Gonadotropin-releasing hormone analog (GnRHa) therapy is an efficacious treatment for suppressing pubertal progression in young patients with central precocious puberty (CPP), is considered standard-of-care for this indication, and results in improved height and psychosocial outcomes (1). However, usage of GnRHa’s in children with early-normal and/or normally-timed but rapid tempo puberty lacks clear-cut efficacy in terms of height preservation/augmentation (2). While there has been concern that GnRHa therapy may be associated with increases in body mass index and decreases in bone mineral density, available long-term data do not support these or other long-term adverse consequences (3). However, there remain conflicting data on the long-term risk of polycystic ovarian syndrome in conjunction with CPP (3). Treatment with injectable GnRHa formulations does not appear to impair gonadal function after treatment cessation, with onset or return of menarche within 1-2 years of treatment cessation, and normal rates of fertility so far in limited long-term follow-up studies (4). Because of these limited available data from females in their late teens to adulthood regarding the impact of GnRHa therapy on fertility, a long-term study investigating fertility, fecundity, and health of offspring would be a valuable addition to our understanding of the safety of this class of drugs. The ability to compare differential results among types of GnRHa therapy used is limited by the depth of the published literature. Physiological effects after treatment discontinuation with histrelin, which has only been available in US to treat children with CPP for ~9 years, have not been fully evaluated, but clearly merit further assessment and we await results from a patient registry investigating long-term follow-up of girls with CPP treated with histrelin, which will evaluate time to menarche or resumption of menses. There are currently no long-term post-treatment follow-up data on 3-monthly depot leuprolide, and such data would also be of great value.
Efficacy and Safety of Long-Acting Gonadotropin Releasing Hormone Analogs
Other
Efficacy and Safety of Long-Acting Gonadotropin Releasing Hormone Analogs
J Clin Res Pediatr Endocrinol 2016;8(1):10-10
- 1Center For Endocrinology, Diabetes & Metabolism, Children’S Hospital Los Angeles, Keck School Of Medicine Of Usc, Los Angeles, California, United States Of America
Corresponding Author: Center For Endocrinology, Diabetes & Metabolism, Children’S Hospital Los Angeles, Keck School Of Medicine Of Usc, Los Angeles, California, United States Of America
Licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 (CC BY-NC-ND) International License.
CC BY-NC-ND — Attribution-NonCommercial-NoDerivatives 4.0 InternationalThe statements, opinions, and data contained in articles published in this journal are solely those of the individual author(s) and contributor(s) and do not necessarily reflect the views of the journal, its editors, editorial board, owner, or Galenos Publishing House.
Neither the journal nor Galenos Publishing House endorses or recommends any commercial product, process, service, institution, or organization that may be mentioned or advertised in the journal. The publication of advertisements, product information, or links to external websites does not constitute endorsement or approval by the journal or the publisher.
The journal, its editors, editorial board, owner, and Galenos Publishing House make reasonable efforts to ensure the accuracy and integrity of published content; however, they cannot be held responsible for errors, omissions, or any consequences arising from the use of information contained in the journal, to the extent permitted by applicable law.
Information published in the journal is intended for scientific and educational purposes and should not be considered a substitute for professional medical advice, diagnosis, or treatment. Readers should consult appropriately qualified healthcare professionals regarding individual medical conditions or treatment decisions.
External links are provided for informational convenience only. The journal and Galenos Publishing House are not responsible for the availability, accuracy, content, privacy practices, or policies of external websites.
