COMBINATION THERAPY WITH GH AND CYPROTERONE-ACETATE DOES NOT IMPROVE FINAL HEIGHT IN BOYS WITH NON-GH-DEFICIENT SHORT STATURE

BACKGROUND AND OBJECTIVE Recently, we reported that GH therapy without gonadal suppression (GS) decreased the final height of boys with non- GH-deficient short stature by decreasing the height standard deviation score (SDS) for bone age (BA) during puberty. Combination therapy wit h GH and GS has been reported to suppress bone maturation and improve final height in some cases. We evaluated the effects of combination th erapy with GH and GS using cyproterone acetate on the final height of boys with non-GH-deficient short stature. PATIENTS Fifty nine boys wit h non-GH deficient short stature were observed retrospectively until t hey reached their final height. The boys were divided into 3 groups: G roup A consisted of 26 boys who were not treated with GH, group a cons isted of 13 boys who were treated with GH alone, and group C consisted of 20 boys who were treated with combination therapy with GH and GS u sing cyproterone acetate. At the start of observation, the height SDS for BA and projected height were matched among these three groups. RES ULTS The mean +/- SDS of the final height for groups A, B, and C were 162.7 +/- 5.3 cm, 155.4 +/- 4.9 cm, and 161.9 +/- 3.2 cm, respectively . GH therapy did not affect the height SDS for BA during the prepubert al period. GH therapy without GS decreased the height SDS for BA durin g puberty in group B. Combination therapy with GH and cyproterone acet ate increased the height SDS for BA between 12 and 14 years BA in grou p C. However, after GS therapy was discontinued at 14 years BA, the he ight SDS for BA gradually decreased and eventually reached the same va lue as that in group A. CONCLUSIONS GH therapy during the prepubertal period did not improve the final height of boys with non-GH-deficient short stature. GH therapy without GS decreased pubertal height gain, r esulting in reduced final height. Combination therapy with GH and GS u sing cyproterone acetate decelerated the bone maturation during pubert y which might be accelerated by GH therapy, but did not improve the fi nal height which might have been attained without treatment.