COMPARATIVE EFFICACY AND SAFETY OF THREE CURRENT CLINICAL TREATMENTS FOR GIRLS WITH CENTRAL PRECOCIOUS PUBERTY: A...

Area of Science:

• Pediatric Endocrinology
• Reproductive Medicine
• Clinical Pharmacology

Background:

• Central precocious puberty (CPP) in girls presents diagnostic and therapeutic challenges.
• Optimal treatment strategies for CPP are not well-established, necessitating comparative efficacy studies.
• Existing treatments include gonadotropin-releasing hormone analogue (GnRHa) therapy and combination therapy with growth hormone (GH).

Purpose of the Study:

• To conduct a network meta-analysis (NMA) evaluating the efficacy and safety of treatments for girls with CPP.
• To provide evidence-based clinical guidelines for CPP management.
• To compare GnRHa therapy, GnRHa plus GH combination therapy, and no-treatment control.

Main Methods:

• Systematic electronic literature search across PubMed, Embase, CNKI, and Wanfang Data databases.
• Inclusion of 22 studies with 1,268 patients comparing GnRHa, GnRHa + GH, and no treatment.
• Analysis of outcomes including bone maturation ratio, final height, growth velocity, and predicted adult height (PAH) using mean differences and 95% confidence intervals; Surface Under the Cumulative Ranking Curve (SUCRA) for treatment ranking.

Main Results:

• GnRHa plus GH combination therapy demonstrated superior performance in improving final height, final height vs. target height, growth velocity, height gain, and gain in predicted adult height (ΔPAH), with high SUCRA values.
• GnRHa monotherapy showed the highest ranking for bone maturation ratio (SUCRA = 0.663).
• No severe adverse effects were reported across the included studies.

Conclusions:

• GnRHa plus GH combination therapy is likely the optimal treatment for enhancing final height in girls with CPP.
• This combination therapy offers the highest probability of achieving improved adult height outcomes.
• The evaluated treatments were generally safe, with no severe adverse events noted.