Mr. Zacharin et Gl. Warne, TREATMENT OF HYPOGONADAL ADOLESCENT BOYS WITH LONG-ACTING SUBCUTANEOUS TESTOSTERONE PELLETS, Archives of Disease in Childhood, 76(6), 1997, pp. 495-499
Aims-Long acting subcutaneous testosterone pellets are of proved effic
acy for the treatment of hypogonadal men, but have not been reported a
s a treatment modality in adolescent boys. Pharmacodynamic studies of
subcutaneous testosterone release have shown prolonged normalisation o
f testosterone levels for at least four months. Administration of a lo
ng acting, safe, effective, and convenient form of treatment is desira
ble when lifelong treatment is indicated. Patients and methods-Eightee
n boys (aged 13.9-17.5 years at the start of treatment)-seven with pri
mary hypogonadism, nine with secondary hypogonadism, and two boys bein
g treated with testosterone for tall stature-were given testosterone p
ellets (8-10 mg/kg) every six months for 18 months. Height, weight, pu
bertal status, and psychosocial parameters were assessed and follicle
stimulating hormone, luteinising hormone, testosterone, prolactin, and
lipids were measured at 0, 1, 3, 6, 12, and 18 months. Bone age was m
easured at 0 and 12 months. Results-In all boys growth velocity contin
ued appropriately for bone age. Puberty continued to progress in all b
oys and in two boys the amount of virilisation exceeded that seen with
previous treatment with intramuscular testosterone. After testosteron
e administration, follicle stimulating hormone and luteinising hormone
suppressed incompletely in the boys with primary hypogonadism. Serum
testosterone ranged from 4.3 to 26.7 nmol/l at three months to less th
an 10 nmol/l at six months after implantation. Prolactin and lipid lev
els were normal throughout the study. By report, there was an improvem
ent in mood and emotional wellbeing. No pellet extrusions occurred in
a total of 156 pellet insertions. Conclusions-All boys preferred this
mode of testosterone administration to intramuscular injections. Long
acting subcutaneous testosterone pellets are safe, efficacious, well t
olerated, and convenient, and result in normal physical growth and imp
roved psychological outlook in adolescent hypogonadal boys.