Abstract
In patients with CPP, we lack criteria to determine optimal age when GnRH agonist therapy should be stopped. In 18 patients with CPP (16 girls, 2 boys) treated with buserelin intranasally (1.2 to 1.8 mg/day) for 1 to 3 yrs (mean: 2.3 yrs), we examined whether BA affected the subsequent rates of growth and of bone maturation. During therapy, pubertal development showed regression in 10 patients and arrest in 8, while mean (± ISD) height velocity (pretreatment, 10.7 ± 3.6 cm/yr) decreased to 6.5 ± 1.5, 4.6 ± 1.4 and 3.6 ± 1.2 cm/yr after 1, 2 and 3 yrs of treatment, respectively. In order to evaluate the growth rates vs the rates of bone maturation, SD Scores (SDS) of height for BA (TW2, RUS) were calculated before and during the 1st, 2nd and 3rd yrs of therapy. The difference in SDS of height for BA observed during therapy (range: -1.2 to +1.2 SD) were directly related (r = +0.51) to BA (range: 10,1 to 13.7 yrs). This was because increase in BA resulted in a reduced ΔBA/ΔCA (range: 1.9 to 0.1, r = -0.58). Thus, although height velocity is decreasing with age and duration of buserelin therapy, the concomitant reduction in BA velocity results in an apparent growth saving effect occurring with advancement in BA. Therefore, study of BA does not provide arguments for stopping GnRH agonist therapy. Possible criteria related to the capacity af achieving a residual growth spurt after stopping treatment warrant further evaluation.
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Heinrichs, C., Vandeweghe, M. & Bourguignon, J. 137 IMPORTANCE OF BONE AGE (BA) FOR SUBSEQUENT RESPONSE TO BUSERELIN THERAPY INCENTRAL PRECOCIOUS PUBERTY (CPP). Pediatr Res 24, 540 (1988). https://doi.org/10.1203/00006450-198810000-00158
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DOI: https://doi.org/10.1203/00006450-198810000-00158