TREATMENT OF HYPOGONADAL ADOLESCENT BOYS WITH LONG-ACTING SUBCUTANEOUS TESTOSTERONE PELLETS

Citation
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
Citations number
17
Categorie Soggetti
Pediatrics
ISSN journal
00039888
Volume
76
Issue
6
Year of publication
1997
Pages
495 - 499
Database
ISI
SICI code
0003-9888(1997)76:6<495:TOHABW>2.0.ZU;2-E
Abstract
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.