Treatment with a Luteinizing Hormone–Releasing Hormone Agonist in Adolescents with Short Stature

• Published in: The New England journal of medicine Vol. 348; no. 10; pp. 908 - 917
• Main Authors: Yanovski, Jack A, Rose, Susan R, Municchi, Giovanna, Pescovitz, Ora H, Hill, Suvimol C, Cassorla, Fernando G, Cutler, Gordon B
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 06.03.2003
• Subjects: Adolescent; Age; Biological and medical sciences; Body Height - drug effects; Bone density; Bone Density - drug effects; Child; Double-Blind Method; Enzyme Inhibitors - adverse effects; Enzyme Inhibitors - pharmacology; Enzyme Inhibitors - therapeutic use; Female; Follicle Stimulating Hormone - blood; Growth - drug effects; Growth Disorders - drug therapy; Growth Disorders - etiology; Height; Hormones. Endocrine system; Humans; Luteinizing Hormone - blood; Male; Medical sciences; Pharmacology. Drug treatments; Puberty - drug effects; Teenagers; Triptorelin Pamoate - adverse effects; Triptorelin Pamoate - analogs & derivatives; Triptorelin Pamoate - pharmacology; Triptorelin Pamoate - therapeutic use; Human; Puberty; Agonist; Treatment efficiency; Peptide hormone; Gonadotropin RH; Male; Growth retardation; Hypothalamic hormone; Treatment; Body size; Adolescent; Placebo; Female; Bone mineral density; Hormone releasing factor
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa013555

Treatment with a luteinizing hormone–releasing hormone (LHRH) agonist increases adult height in children with precocious puberty. This study was designed to determine whether LHRH-agonist therapy would increase adult height in short adolescents with normally timed puberty. The adolescents had an increase of 0.6 in the standard-deviation score for height, as compared with the initially predicted adult height; however, bone mineral density was decreased. An LHRH agonist cannot be recommended. Puberty first accelerates the rate of growth and then induces epiphyseal fusion, terminating the growth of long bones. 1 In the 1970s, long-acting agonists of luteinizing hormone–releasing hormone (LHRH) were shown to suppress gonadotropin secretion. In children with LHRH-dependent precocious puberty, treatment with LHRH agonists slows bone maturation, delays epiphyseal fusion, and increases adult height. 2 – 7 Studies of patients with hypogonadotropic hypogonadism, 8 estrogen insensitivity, 9 or estrogen deficiency 10 have suggested that prolonging the period of growth by delaying senescence of the growth plate 11 can increase adult height. However, changes in the tempo of puberty within the normal range do not influence adult . . .