Efficacy of Leuprolide Acetate 1-Month Depot for Central Precocious Puberty (CPP): Growth Outcomes During a Prospective, Longitudinal Study

This prospective, open-label study had a long-term, observational, follow-up period. Forty-nine females and 6 males were enrolled. Leuprolide acetate depot was administered intramuscularly every 28 days. Height and growth rate during and after treatment until adulthood were measured.Among 30 of 49 females having an adult height (AH) measurement, 29 had target heights available (mean = 163.8 cm) and 27 had pretreatment predicted adult heights (PAHs; mean = 157.4 cm). After treatment, the mean AH at mean age 21.8 years [range 13.7-26.7 years] was 162.5 cm, a mean height gain over baseline PAH of 4.0 cm. The mean height standard deviation score was -0.1 at AH.Treatment of CPP with leuprolide acetate 1-month depot had beneficial effects on growth rate and preservation of AH.ClinicalTrials.gov: NCT00660010Central precocious puberty (CPP) commonly refers to the development of pubertal sex characteristics as a consequence of the premature activation of the hypothalamic-pituitary-gonadal (HPG) axis before the age of 8 years in girls and 9 years in boys. The pathogenesis of CPP includes early activation of pulsatile release of gonadotropin-releasing hormone (GnRH), leading to an increase in secretion of gonadotropins and gonadal steroids. Central precocious puberty occurs much more frequently among females than males (greater than 20:1 ratio) [1].The treatment goals for children with CPP include hormonal suppression, regression or cessation of development of pubertal characteristics and the prevention of short stature in adulthood. Patients with CPP are at risk of short stature in adulthood because of disproportionately advanced skeletal maturation in relation to growth acceleration, resulting in early epiphyseal fusion that limits growth potential [2].Analogs of GnRH (GnRHa) have been the standard of care for the treatment of children with CPP for more than 20 years [2], with the usage of the depot form reported in 1989 [3]. However, despite the widespread use of GnRHa in t