Vottero Alessandra, Pedori Simona, Verna Marta, Pagano Blandina, Cappa Marco, Loche Sandro, Bernasconi Sergio, Ghizzoni Lucia
Department of Pediatrics, University of Parma, Via Gramsci 14, 43100 Parma, Italy.
J Clin Endocrinol Metab. 2006 Apr;91(4):1284-7. doi: 10.1210/jc.2005-1693. Epub 2006 Jan 31.
GnRH analogs (GnRHa) are considered the treatment of choice for central precocious puberty (CPP). During GnRHa administration, the suppression of the pituitary-gonadal axis results in decreased rates of linear growth and skeletal maturation and in improved adult height. However, in some patients, the growth deceleration is so marked that the expected improvement in predicted adult height is not achieved.
The objective of this study was to assess whether the addition of oxandrolone (Ox) may affect the height outcome of patients with CPP and growth deceleration during GnRHa treatment.
This was an open-label, clinical study.
The study was performed at a pediatric endocrinology referral clinic.
Twenty patients with CPP and marked growth deceleration during GnRHa treatment were studied.
Treatment consisted of GnRHa (Leuprorelina, 3.75 mg im every 28 d) alone (10 patients) or in combination with Ox (0.06 mg/kg.d by mouth) (10 patients).
The main outcome measure was the patients' adult height.
The adult height of the patients treated with GnRHa plus Ox was significantly higher than pretreatment predicted adult height (162.6 +/- 2.3 vs. 154.8 +/- 1.7 cm, mean +/- sem; P < 0.05) and target height (162.6 +/- 2.3 vs. 158.0 +/- 1.9; P > 0.05). Patients treated with GnRHa alone reached an adult height similar to the pretreatment predicted adult height (151.9 +/- 1.2 vs. 155.4 +/- 2.1 cm) but significantly lower than target height (151.9 +/- 1.2 vs. 156.6 +/- 1.4 cm; P < 0.005). No side effects were recorded in either group of patients.
Combined GnRHa and Ox therapy is a viable treatment option for children with CPP and marked growth deceleration during treatment with GnRHa alone.
促性腺激素释放激素类似物（GnRHa）被认为是中枢性性早熟（CPP）的首选治疗方法。在使用GnRHa期间，垂体 - 性腺轴的抑制导致线性生长和骨骼成熟速率降低，并改善成年身高。然而，在一些患者中，生长减速非常明显，以至于无法实现预期的成年身高改善。
本研究的目的是评估添加氧雄龙（Ox）是否会影响GnRHa治疗期间CPP和生长减速患者的身高结局。
这是一项开放标签的临床研究。
该研究在一家儿科内分泌转诊诊所进行。
研究了20例在GnRHa治疗期间患有CPP且生长明显减速的患者。
治疗包括单独使用GnRHa（亮丙瑞林，每28天肌肉注射3.75mg）（10例患者）或与Ox联合使用（口服0.06mg/kg.d）（10例患者）。
主要结局指标是患者的成年身高。
接受GnRHa加Ox治疗的患者的成年身高显著高于治疗前预测的成年身高（162.6±2.3 vs. 154.8±1.7cm，平均值±标准误；P<0.05）和靶身高（162.6±2.3 vs. 158.0±1.9；P>0.05）。单独接受GnRHa治疗的患者达到的成年身高与治疗前预测的成年身高相似（151.9±1.2 vs. 155.4±2.1cm），但显著低于靶身高（151.9±1.2 vs. 156.6±1.4cm；P<0.005）。两组患者均未记录到副作用。
GnRHa与Ox联合治疗是CPP患儿以及在单独使用GnRHa治疗期间生长明显减速患儿的一种可行治疗选择。
