GROWTH, BONE MATURATION AND HEIGHT PREDICTION AFTER 3 YEARS OF THERAPY WITH THE SLOW RELEASE GNRH-AGONIST DECAPEPTYL-DEPOT IN CHILDREN WITHCENTRAL PRECOCIOUS PUBERTY

More than 100 patients with central precocious puberty are participati ng in this international multicenter study using monthly i.m. injectio ns of the slow-release GnRH agonist Decapeptyl-Depot. In 15 patients, Decapeptyl-Depot treatment could be discontinued after 2 years of ther apy. Gonadal suppression was promptly reversible in all of them, as sh own by prepubertal low gonadotrophin-and sex steroid levels. Of the re maining 90 patients, 40 have been treated for more than 3 years, inclu ding 33 girls and 7 boys. Plasma levels of LH, FSH, estradiol and test osterone dropped to the prepubertal range after one month of Decapepty l-Depot and remained there for the whole period of therapy. At start o f therapy, mean chronologic age of these 40 children was 6.6 +/- 1.4 ( SD) years, mean bone age 10.2 +/- 1.9 years. Mean predicted adult heig ht increased in the boys from 173.6 +/- 13.8 (SD) cm at start of thera py to 184.6 +/- 17.0 cm after 3 years. Predicted adult height increase d in girls from 158.0 +/- 12.2 to 161.0 +/- 7.5 cm. Undue side effects were not seen, long term tolerance was good. It is concluded that Dec apeptyl-Depot injected i.m. every 4 weeks suppresses the pituitary-gon adal axis in children with central precocious puberty without clinical or biochemical escapes, and leads to an increase in predicted adult h eight by more than 3 cm in all boys and in 53% of the girls after thre e years of treatment.