In boys with constitutional delay of growth and puberty (CDGP), puberty may be induced with a short course of testosterone, either as esters or enantate injections. While both types of testosterone are known to be effective in inducing puberty, there are no studies comparing their efficacies. We have compared height gain, a quantitative marker of puberty, between boys treated with a short course of testosterone esters and enantate injections in a retrospective, observational study.
Aim: To investigate the extent of short-term height gain following induction of puberty with testosterone esters and enantate in boys with CDGP.
Methods: Height in SDS and stage of puberty were examined in boys prior to and at 46 months (1st follow up) and 1012 months (2nd follow up) after 3 weekly treatment with 50 mg testosterone esters (n=19) and 6 weekly treatment with 125 mg testosterone enantate (n=18) for 3 doses.
Results: No difference was observed between the groups who received testosterone esters and enantate in age (median (range) 14.3 (12.8, 16.3) vs 13.9 (13.1, 16.3), P=0.6), height SDS (−2.1 (−3.7, 0.3) vs −2.1 (−3.9, 0.0), P=0.8), bone age delay (1.3 (−0.5, 6.5) vs 2.8 (−0.2, 5.8) years, P=0.3) and testicular volumes (4 (2, 6) vs 5 (3, 6) ml, P=0.1) prior to treatment. At the 1st follow up, height SDS increment was greater in those who received enantate (0.2 (−0.4, 0.6)) compared to those who received esters (0.1 (−0.1, 0.4), P=0.003). In regression analysis (R2=0.9, P<0.001), height gain was associated with the type of testosterone (P=0.002) after controlling for the stage of puberty and duration of treatment. At the 2nd follow up, there was no difference in height increment between the treatment groups (P=0.6). Testicular volumes increased in both groups over time (P<0.001), but the difference between the groups was not significant at the 1st (P=0.9) or 2nd follow up (P=0.5) appointments.
Conclusions: In our study, boys with CDGP who received testosterone enantate achieved greater short-term height gain in comparison with those who received testosterone esters. Following induction of puberty, testicular volumes increased equally in both treatment groups.
05 - 07 Nov 2008
British Society for Paediatric Endocrinology and Diabetes