Height benefits after GnRHa treatment in girls aged over 6 years with central precocious puberty: a meta-analysis

The aim of this meta-analysis was to evaluate the impact of gonadotropin-releasing hormone analog (GnRHa) treatment on height outcomes in girls aged over 6 years with central precocious puberty (CPP).

A systematic search was performed across PubMed, Cochrane Library, Web of Science, MEDLINE, EMBASE, CNKI, and Wan Fang databases to identify eligible studies. The meta-analysis protocol was registered at PROSPERO, and the quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS). A random-effects meta-analysis was used to synthesize data on height gain, final adult height (FAH), FAH standard deviation score (SDS), bone age, and the difference between FAH and target height (TH).

Fifteen studies including 1270 girls were identified. The results indicated that GnRHa therapy significantly improves height outcomes in girls with CPP aged over 6 years. By effectively delaying pubertal progression and bone age maturation, GnRHa treatment enables these girls to achieve a greater FAH and potentially surpass their TH. Meta-analysis showed that the GnRHa treatment group demonstrated significantly greater height gain (WMD = 2.52, 95% CI [1.66, 3.37]), FAH (WMD = (WMD = 3.18, 95% CI [1.49, 4.87]), and FAH minus TH (WMD = 0.61, 95% CI [0.42, 0.79]) compared to the control group. Additionally, bone age (WMD = -1.02, 95%CI [-1.99, -0.06]) was significantly lower than the control group. However, FAH SDS showed no significant difference between the groups (WMD = 0.09, 95%CI [-0.40, 0.58]).

GnRHa treatment demonstrates substantial benefits in promoting height outcomes in girls over 6 years old with CPP. This meta-analysis contributes to the growing body of evidence supporting the efficacy of GnRHa in managing CPP and underscores the importance of early intervention to maximize height potential in affected individuals.