Long-Term Treatment of Central Precocious Puberty with a Long-Acting Analogue of Luteinizing Hormone-Releasing Hormone: Effects on Somatic Growth and Skeletal Maturation
The gonadotropin-releasing hormone–like agonist d-Trp 6 -Pro 9 -NEt-LHRH (LHRH a ) 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 featur...
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| Veröffentlicht in: | The New England journal of medicine 1983-11, Vol.309 (21), p.1286-1290 |
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| container_issue | 21 |
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| container_title | The New England journal of medicine |
| container_volume | 309 |
| creator | Mansfield, M.Joan Beardsworth, Donna E Loughlin, Jacquelyn S Crawford, John D Bode, Hans H Rivier, Jean Vale, Wylie Kushner, David C Crigler, John F Crowley, William F |
| description | The gonadotropin-releasing hormone–like agonist d-Trp
6
-Pro
9
-NEt-LHRH (LHRH
a
) 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 LHRH
a
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 |
| doi_str_mv | 10.1056/NEJM198311243092104 |
| format | Article |
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6
-Pro
9
-NEt-LHRH (LHRH
a
) 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 LHRH
a
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).
Complete suppression of the pituitary-gonadal axis can be maintained by LHRH
a
therapy, resulting in slowing of excessively rapid growth and skeletal maturation and in increased predicted adult height in girls with precocious puberty. (N Engl J Med 1983; 309:1286–90.)
IN the child with precocious puberty in the absence of a correctable anatomic lesion, the goal of therapy is suppression of gonadal function in order to arrest or reverse secondary sexual development, decrease the linear growth rate to a normal prepubertal velocity, and slow skeletal maturation to prevent short stature caused by premature epiphyseal fusion. To date, no therapeutic approach has achieved all these objectives. Treatment with progestins and antiandrogens has controlled breast development and menstruation in the majority of female subjects but not in all of them
1
2
3
4
5
6
7
; antiandrogens have met with similar limited success in male subjects.
2
3
4
,
6
,
7
However, . . .</description><identifier>ISSN: 0028-4793</identifier><identifier>EISSN: 1533-4406</identifier><identifier>DOI: 10.1056/NEJM198311243092104</identifier><identifier>PMID: 6415479</identifier><identifier>CODEN: NEJMAG</identifier><language>eng</language><publisher>Boston, MA: Massachusetts Medical Society</publisher><subject>Age ; Age Determination by Skeleton ; Biological and medical sciences ; Body Height - drug effects ; Bone Development - drug effects ; Child ; Child, Preschool ; Female ; Follicle Stimulating Hormone - blood ; Genital system. Reproduction ; Gonadotropin-Releasing Hormone - adverse effects ; Gonadotropin-Releasing Hormone - analogs & derivatives ; Gonadotropin-Releasing Hormone - pharmacology ; Gonadotropin-Releasing Hormone - therapeutic use ; Growth - drug effects ; Growth rate ; Humans ; Long-Term Care ; Luteinizing Hormone - blood ; Medical sciences ; Patients ; Pharmacology. Drug treatments ; Physical growth ; Puberty, Precocious - drug therapy ; Sexual Maturation - drug effects ; Triptorelin Pamoate - analogs & derivatives</subject><ispartof>The New England journal of medicine, 1983-11, Vol.309 (21), p.1286-1290</ispartof><rights>1984 INIST-CNRS</rights><rights>Copyright Massachusetts Medical Society Nov 24, 1983</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c382t-6e0a8cffc91aec953267fa51ce23823c32796e1c6a50f3cfd38959f087069c233</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1875462998?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=9331627$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/6415479$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mansfield, M.Joan</creatorcontrib><creatorcontrib>Beardsworth, Donna E</creatorcontrib><creatorcontrib>Loughlin, Jacquelyn S</creatorcontrib><creatorcontrib>Crawford, John D</creatorcontrib><creatorcontrib>Bode, Hans H</creatorcontrib><creatorcontrib>Rivier, Jean</creatorcontrib><creatorcontrib>Vale, Wylie</creatorcontrib><creatorcontrib>Kushner, David C</creatorcontrib><creatorcontrib>Crigler, John F</creatorcontrib><creatorcontrib>Crowley, William F</creatorcontrib><title>Long-Term Treatment of Central Precocious Puberty with a Long-Acting Analogue of Luteinizing Hormone-Releasing Hormone: Effects on Somatic Growth and Skeletal Maturation</title><title>The New England journal of medicine</title><addtitle>N Engl J Med</addtitle><description>The gonadotropin-releasing hormone–like agonist d-Trp
6
-Pro
9
-NEt-LHRH (LHRH
a
) 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 LHRH
a
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).
Complete suppression of the pituitary-gonadal axis can be maintained by LHRH
a
therapy, resulting in slowing of excessively rapid growth and skeletal maturation and in increased predicted adult height in girls with precocious puberty. (N Engl J Med 1983; 309:1286–90.)
IN the child with precocious puberty in the absence of a correctable anatomic lesion, the goal of therapy is suppression of gonadal function in order to arrest or reverse secondary sexual development, decrease the linear growth rate to a normal prepubertal velocity, and slow skeletal maturation to prevent short stature caused by premature epiphyseal fusion. To date, no therapeutic approach has achieved all these objectives. Treatment with progestins and antiandrogens has controlled breast development and menstruation in the majority of female subjects but not in all of them
1
2
3
4
5
6
7
; antiandrogens have met with similar limited success in male subjects.
2
3
4
,
6
,
7
However, . . .</description><subject>Age</subject><subject>Age Determination by Skeleton</subject><subject>Biological and medical sciences</subject><subject>Body Height - drug effects</subject><subject>Bone Development - drug effects</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Follicle Stimulating Hormone - blood</subject><subject>Genital system. Reproduction</subject><subject>Gonadotropin-Releasing Hormone - adverse effects</subject><subject>Gonadotropin-Releasing Hormone - analogs & derivatives</subject><subject>Gonadotropin-Releasing Hormone - pharmacology</subject><subject>Gonadotropin-Releasing Hormone - therapeutic use</subject><subject>Growth - drug effects</subject><subject>Growth rate</subject><subject>Humans</subject><subject>Long-Term Care</subject><subject>Luteinizing Hormone - blood</subject><subject>Medical sciences</subject><subject>Patients</subject><subject>Pharmacology. Drug treatments</subject><subject>Physical growth</subject><subject>Puberty, Precocious - drug therapy</subject><subject>Sexual Maturation - drug effects</subject><subject>Triptorelin Pamoate - analogs & derivatives</subject><issn>0028-4793</issn><issn>1533-4406</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1983</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kV9LHDEUxUNR7Lr2ExQh0OJLmZo_M5nkcVm0KmsV2T4PMd5sZ5kkmsxUtp_ebHdZRIp5uXDP79zLzUHoMyXfKanE6c-zq2uqJKeUlZwoRkn5AY1oxXlRlkTsoREhTBZlrfhHdJjSkuRHS3WADkRJq9wfoT-z4BfFHKLD8wi6d-B7HCye5hp1h28jmGDaMCR8O9xD7Ff4ue1_Y43_GSemb_0CT7zuwmKAtXM29ND69u-6fxGiCx6KO-hAp1edI7RvdZfg07aO0a_zs_n0opjd_LicTmaF4ZL1hQCipbHWKKrBqIozUVtdUQMs69xwVisB1AhdEcuNfeBSVcoSWROhDON8jE42cx9jeBog9Y1rk4Gu0x7yTY0kNaulpBn88gZchiHms1JDZV2Vgqn802PEN5SJIaUItnmMrdNx1VDSrDNp_pNJdh1vZw_3Dh52nm0IWf-61XUyurNRe9OmHaY4p4LVGfu2wZxLjYele3fpC_m4n60</recordid><startdate>19831124</startdate><enddate>19831124</enddate><creator>Mansfield, M.Joan</creator><creator>Beardsworth, Donna E</creator><creator>Loughlin, Jacquelyn S</creator><creator>Crawford, John D</creator><creator>Bode, Hans H</creator><creator>Rivier, Jean</creator><creator>Vale, Wylie</creator><creator>Kushner, David C</creator><creator>Crigler, John F</creator><creator>Crowley, William F</creator><general>Massachusetts Medical Society</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0TZ</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K0Y</scope><scope>LK8</scope><scope>M0R</scope><scope>M0T</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2P</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>19831124</creationdate><title>Long-Term Treatment of Central Precocious Puberty with a Long-Acting Analogue of Luteinizing Hormone-Releasing Hormone</title><author>Mansfield, M.Joan ; Beardsworth, Donna E ; Loughlin, Jacquelyn S ; Crawford, John D ; Bode, Hans H ; Rivier, Jean ; Vale, Wylie ; Kushner, David C ; Crigler, John F ; Crowley, William F</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c382t-6e0a8cffc91aec953267fa51ce23823c32796e1c6a50f3cfd38959f087069c233</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1983</creationdate><topic>Age</topic><topic>Age Determination by Skeleton</topic><topic>Biological and medical sciences</topic><topic>Body Height - drug effects</topic><topic>Bone Development - drug effects</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>Follicle Stimulating Hormone - blood</topic><topic>Genital system. Reproduction</topic><topic>Gonadotropin-Releasing Hormone - adverse effects</topic><topic>Gonadotropin-Releasing Hormone - analogs & derivatives</topic><topic>Gonadotropin-Releasing Hormone - pharmacology</topic><topic>Gonadotropin-Releasing Hormone - therapeutic use</topic><topic>Growth - drug effects</topic><topic>Growth rate</topic><topic>Humans</topic><topic>Long-Term Care</topic><topic>Luteinizing Hormone - blood</topic><topic>Medical sciences</topic><topic>Patients</topic><topic>Pharmacology. Drug treatments</topic><topic>Physical growth</topic><topic>Puberty, Precocious - drug therapy</topic><topic>Sexual Maturation - drug effects</topic><topic>Triptorelin Pamoate - analogs & derivatives</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mansfield, M.Joan</creatorcontrib><creatorcontrib>Beardsworth, Donna E</creatorcontrib><creatorcontrib>Loughlin, Jacquelyn S</creatorcontrib><creatorcontrib>Crawford, John D</creatorcontrib><creatorcontrib>Bode, Hans H</creatorcontrib><creatorcontrib>Rivier, Jean</creatorcontrib><creatorcontrib>Vale, Wylie</creatorcontrib><creatorcontrib>Kushner, David C</creatorcontrib><creatorcontrib>Crigler, John F</creatorcontrib><creatorcontrib>Crowley, William F</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Pharma and Biotech Premium PRO</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>New England Journal of Medicine</collection><collection>ProQuest Biological Science Collection</collection><collection>Consumer Health Database</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The New England journal of medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mansfield, M.Joan</au><au>Beardsworth, Donna E</au><au>Loughlin, Jacquelyn S</au><au>Crawford, John D</au><au>Bode, Hans H</au><au>Rivier, Jean</au><au>Vale, Wylie</au><au>Kushner, David C</au><au>Crigler, John F</au><au>Crowley, William F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-Term Treatment of Central Precocious Puberty with a Long-Acting Analogue of Luteinizing Hormone-Releasing Hormone: Effects on Somatic Growth and Skeletal Maturation</atitle><jtitle>The New England journal of medicine</jtitle><addtitle>N Engl J Med</addtitle><date>1983-11-24</date><risdate>1983</risdate><volume>309</volume><issue>21</issue><spage>1286</spage><epage>1290</epage><pages>1286-1290</pages><issn>0028-4793</issn><eissn>1533-4406</eissn><coden>NEJMAG</coden><abstract>The gonadotropin-releasing hormone–like agonist d-Trp
6
-Pro
9
-NEt-LHRH (LHRH
a
) 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 LHRH
a
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).
Complete suppression of the pituitary-gonadal axis can be maintained by LHRH
a
therapy, resulting in slowing of excessively rapid growth and skeletal maturation and in increased predicted adult height in girls with precocious puberty. (N Engl J Med 1983; 309:1286–90.)
IN the child with precocious puberty in the absence of a correctable anatomic lesion, the goal of therapy is suppression of gonadal function in order to arrest or reverse secondary sexual development, decrease the linear growth rate to a normal prepubertal velocity, and slow skeletal maturation to prevent short stature caused by premature epiphyseal fusion. To date, no therapeutic approach has achieved all these objectives. Treatment with progestins and antiandrogens has controlled breast development and menstruation in the majority of female subjects but not in all of them
1
2
3
4
5
6
7
; antiandrogens have met with similar limited success in male subjects.
2
3
4
,
6
,
7
However, . . .</abstract><cop>Boston, MA</cop><pub>Massachusetts Medical Society</pub><pmid>6415479</pmid><doi>10.1056/NEJM198311243092104</doi><tpages>5</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0028-4793 |
| ispartof | The New England journal of medicine, 1983-11, Vol.309 (21), p.1286-1290 |
| issn | 0028-4793 1533-4406 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_80727881 |
| source | MEDLINE; ProQuest Central UK/Ireland |
| subjects | Age Age Determination by Skeleton Biological and medical sciences Body Height - drug effects Bone Development - drug effects Child Child, Preschool Female Follicle Stimulating Hormone - blood Genital system. Reproduction Gonadotropin-Releasing Hormone - adverse effects Gonadotropin-Releasing Hormone - analogs & derivatives Gonadotropin-Releasing Hormone - pharmacology Gonadotropin-Releasing Hormone - therapeutic use Growth - drug effects Growth rate Humans Long-Term Care Luteinizing Hormone - blood Medical sciences Patients Pharmacology. Drug treatments Physical growth Puberty, Precocious - drug therapy Sexual Maturation - drug effects Triptorelin Pamoate - analogs & derivatives |
| title | Long-Term Treatment of Central Precocious Puberty with a Long-Acting Analogue of Luteinizing Hormone-Releasing Hormone: Effects on Somatic Growth and Skeletal Maturation |
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