Experience with cyproterone acetate in the treatment of precocious puberty

The authors review their experience (1967-present) in the use of cyproteron e acetate (CPA) in precocious puberty. CPA was found effective in persisten tly suppressing pituitary gonadotropic secretion when administered orally a t a dose of 50 mg b.i.d. (70-100 mg/d). After the introduction of gonadotro pic analogues (GnRHa) for treatment of central precocious puberty, short te rm use of CPA was found useful to counteract the initial stimulatory effect of the GnRHa as well as an adjunct drug in case of very active adrenarche causing advanced bone age during GnRHa treatment, The final heights of girl s treated with CPA and girls treated with D-Trp(6)-LHRH were found comparab le: 157.8+/-5.1 cm vs 159.6+/-6.3 cm, respectively. The main adverse effect s were occasional fatigue due to partial adrenal insufficiency with CPA and gynecomastia in a few boys, Liver function tests were normal in all patien ts with the exception of one boy with severe hypothalamic disease, includin g precocious puberty, who developed liver cirrhosis 3 years after stopping CPA following 5 years treatment. Other indications for CPA treatment during childhood and adolescence, such as fast puberty, congenital adrenal hyperp lasia and acne, are also mentioned.