ESPEYB20 5. Puberty Clinical Guidance and Studies (8 abstracts)
5.1. Leuprolide and triptorelin treatment in children with idiopathic central precocious puberty: an efficacy/tolerability comparison study
Valenzise M , Nasso C , Scarfone A , Rottura M , Cafarella G , Pallio G , Visalli G , Di Prima E , Nasso E , Squadrito V , Wasniewska M , Irrera P , Arcoraci V & Squadrito F
Front Pediatr. 2023;11:1170025.PMID: 37266535. https://www.frontiersin.org/articles/10.3389/fped.2023.1170025/full
Brief summary: This retrospective study compared the efficacy and tolerability profiles of leuprolide and triptorelin in patients with central precocious puberty and did not find any significant difference between the two drugs.
Treatment with GnRH analogues represents the standard of care for central precocious puberty (CPP) in order to preserve adult height potential1. Leuprolide and Triptorelin are the most prescribed drugs (1,2). They are generally considered to be safe (3) despite some mild side effects (4). This study retrospectively analyzed the treatment of 110 girls affected with CPP; 48 received Leuprolide and 62 received Triptorelin. Height at the end of treatment (P-value =0.3), gain in predicted adult height and number of observed side effects did not differ between treatment. 41.8% of patients reported at least on side effect. The most frequent were pain at injection site, headache, appetite increase and mood swings, consistently with previous studies (5). A novel aspect of this study is the focus on factors that could be related to the onset of side effects. A negative correlation was found between the risk of side effects and bone age at treatment initiation (P-value =0.038): the probability of side effects appearance significantly reduced with the increase of the initial bone age. Other parameters (duration of treatment, weight, height, chronological age, hormonal levels and radiological pelvic parameters) did not correlate with the risk of side effects.
In conclusion, Leuprolide and Triptorelin treatment appear to be effective and safe, without significant difference between the 2 drugs.
References: 1. Carel JC, Eugster EA, Rogol A, Ghizzoni L, Palmert MR. Consensus statement on the use of gonadotropin-releasing hormone analogs in children. Pediatrics. 2009; 123:752–62. 2. Bertelloni S, Mul D. Treatment of central precocious puberty by GnRH analogs: long-term outcome in men. Asian J Androl. 2008; 10:525–34. 3. Cantas-Orsdemir S, Eugster EA. Update on central precocious puberty: from etiologies to outcomes. Expert Rev Endocrinol Metab. 2019; 14:123–30. 4. Tonini G, Lazzerini M. Side effects of GnRH analogue treatment in childhood. J Pediatr Endocrinol Metab. 2000; 13:795–803. 5. de Sanctis V, Soliman AT, di Maio S, Soliman N, Elsedfy H. Long-term effects and significant adverse drug reactions (ADRs) associated with the use of gonadotropin-releasing hormone analogs (GnRHa) for central precocious puberty: a brief review of literature. Acta Biomed. 2019; 90:345–59.
Volume 20
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ESPE Yearbook of Paediatric Endocrinology
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