a Pediatric and Adolescent Endocrinology, Pediatric Division, Department of Obstetrics, Gynecology and Pediatrics , Azienda Ospedaliero-Universitaria Pisana , Pisa , Italy.
Expert Rev Clin Pharmacol. 2018 Jul;11(7):659-667. doi: 10.1080/17512433.2018.1494569. Epub 2018 Jul 26.
Triptorelin depot is largely used to treat central precocious puberty (CPP) in children. Areas covered: This review updates triptorelin depot treatment of CPP, focusing on trials that compared 3.75 mg/28 day treated and untreated children till the adult height (AH). Efficacy of the new 11.25 mg/90 days or 22.5 mg/6 month formulations in suppressing pituitary-gonadal axis in short-term trials is also addressed. Short- and long-term safety was summarized. Expert commentary: Long experience on triptorelin depot use in children with CPP is available. Outcome differences on AH are reported; they may be due to heterogenicity of treated patients; some items remain to be optimized. No long term-adverse events on reproductive function are reported; additional studies would clarify if CPP per sè or triptorelin depot administration may increase hyperandrogenism and/or polycystic ovary syndrome risk in adulthood. The quarterly formulation seems to be able to suppress pituitary-gonadal axis and pubertal development and to determine similar end-results as monthly formulation, but additional trials are needed. Few data are available for the 22.5 mg/6 month formulation. Triptorelin depot treatment of CPP should be restricted to tertiary pediatric endocrinology centers, considering that some uncertainties still exist and that rare but serious adverse events may occur.
曲普瑞林微球主要用于治疗儿童中枢性性早熟(CPP)。
本综述更新了曲普瑞林微球治疗 CPP 的内容,重点关注了比较 3.75mg/28 天治疗和未治疗儿童直至成人身高(AH)的试验。还讨论了新的 11.25mg/90 天或 22.5mg/6 个月制剂在短期试验中抑制垂体-性腺轴的疗效。总结了短期和长期安全性。
曲普瑞林微球在 CPP 儿童中的长期应用经验丰富。已报道了 AH 方面的结果差异;这些差异可能是由于治疗患者的异质性所致;一些项目仍有待优化。尚未报道曲普瑞林微球治疗 CPP 对生殖功能的长期不良事件;需要进一步的研究来阐明 CPP 本身或曲普瑞林微球治疗是否会增加成年后患高雄激素血症和/或多囊卵巢综合征的风险。
每季度制剂似乎能够抑制垂体-性腺轴和青春期发育,并产生与每月制剂相似的最终结果,但需要更多的试验。关于 22.5mg/6 个月制剂的数据较少。考虑到仍存在一些不确定性且可能发生罕见但严重的不良事件,曲普瑞林微球治疗 CPP 应限于三级儿科内分泌中心。