Acceleration of delayed growth with fluoxymesterone

Area of Science:

• Pediatric Endocrinology
• Adolescent Medicine
• Growth Hormone Therapy

Background:

• Constitutional delay of growth and maturation (CDGM) affects many boys, leading to psychosocial distress.
• Early intervention can mitigate the negative impacts of CDGM on height and social well-being.

Purpose of the Study:

• To evaluate the efficacy of fluoxymesterone in accelerating growth in boys with CDGM.
• To assess the impact of fluoxymesterone on final height potential and psychosocial outcomes.

Main Methods:

• A cohort of 61 boys (aged 9-19 years) with CDGM received fluoxymesterone (0.05-0.24 mg/kg/day) for 0.4-3.6 years.
• Growth velocity and predicted final height were monitored and compared to 37 untreated boys.
• Therapy involved continuous oral administration with age-adjusted dosing.

Main Results:

• All treated boys experienced increased growth velocity, with a mean first-year increment of 4.3 cm/year.
• Most boys showed a reduced height discrepancy with peers, achieving psychosocial relief.
• Post-therapy growth velocity decreased but remained elevated; final height prediction showed no average loss of height potential.

Conclusions:

• Fluoxymesterone is effective in accelerating growth and improving psychosocial status in boys with CDGM.
• The treatment appears to preserve final height potential, particularly in individuals with a bone age over 10.5 years.
• Individualized assessment is crucial for optimizing fluoxymesterone therapy outcomes.