Six-year results of spironolactone and testolactone treatment of familial male-limited precocious puberty with addition of deslorelin after central puberty onset

Short term treatment with spironolactone, testolactone, and, after the onse t of central puberty, deslorelin can normalize the rate of growth and bone maturation in boys with familial male-limited precocious puberty. To test t he hypothesis that this treatment can achieve long term normalization of th e growth and development of these children, are examined the growth rate, b one maturation rate (change in bone age/change in chronological age), and p redicted adult height of 10 boys who were treated with spironolactone (5.7 mg/ kg day) and testolactone (40 mg/kg day) for at least 6 yr. Deslorelin ( 4 mu g/kg.day) treatment was initiated 2.6 +/- 1.3 yr after beginning spiro nolactone and testolactone treatment. The growth rate normalized within 1 yr of starting treatment and remained n ormal during the next 5 yr of treatment (P < 0.001). The rate of bone matur ation normalized during the second year of treatment and remained normal th ereafter (P < 0.001). Predicted height increased from 160.7 +/- 14.7 centim eters at baseline to 173.6 +/- 10.1 centimeters after 6 yr of treatment (P < 0.05 during the fourth through the sixth year of treatment compared to ba seline). We conclude that long term treatment with spironolactone, testolactone, and , after central puberty, deslorelin normalizes the growth rate and bone mat uration and improves the predicted height in boys with familial male-limite d precocious puberty. The ultimate effect of this approach on adult height will require further study.