In true precocious puberty, the increased gonadal steroid secretion increases height velocity, somatic and psychosocial development, and the rate of skeletal maturation and can lead to short adult height. The aim is to assess the impact of suppression therapy of CPP with triptorelin on final adult height and the timing of menarche and pattern of menstrual cycle post-treatment.
Materials and methods: Nineteen girls, with CPP, which had completed at least two years of triptorelin therapy and have attained final height at the time of last evaluation, were incorporated in the study. The diagnosis of PP was based on combined data concerning early occurrence of secondary pubertal signs, advanced bone age (BA) and accelerated growth rate based on multiple height measurements and LHRH response consistent with CPP. Seven girls with central precocious puberty, which did not initiate triptorelin therapy mainly due to their parents refusal and had attained the final height, were used for comparisons. The mean (S.E.M.) chronological age at diagnosis was: 8.42 (0.15) years and 8.44 (0.57) years and (BA) 10.76 (0.32) and 11.2 (0.43) yrs for patients and controls respectively. Girls were treated with triptorelin (Arvecap, IPSEN, Greece) every 4 weeks at a dose of 3.75 mg.
Results: Mean final height was not statistically different from mean target height (157.28 vs 159.55 cm, P=0.055). Mean age of menarche was statistically different between treated girls and controls (12.45 vs 11.02 years P=0.004). Menarche was observed 1.37 years±0.73 (range: 0.43.57) following triptorelin discontinuation. Menstrual cycle was regular ranging from 28 to 40 days in 17 (89.5%) out of 19 girls.
Conclusions: Suppression therapy seems to be effective on attainment of final height in the range of target height. Spontaneous menarche occurs in all patients followed by regular menstruation in the vast majority of treated subjects.
03 - 07 May 2008
European Society of Endocrinology