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Treatment of children with central precocious puberty by a slow-release gonadotropin-releasing hormone agonist

  • Endocrinology
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Abstract

A total of 82 patients (74 girls, 8 boys) are presently participating in an international multicentre trial for treatment of central precocious puberty (CPP) with a slow release gonadotropin-releasing hormone (GnRH) agonist depot preparation: Decapeptyl-Depot (DD). Of these patients, 53 (3 boys) were previously untreated (group 1) and 29 (5 boys) have been treated before with either a short-acting GnRH analogue or cyproterone acetate (group 2). Fifty-one patients (44 girls, 7 boys) were treated with DD for 12 months or more. Basal plasma luteinizing hormone (LH) levels decreased in both groups after 1 year of therapy. The LH response to intravenous GnRH was reduced in both groups. Basal plasma follicle stimulating hormone (FSH) levels decreased in both groups. Stimulated FSH levels were reduced in both groups after 1 year of DD treatment. Plasma oestradiol levels in the girls decreased to prepubertal levels in both groups. In all patients the clinical signs of precocious gonadarche such as breast development and menstruations (girls) and an increased testis volume (boys), did not further progress and sometimes regressed in several patients. Growth velocity decreased in the girls of group 1 from 9.0±0.72cm/year (mean±SEM) in the last half-year before treatment to 6.3±0.50 in the first half-year of treatment (P<0.01) and to 4.5±0.23 cm/year in the second half-year (P<0.01). After 12 months a stabilization of growth velocity was observed. The ΔBA/ΔCA ratio decreased during treatment in this group of girls, resulting in an improvement of adult height prediction from 161.9±3.3 cm (mean±SEM) at the start to 164.1±3.5cm after 18 months of therapy (P<0.05). No change of height prediction was observed in group 2. At present we consider one i.m. injection of DD every 4 weeks as the treatment of choice in children with CPP.

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Abbreviations

CPA:

cyproterone acetate

CPP:

central precocious puberty

DD:

Decapeptyl-Depot

DHEAS:

dehydroepiandrosterone-sulphate

FSH:

follicle stimulating hormone

GnRH:

gonadotropin-releasing hormone

LH:

luteinizing hormone

SEM:

standard error of mean

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Authors and Affiliations

  1. Department of Paediatrics, University of Leiden, P. O. Box 9600, 2300, RC Leiden, The Netherlands

    W. Oostdijk

  2. Kinderklinik der Universität Kiel, D-2300, Kiel, Federal Republic of Germany

    R. Hümmelink, C. J. Partsch, F. Lorenzen & W. G. Sippell

  3. Department of Paediatrics, University of Amsterdam, The Netherlands

    R. J. H. Odink

  4. Department of Paediatrics, University of Rotterdam, The Netherlands

    S. L. S. Drop

  5. Department of Medical Statistics, University of Leiden, Leiden, The Netherlands

    E. A. van der Velde

  6. Ferring Arzneimittel GmbH, D-2300, Kiel, Federal Republic of Germany

    H. Schultheiss

Authors
  1. W. Oostdijk
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  2. R. Hümmelink
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  3. R. J. H. Odink
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  4. C. J. Partsch
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  5. S. L. S. Drop
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  6. F. Lorenzen
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  7. W. G. Sippell
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  8. E. A. van der Velde
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  9. H. Schultheiss
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Additional information

On behalf of the Dutch-German Precocious Puberty Study Group. The clinical investigators participating in the internnational multicentre trial of Decapeptyl-Depot in children with central precocious puberty are: J. Brämswig, Münster; H. Dörr, München; S.L.S. Drop, Rotterdam; M. Gons, Amsterdam; A. Grüters, Berlin; P. Heidemann, Göttingen; U. Heinrich, Heidelberg; U. Irle, Bremen; M. Jansen, Utrecht; K. Kruse, Würzburg; U. Kuhnle, München; R. Mühlenberg, Krefeld; K.E. Mühlendahl von, Osnabrück; R.J.H. Odink, Amsterdam; W. Oostdijk, Leiden; A. Otten, Giessen; B.J. Otten, Nijmegen; W. Petrykowski, Freiburg; C. Rouwe, Groningen; K. von Schnakenburg, Bonn; W. G. Sippell, Kiel; H. Stolecke, Essen; H.U. Tietze, Nürnberg; J.J.J. Waelkens, Eindhoven; W. Weltersbach, Köln; J. Wiebel, Hamburg

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Oostdijk, W., Hümmelink, R., Odink, R.J.H. et al. Treatment of children with central precocious puberty by a slow-release gonadotropin-releasing hormone agonist. Eur J Pediatr 149, 308–313 (1990). https://doi.org/10.1007/BF02171554

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  • DOI: https://doi.org/10.1007/BF02171554

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