Endocrine Abstracts

Central precocious puberty (CPP) is a common and well-recognised condition characterised by premature activation of the hypothalamic-pituitary-gonadal axis, with consequent potential adverse health and psychosocial outcomes. Standard management of CPP is with periodic injections of gonadotropin-releasing hormone analogue therapy. Decapeptyl SR (Triptorelin pamoate) has for several years been available as a long-acting (12-weekly, 11.25 mg) preparation, but more recently is available as a 24-weekly (22.5 mg) preparation. We aimed to examine the efficacy and tolerance of this 24-weekly Decapeptyl preparation in our clinical CPP cohorts at the Royal London Children’s Hospital (RLH) and Royal Victoria Infirmary Newcastle (RVI). We completed a cross-sectional cohort study and patient questionnaire in each centre. The current patient cohort at the RLH consists of 56 patients treated with 12-weekly Decapeptyl, 12 (11 female, 1 male) of whom have converted to 24-weekly Decapeptyl. The RVI cohort consists of 66 patients (59 female, 7 male) that have been treated solely with 24-weekly Decapeptyl, and 18 (15 female, 3 male) who were treated with 12-weekly first and then converted to 24-weekly Decapeptyl. Analysis of the cohort data suggested that the 12-weekly and 24-weekly Triptorelin preparations have a similar efficacy, with biochemical evidence of luteinising hormone (LH) suppression in 82% of patients on the 12-weekly preparation and 99% of those on the 24-weekly regime (P=0.25, 95% CI -1.325 to 0.3748). The median change in Tanner breast stage post treatment was +0.4 in the 12-weekly group and -0.22 in the 24-weekly group (P=0.1495, 95% CI -0.2485 to 1.493). There was also no significant difference in post-treatment height, height velocity or BMI between the two groups. Overall, the results demonstrated no significant difference in efficacy between the 12-weekly and 24-weekly preparations. 100% of patients that completed the questionnaire indicated that the less frequent injection schedule was preferable, suggesting that adopting the 24-weekly treatment into clinical practice would be well received. In addition, in view of the equivalent dose cost of the 24-weekly preparation, there is an estimated cost saving due to the reduced clinic time required to administer this preparation.