FINAL HEIGHT IN CENTRAL PRECOCIOUS PUBERTY AFTER LONG-TERM TREATMENT WITH A SLOW-RELEASE GNRH AGONIST

Objective-To study the resumption of puberty and the final height achi eved in children with central precocious puberty (CPP) treated with th e GnRH agonist triptorelin. Patients-31 girls and five boys with CPP w ho were treated with triptorelin 3.75 mg intramuscularly every four we eks. Girls were treated for a mean (SD) of 3.4 (1.0) years and were fo llowed up for 4.0 (1.2) years after the treatment was stopped. Results -The rate of bone maturation decreased during treatment and the predic ted adult height increased from 158.2 (7.4) cm to 163.9 (7.5) cm at th e end of treatment (p<0.001). When treatment was stopped bone maturati on accelerated, resulting in a final height of 161.6 (7.0) cm, which w as higher than the predicted adult height at the start of treatment (p <0.001), Height at the start of treatment was the most important facto r positively influencing final height (r = 0.75, p<0.001). Bone age at cessation of treatment negatively influenced final height (r = -0.52, p = 0.03). A negative correlation between bone age and height increme nt after discontinuation of treatment was observed (r = -0.85, p = 0.0 01). Residual growth capacity was optimal when bone age on cessation o f treatment was 12 to 12.5 years. Body mass index increased during tre atment and remained high on cessation. At final height, the ratio of s itting height to subischial leg length was normal, Menarche occurred a t 12.3 (1.1) years, and at a median (range) of 1.1 (0.4 to 2.6) years after treatment was stopped. The ovaries were normal on pelvic ultraso nography. Conclusions-Treatment of CPP with triptorelin increases fina l height, with normal body proportions, and seems to increase body mas s index. The best results were achieved in girls who were taller at th e start of treatment. Puberty was resumed after treatment, without the occurrence of polycystic ovaries.