Optimization of Triptorelin Administration in Children With Central Precocious Puberty and Short Stature

The objective of this study is to investigate the individualized use of triptorelin in children diagnosed with central precocious puberty (CPP) and short stature.

Twenty-six children with CPP and short stature who received triptorelin treatment from June 2018 to May 2022 were included in the study. Treatment-related conditions, including treatment purpose, indications, protocols, monitoring and changes in predicted adult height (PHA), were summarized and analysed.

Of the 26 cases, 24 children were treated to improve height, while two cases were treated for suppression of premature sexual development. Among the 24 cases treated with the goal of improving height, there were 13 cases of PHA-defined short stature, eight had severely impaired target height (TH) and three showed low TH. The distribution of bone age (BA) of the study participants upon undergoing triptorelin treatment ranged from 9 to 11.5 years in 21 cases, 11.5 to 13 years in three cases and over 14 years in one case. Additionally, one 9-year-old boy with congenital adrenal hyperplasia (CAH) had a BA of 16 years. Four children received triptorelin monotherapy, while 22 were treated with a combination of triptorelin and growth hormone (GH). Significant improvements in PHA were observed in the 24 children who completed a 1-year treatment course.

Triptorelin is effective not only in the treatment of CPP but also for children with short stature who exhibit premature sexual development, short PHA or impaired TH. In girls with early menarche, the BA indication can be relaxed to 12.5 or even 13 years, with early triptorelin-GH combination therapy recommended to maximize height potential. For those showing adequate pubertal suppression, triptorelin administration intervals can be extended from 4 to 5 weeks. In cases of insufficient suppression, the interval may need to be shortened to 3 weeks. Individualized triptorelin and GH combination therapy appears to offer superior height outcomes, with careful consideration required for optimal timing and duration of treatment.