Long-Term Treatment of Central Precocious Puberty with a Long-Acting Analogue of Luteinizing Hormone-Releasing Hormone

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Abstract
The gonadotropin-releasing hormone–like agonist d-Trp6-Pro9-NEt-LHRH (LHRHa) has been shown to induce a reversible short-term suppression of gonadotropins and gonadal steroids in patients with central precocious puberty. Since accelerated statural growth and bone maturation are clinical features of precocity not well controlled by conventional therapies, we examined the effects of prolonged LHRHa therapy for 18 consecutive months on growth and skeletal maturation in nine girls with neurogenic or idiopathic precocious puberty. Suppression of gonadotropin pulsations and gonadal steroids was maintained in all subjects. Growth velocity fell from a mean rate (±S.E.M.) of 9.35±0.64 cm per year during the 19 months before treatment to 4.58±0.60 cm per year during treatment (P<0.001). Bone age advanced a mean of 9.4 ±2.3 months during treatment. These changes resulted in a mean increase of 3.3 cm in predicted height (P<0.01).