COMPARISON OF COMPLETE AND INCOMPLETE SUPPRESSION OF PITUITARY-GONADAL ACTIVITY IN GIRLS WITH CENTRAL PRECOCIOUS PUBERTY - INFLUENCE ON GROWTH AND PREDICTED FINAL HEIGHT

The question as to whether treatment with short-acting or with slow-re lease gonadotropin-releasing hormone (GnRH) agonists has different eff ects on growth and bone maturation when treating girls with central pr ecocious puberty has not yet been studied. In a meta-analysis, we comp ared 21 naive girls with central precocious puberty who were treated w ith buserelin with 22 naive girls with central precocious puberty who received Decapeptyl in depot form. Treatment lasted for at least 18 mo nths. At the start of therapy, chronological age, bone age, growth vel ocity and pubertal stage in the two groups were very similar. During t he first 6 months of treatment, significantly more phases of incomplet e suppression of pituitary-gonadal activity occurred in the buserelin group. As a result, growth velocity and bone maturation (Delta bone ag e/Delta chronological age) remained significantly higher than in the D ecapeptyl Depot group (p <0.0001 and p <0.01, respectively). In contra st to the Decapeptyl Depot group, the height standard deviation score (SDS) for bone age in the buserelin group did not change significantly in the first 6 months of treatment, and the predicted adult height de creased. Between the 6th and 18th months of therapy, the development o f growth rate, Delta bone age/Delta chronological age, height SDS for bone age and predicted adult height in both groups became almost ident ical. However, the rate of growth and bone maturation in the buserelin group remained faster than in the Decapeptyl group, though not signif icantly so. The mean predicted adult height had risen significantly af ter 18 months in the Decapeptyl Depot group but not in the group treat ed with buserelin. Treatment with the slow-release GnRH agonist Decape ptyl Depot is more effective for children with central precocious pube rty than therapy with the short-acting agonist buserelin, not only wit h regard to long-term compliance but also for auxological reasons, sin ce Decapeptyl Depot suppresses gonadotropins and oestradiol faster and more completely at least during the first 6 months of treatment.