Efficacy and outcomes of 6-month triptorelin formulation in girls treated for central precocious puberty for 24 months and beyond

Abstract Objectives Gonadotropin-releasing hormone agonists are used to suppress physical signs of puberty and improve height outcomes by decelerating bone age maturation in patients with central precocious puberty (CPP). Published data assessing biochemical and clinical parameters in patients with CPP treated with six-monthly triptorelin beyond 12 months is scant. Methods Thirty-seven girls with CPP were treated with 22.5 mg six-monthly intramuscular triptorelin. We assessed luteinizing hormone (LH) and E2 levels throughout treatment and changes in pubertal stage, bone age (BA), and predicted adult height (PAH). Results LH was suppressed in 100 % of girls through 36 months on treatment, except for 2 girls with an LH >4 mIU/mL at 6 months, both suppressed by 12 months and beyond. Estradiol was suppressed in all girls at all points measured. Fifty-one per cent and 32.4 % had no further breast development or regression, respectively, and 16.2 % had further breast development. Average BA/CA remained at 1.2 ± 0.1 until 24 months, at which time it decreased to 1.1 ± 0.1. Height velocity over the first 12 months of treatment averaged at 5.5 cm/year ± 2.2 cm, 4.6 cm/year ± 1.6 between 12 and 24 months, and 3.8 cm/year ± 2.2 between 24 and 36 months. On average, PAH increased by 5.4 ± 5.5 cm on treatment (range 1.8–18 cm). Conclusions Six-monthly intramuscular triptorelin for the treatment of CPP in girls demonstrated efficacy in LH and estradiol suppression, regression or stabilization of breast maturation, normalization of height velocity, improved BA/CA ratio, and increased PAH, throughout 2 years of treatment and beyond.