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[Treatment of precocious puberty by GnRH agonists]

Jean-Claude Carel1

  • 1Endocrinologie pédiatrique & INSERM U561, groupe hospitalier Cochin-Saint-Vincent-de-Paul, 82, avenue Denfert-Rochereau, 75674 Paris 14, France.

Annales D'Urologie
|November 24, 2005
PubMed

Insights

Gonadotropin-releasing hormone (GnRH) agonist treatment for precocious puberty effectively blocks development and improves adult height. Newer long-acting formulations enhance treatment compliance in pediatric patients.

Area of Science:

  • Pediatric Endocrinology
  • Reproductive Medicine
  • Pharmacology

Background:

  • Precocious puberty requires treatment to prevent adverse effects on skeletal growth and adult height.
  • Gonadotropin-releasing hormone (GnRH) agonists are standard treatment, but frequent injections pose compliance challenges.
  • Long-acting formulations offer improved convenience and compliance in pediatric care.

Purpose of the Study:

  • To evaluate the efficacy and safety of a new 3-month depot formulation of triptorelin acetate in pediatric patients with precocious puberty.
  • To assess the impact of GnRH agonist treatment on pubertal suppression and potential long-term outcomes.

Main Methods:

  • A European multicentre open trial involving 54 girls and 10 boys with precocious puberty.
  • Triptorelin acetate (11.25 mg) administered intramuscularly every trimester for one year.
  • Luteinizing hormone (LH) peak post-GnRH stimulation test at three months served as the primary efficacy endpoint.

Main Results:

  • The 3-month depot triptorelin acetate formulation demonstrated effectiveness in suppressing pubertal progression, comparable to other GnRH analogs.
  • The treatment was found to be effective, with LH suppression indicating successful GnRH agonism.
  • Side effects were generally related to sex steroid deprivation, occurring in 20-30% of cases.

Conclusions:

  • The 3-month depot formulation of triptorelin acetate is an effective and potentially more compliant treatment option for pediatric precocious puberty.
  • Further studies are needed to fully assess long-term auxological effects, including final adult height, and impacts on fertility and body composition.

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