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[Clinical efficacy of letrozole in boys with idiopathic central precocious puberty]
1Department of Endocrinology, Shenzhen Children's Hospital, Shenzhen, Guangdong 518026, China. zoeman221@163.com.
Insights
Letrozole treatment effectively delays bone maturation and enhances predicted adult height in boys with idiopathic central precocious puberty (ICPP) and short stature. This study found no significant adverse effects associated with letrozole therapy.
Area of Science:
- Pediatric Endocrinology
- Growth and Development
- Pharmacology
Background:
- Idiopathic central precocious puberty (ICPP) leads to early bone maturation and reduced adult height.
- Boys with ICPP and advanced bone age (above 13 years) and short stature require effective treatment strategies.
- Assessing interventions to optimize growth potential in these patients is crucial.
Purpose of the Study:
- To evaluate the efficacy of letrozole in delaying bone maturation in ICPP boys.
- To determine if letrozole increases predicted adult height in this cohort.
- To assess the safety and adverse effects of letrozole treatment.
Main Methods:
- A randomized controlled trial involving 20 ICPP boys with bone age >13 years and short stature.
- Treatment group received oral letrozole (2.5 mg/m²/day) for 6 months; control group received no treatment.
- Measurements included bone age, growth rate, predicted adult height, and hormone levels (FSH, LH, T, E2, etc.).
Main Results:
- Letrozole significantly slowed bone age advancement (13.82 vs 14.47 years) and increased predicted adult height SD score (-1.69 vs -1.91).
- Testosterone levels increased significantly in the letrozole group, but other hormone levels and testicular volume remained unchanged.
- No significant adverse reactions were reported during the 6-month treatment period.
Conclusions:
- Letrozole is effective in delaying bone maturation and improving predicted adult height in ICPP boys with advanced bone age and short stature.
- The treatment demonstrates a favorable safety profile with no observed adverse effects.
- Letrozole represents a potential therapeutic option for managing growth in specific ICPP patient populations.
Objective:
To investigate the efficacy of letrozole for delaying bone maturation and increasing predicted adult height in boys with idiopathic central precocious puberty (ICPP) who have a bone age above 13 years and a short stature, and its adverse effects.
Methods:
Twenty ICPP boys with a bone age above 13 years and a short stature were randomly divided into letrozole treatment (n=10) and control groups (n=10). The letrozole treatment group received oral letrozole [2.5 mg/(m(2)·d), Qd] for 6 months, while the control group received no treatment and was observed periodically. Bone age, growth rate, height standard deviation (SD) score, predicted adult height SD score, sexual maturity, and levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), dehydroepiandrosterone, testosterone (T), estradiol (E2), progesterone (P), and androstenedione (ASD) were measured. The letrozole-related adverse reactions were evaluated.
Results:
After 6 months of treatment, both groups had a significantly increased bone age, but the letrozole group had a significantly slowed increase in bone age compared with the control group (13.82 ± 0.23 years vs 14.47 ± 0.30 years; P<0.05); compared with the control group, the letrozole group had a significantly increased predicted adult height SD score (-1.69 ± 0.26 vs -1.91 ± 0.35; P<0.05) and a significantly increased T level (4.9 ± 0.9 nmol/L vs 4.4 ± 0.8 nmol/L; P<0.05). There was no significant difference in testicular volume between the two groups. The treatment led to no significant changes in growth rate, Tanner stage, and levels of FSH, LH, P, E2 and ASD in the two groups, and there was no significant difference in these indices between the two groups. No adverse reactions were observed during letrozole treatment.
Conclusions:
Letrozole delays bone maturation and increases predicted adult height in ICPP boys with a bone age above 13 years and a short stature, and it causes no obvious adverse reactions.
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