final height is thought to be influenced by the rate of deceleration of bone age maturation and growth rate during treatment.…”