Gonadotrophin releasing hormone agonist with or without recombinant human GH in children with early puberty

BACKGROUND Early onset of puberty is frequently observed in adopted childre n. During treatment with a gonadotrophin releasing hormone agonist (GnRHa), a decrease in height velocity (HV) precludes height gain. OBJECTIVE AND DESIGN We studied the effect of the addition of GH to GnRHa t reatment in a 3-year prospective randomized trial in 30 adopted children wi th early puberty. PATIENTS Mean age (SD) at start of treatment was 9.6 (0.9) years in girls a nd predicted adult height (PAH) using a segmented bone age (BA) assessment method was 148.0 (5.3) cm. RESULTS HV decreased gradually in both groups with a higher HV in the group with GH addition (group B). No significant difference between the rates of bone maturation [change in bone age (ABA)/change in chronological age (ACA )] of both treatment groups was observed. After 3 years of treatment, PAH i ncrease was 5.7 (3.8) cm in group A (GnRHa alone) and 10.1 (3.8) cm in grou p B (P < 0.01). IGF-I levels were higher in group B. HV decreased slowly in both groups during treatment, unlike stabilization of IGF-I levels. CONCLUSION We conclude that, after 3 years of treatment, the addition of GH to GnRHa results in higher HV and a significant increase in PAH compared t o GnRHa alone.