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Treatment of tall stature in boys: comparison of two different treatment regimens
Thomas Reinehr1, Mirjam Gueldensupp, Rainer Wunsch
1Department of Pediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Adolescents Datteln, University of Witten/Herdecke, Datteln, Germany. t.reinehr@kinderklinik-datteln.de
Background:
High-dose testosterone treatment is a well-known, though still controversial, therapy in boys with tall stature.
Methods:
161 boys with constitutional tall stature were treated at two different treatment centers (center A 114 patients; center B 47 patients). In center A, boys were treated with 500 mg and in center B with 250 mg testosterone enanthate intramuscularly every 2 weeks. Predicted adult height (PAH) was calculated according to the Bayley/Pinneau method using the Greulich-Pyle method for bone age determination.
Results:
At onset of treatment, the patients at the two centers did not differ with respect to chronological age (center A 14.2 ± 1.3 years; center B 13.5 ± 1.1 years), height (center A 187.8 ± 7.3 cm; center B 185.5 ± 5.5 cm), bone age (center A 13.8 ± 0.8 years; center B 13.6 ± 0.7 years), or PAH (center A 205.2 ± 5.2 cm; center B 204.8 ± 5.5 cm). Mean treatment duration was significantly longer in center A than in center B (14.2 ± 4.0 vs. 11.3 ± 2.2 months). At the end of the testosterone treatment, PAH did not differ significantly (center A 197.7 ± 5.3 cm; center B 196.1 ± 4.7 cm). The mean reduction in PAH at the end of treatment was 7.6 ± 5.0 cm (center A) and 8.7 ± 5.6 cm (center B) which is ∼50% of the expected growth at onset of treatment.
Conclusions:
A testosterone enanthate dose of 250 mg every 2 weeks was as effective in reducing adult height in boys with tall stature as a dose of 500 mg every 2 weeks.
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