Treatment of Central Precocious Puberty by Subcutaneous Injections of Leuprorelin 3-Month Depot (11.25 mg)

Carel, Jean‐Claude; Lahlou, Najiba; Jaramillo, O; Montauban, V.; Teinturier, Cécile; Colle, M.; Lucas, C.; Chaussain, J L

doi:10.1210/jc.2001-020243

Cited by 99 publications

(67 citation statements)

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“…They also confirm the need for precise monitoring of gonadotropin secretion in children treated with GnRH agonists. These results confirm the efficacy, tolerability and acceptability of the 3-month formulations of GnRH agonists in children (16).…”

Section: Discussionsupporting

confidence: 79%

“…Subcutaneous intolerance to depot GnRH agonists has been reported and is mostly due to reaction to the lactide-coglycolide polymer (9,11,16,26,27). In the present study, mild-to-moderate local reactions at the injection site were reported in 8% of the children, and injection pain in only 3%.…”

Section: Discussionsupporting

confidence: 39%

“…The LH peak threshold of 7 IU/l used in this study to define CPP was higher than that used as a reference (5 IU/l) in most other clinical trials (16). Therefore, children in the present trial were selected on the basis of rather stringent criteria for CPP, likely to correspond to pubertal stage 3 (21).…”

Section: Discussionmentioning

confidence: 99%

“…FSH and LH serum concentrations were assessed by fluoroimmunoassay (16) with limits of detection of 0.01 IU/l for both parameters. Estradiol and testosterone serum concentrations were determined by RIAs with limits of detection of 2.4 pg/ml and 0.02 ng/ml respectively (16). Triptorelin plasma concentrations were measured by a validated RIA procedure with a limit of detection of 20 pg/ml.…”

Section: Methodsmentioning

confidence: 99%

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Three-month sustained-release triptorelin (11.25 mg) in the treatment of central precocious puberty

et al. 2006

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Objective: Depot GnRH agonists are commonly used in the treatment of central precocious puberty (CPP). The triptorelin 11.25 mg 3-month depot, currently used in adult indications, had not previously been evaluated in CPP. Design: This was a multicenter, open-label, 12 month trial conducted in 64 CPP children (54 girls and 10 boys), treated quarterly. Methods: Children with a clinical onset of pubertal development before the age of 8 years (girls) or 9 years (boys), pubertal response of LH to GnRH $ 7 IU/l, advanced bone age . 1 year, enlarged uterus ($36 mm) and testosterone level $0.5 ng/ml (boys), were included. Suppression of gonadotropic activation, as determined from serum LH, FSH, estradiol or testosterone, and pubertal signs were assessed at Months 3, 6 and 12. Results: GnRH-stimulated peak LH #3 IU/l, the main efficacy criterion, was met in 53 out of 62 (85%), 60 out of 62 (97%) and 56 out of 59 (95%) of the children at Months 3, 6 and 12 respectively. Serum FSH and sex steroids were also significantly reduced, while pubertal development regressed in most patients. Mean residual triptorelin levels were stable from Month 3 through to Month 12. The triptorelin 3-month depot was well tolerated. Severe injection pain was experienced in only one instance. Five girls experienced mild-to-moderate or severe (one girl) withdrawal bleeding. Conclusions: The triptorelin 3-month depot efficiently suppresses the pituitary -gonadal axis and pubertal development in children with CPP. This formulation allows a 3-fold reduction, over the once-a-month depot, in the number of i.m. injections required each year.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionsupporting

confidence: 39%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Three-month sustained-release triptorelin (11.25 mg) in the treatment of central precocious puberty

et al. 2006

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“…Nos prontuários das 31 pacientes restantes (17,7%) foram relatados antecedentes familiais de PP (mãe em 14 casos). A menarca materna foi informada em 159 casos, tendo ocorrido aos 12,1 ± 0,1anos (8,(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)0).…”

Section: Características Epidemiológicasunclassified

Puberdade precoce central idiopática em meninas no estado da Bahia

Aguiar

Couto-Silva

Freitas

et al. 2005

Arq Bras Endocrinol Metab

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RESUMOIntrodução: Embora os efeitos benéficos do tratamento com análogos de GnRH (GnRHa) na puberdade precoce central (PPC) estejam estabelecidos, aspectos clínicos podem variar em função do grupo racial. Objetivo e Métodos: Descrever o perfil de 175 meninas com PPC idiopática tratadas com GnRHa na Bahia, Brasil. Resultados: Houve predomínio do grupo racial mulato (73,6%). A puberdade iniciou-se aos 6,3 ± 0,1 anos. Ao diagnóstico, as crianças apresentavam estatura de 2,2 ± 0,1 DP e índice de massa corpórea (IMC) de 1,5 ± 0,1 DP (> 2 DP em 32%), estando este, inversamente associado (R= -0,20, p= 0,008) à idade no início da puberdade. As idades cronológica e óssea foram de 8,4 ± 0,1 anos e 10,3 ± 0,1 anos, respectivamente, ao início do tratamento. No seu término (n= 52), idade, IMC e estatura (n= 52) foram 10,6 ± 0,1 anos, 1,6 ± 0,2 DP e 1,9 ± 0,2 DP, respectivamente. Conclusão: Apresentação clínica e evolução puberal foram similares a outros estudos, independente do grupo racial. O tratamento com GnRHa não resultou em ganho de peso significativo na amostra estudada. To describe the profile of 175 girls from Bahia, Brazil, treated with GnRHa for idiopathic CPP. Results: The mulatto racial group predominated in the sample. The chronological age at puberty was 6.3 ± 0.1 years. At diagnosis, height was 2.2 ± 0.1 SD and body mass index (BMI) was 1.5 ± 0.1 SD (> 2 SD in 32%), this one, inversely associated with age at onset of puberty (R= -0.20, p= 0.008). At treatment, chronological and bone ages were 8.4±0.1 years and 10.3 ± 0.1 years, respectively. At the end of treatment (n= 52) age, BMI and height were 10.6 ± 0.1 years, 1.6 ± 0.2 SD and 1.9 ± 0.2 SD, respectively. Conclusion: Clinical presentation and evolution were similar to other studies, independently of racial characteristics. In this sample, treatment with GnRHa was not associated to significant weight gain. Keywords: Epidemiology; Puberty; Precocious puberty; Girls; GnRH analogues A PUBERDADE PRECOCE CENTRAL (PPC) é definida como o aparecimento de telarca antes dos 8 anos nas meninas e como o aumento do volume testicular antes dos 9 anos em meninos. Decorre da ativação prematura do eixo hipotálamo-hipófise-gonadal e é dita idiopática (PPCI) quando não se identificam lesões no SNC nos exames de imagem.

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Development and Validation of a Combined MRI Radiomics, Imaging and Clinical Parameter‐Based Machine Learning Model for Identifying Idiopathic Central Precocious Puberty in Girls

Zou

Zhang

et al. 2023

Magnetic Resonance Imaging

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BackgroundIdiopathic central precocious puberty (ICPP) impairs child development, without early intervention. The current reference standard, the gonadotropin‐releasing hormone stimulation test, is invasive which may hinder diagnosis and intervention.PurposeTo develop a model for accurate diagnosis of ICPP, by integrating pituitary MRI, carpal bone age, gonadal ultrasound, and basic clinical data.Study TypeRetrospective.PopulationA total of 492 girls with PP (185 with ICPP and 307 peripheral precocious puberty [PPP]) were randomly divided by reference standard into training (75%) and internal validation (25%) data. Fifty‐one subjects (16 with ICPP, 35 with PPP) provided by another hospital as external validation.Field Strength/SequenceT1‐weighted (spin echo [SE], fast SE, cube) and T2‐weighted (fast SE‐fat suppression) imaging at 3.0 T or 1.5 T.AssessmentRadiomics features were extracted from pituitary MRI after manual segmentation. Carpal bone age, ovarian, follicle and uterine volumes and endometrium presence were assessed from radiographs and gonadal ultrasound. Four machine learning methods were developed: a pituitary MRI radiomics model, an integrated image model (with pituitary MRI, gonadal ultrasound and bone age), a basic clinical model (with age and sex hormone data), and an integrated multimodal model combining all features.Statistical TestsIntraclass correlation coefficients were used to assess consistency of segmentation. Receiver operating characteristic (ROC) curves and the Delong tests were used to assess and compare the diagnostic performance of models. P < 0.05 was considered statistically significant.ResultsThe area under of the ROC curve (AUC) of the pituitary MRI radiomics model, integrated image model, basic clinical model, and integrated multimodal model in the training data was 0.668, 0.809, 0.792, and 0.860. The integrated multimodal model had higher diagnostic efficacy (AUC of 0.862 and 0.866 for internal and external validation).ConclusionThe integrated multimodal model may have potential as an alternative clinical approach to diagnose ICPP.Evidence Level3.Technical EfficacyStage 2.

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Treatment of Central Precocious Puberty by Subcutaneous Injections of Leuprorelin 3-Month Depot (11.25 mg)

Cited by 99 publications

References 28 publications

Three-month sustained-release triptorelin (11.25 mg) in the treatment of central precocious puberty

Three-month sustained-release triptorelin (11.25 mg) in the treatment of central precocious puberty

Puberdade precoce central idiopática em meninas no estado da Bahia

Development and Validation of a Combined MRI Radiomics, Imaging and Clinical Parameter‐Based Machine Learning Model for Identifying Idiopathic Central Precocious Puberty in Girls

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