BSPED2009 Oral Communications Oral Communications 2 (2 abstracts)
Final height in Turner syndrome after Oxandrolone and delayed pubertal induction: results of a UK randomised, double-blind, placebo-controlled trial
Emma-Jane Gault 1 , Rebecca Perry 2 , Sarah Casey 2 , Tim Cole 3 , Wendy Paterson 2 , Peter Hindmarsh 3 , Peter Betts 4 , David Dunger 5 & Malcolm Donaldson 1
1University of Glasgow, Glasgow, UK; 2Royal Hospital for Sick Children, Glasgow, UK; 3UCL Institute of Child Health, London, UK; 4Southampton University Hospitals NHS Trust, Southampton, UK; 5University of Cambridge, Cambridge, UK.
The UK Turner Study examined in girls with Turner syndrome (TS) the impact on final height (FH) of Oxandrolone (Ox) and/or delayed pubertal induction (14y).
Methods: Girls with TS aged 7–13y receiving GH were randomised to Ox (0.05 mg/kg per day, max. dose 2.5 mg/day) or placebo from 9y (or from enrolment if >9y). Girls requiring oestrogen were further randomised to begin oral Ethinylestradiol (E2) (Y1:2 μg/day; Y2:4 μg/day; Y3:4 months each of 6/8/10 μg/day) at 12y or 14y. Analysis was by multiple regression.
Results: From 1999 to 2003, 106 girls were recruited at 36 UK hospitals. Fourteen withdrew, and 75 have reached FH. The table gives characteristics of girls by randomisation and outcome.
| 1st randomisation | 2nd randomisation | |||
| Mean (S.D.) | Ox | Placebo | E2 at 12y | E2 at 14y |
| At enrolment | (n=51) | (n=55) | (n=29) | (n=31) |
| Age (y) | 10.3 (1.6) | 10.3 (1.6) | 9.6 (1) | 9.7 (1.2) |
| Height (cm) | 126.7 (8.5) | 125.6 (7.9) | 122.8 (6.9) | 124.2 (6.7) |
| Age at GH start (y) | 7.0 (2.5) | 6.9 (3.0) | 6.7 (2.1) | 5.5 (2.3) |
| At final height | (n=35) | (n=40) | (n=22) | (n=20) |
| Age (yrs) | 16.4 (1.3) | 16.6 (1.3) | 16.3 (1.1) | 16.8 (0.9) |
| FH (cm) | 154.0 (4.8) | 148.9 (6.2) | 149.3 (7.0) | 153.2 (4.4) |
Ox and 14y-induced puberty both increased FH, by 5.0 cm (P=0.0002, n=75) and 3.7 cm (P=0.03, n=42) respectively. The interaction between them was negative and close to significance (P=0.06, n=42) with these FH effects: Ox vs no Ox (E2 at 12y), 8.2 cm; E2 at 14 vs 12y (no Ox), 6.4 cm; Ox/E2 at 14y vs no Ox/E2 at 12y, 8.4 cm. No significant adverse events such as voice deepening or clitoromegaly were reported.
Conclusions: Ox and pubertal induction at 14y both have a positive effect on FH in TS but the effects are not additive so there is little advantage in using both. Ox is a realistic alternative to late pubertal induction for increasing FH.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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