Endocrine Abstracts

JOINT2283

Introduction: Managing short stature can be challenging, often due to delayed diagnosis, as many patients have already entered puberty by their first endocrinological assessment. During puberty, sex hormones accelerate epiphyseal fusion, restricting growth potential. In adolescent boys, aromatase inhibitors may slow estrogen-driven growth plate closure, potentially enhancing adult height.

Objectives: To retrospectively assess the effectiveness of Anastrozole in increasing height Standard Deviation Score (SDS) in adolescent boys with restricted growth potential.

Methods: Medical records of 53 adolescent boys who received Anastrozole for at least three months were reviewed, collecting data on diagnosis, previous treatments, pubertal stage, anthropometrics, and bone age (BA) at treatment initiation (TI) and conclusion (TC).

Results: Among 53 patients, 9 (17%) were born small for gestational age (SGA), 3 (5. 7%) had growth hormone (GH) deficiency, and 4 (7. 5%) had central precocious puberty. In this cohort, 11 (20. 7%) had prior treatment with recombinant human GH (rhGH), while 4 (7. 5%) received GnRH analogues. At TI, the mean (± standard deviation) age was 14. 7 (±1. 8) years, with a mean BA of 14. 7 (±1. 6) years, a mean height SDS of -1. 37 (±0. 83), and BMI SDS of -0. 33 (±1. 02). The average treatment duration was 1. 1 years. At TC, there was no significant change in height SDS (-1. 38 ± 0. 90) or BMI SDS (-0. 23 ± 0. 92). However, in the subgroup of 13 (24. 5%) patients with a BA below 14 years at TI (mean BA 12. 9 ± 1. 2, mean age 12. 9 ± 1. 9 years, mean duration 1. 4 years), height SDS significantly increased from -1. 19 (±0. 72) to -0. 90 (±0. 93) (P < 0. 005). Notably, one patient did not respond to Anastrozole (height SDS at TI -2. 18 and at TC -2. 53) and was later diagnosed with an ACAN mutation. Furthermore, treatment was less effective in SGA patients, as their mean height SDS decreased from -0. 99 (±0. 85) at TI to -1. 29 (±0. 83) at TC, likely due to accelerated puberty. During follow-up, one patient developed transient bilateral knee synovitis and discontinued Anastrozole, but no other adverse events were reported.

Conclusion: Anastrozole may be a promising intervention for improving height outcomes in adolescent boys with limited growth potential, particularly when initiated in those with a BA below 14 years. Further research is necessary to determine the efficacy of aromatase inhibitors in specific subgroups, such as individuals with ACAN mutations or those born SGA. Regular monitoring is essential to identify potential adverse effects.