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Endocrine Abstracts (2009) 23 OC2.1

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.

Table 1
1st randomisation2nd randomisation
Mean (S.D.)OxPlaceboE2 at 12yE2 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.

Volume 23

37th Meeting of the British Society for Paediatric Endocrinology and Diabetes

British Society for Paediatric Endocrinology and Diabetes 

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