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Treatment of precocious puberty using an intranasal luteinizing hormone‐releasing hormone analogue: Buserelin
Author(s) -
LOW L. C. K.,
WANG C.,
CHEUNG P. T.,
CHAN F. L.
Publication year - 1989
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/j.1440-1754.1989.tb01476.x
Subject(s) - medicine , buserelin , nasal administration , luteinizing hormone , precocious puberty , hormone , endocrinology , gonadotropin releasing hormone , central precocious puberty , pharmacology , agonist , receptor
Fourteen patients with precocious puberty were treated for 1‐3 years with 900‐1800 μg/day of intranasal (i.n.) Buserelin. The peak luteinizing hormone and follicle‐stimulating hormone responses to intravenous luteinizing hormone‐releasing hormone were reduced significantly 4 weeks after starting treatment and remained suppressed while the patients were on treatment. Two patients were withdrawn because of drug non‐compliance. Three patients showed regression of pubertal changes, four patients showed no progression and five patients showed progression of breast size or pubic hair staging after 1.5‐2 years of treatment. Treatment was changed to the subcutaneous route in two patients because of hormonal escape and accelerated skeletal maturation. The mean growth velocity decreased from 10.78 cm/year (s.e.m. = 0.64) to 7.06 cm/year (s.e.m. = 0.85) after 1 year of treatment ( P < 0.005). After an increase in dosage (from 900 μg/day to 1800 μg/day) in most patients, further significant falls in growth velocity to 5.29 cm/year (s.e.m. = 0.45), 4.63 cm/year (s.e.m. = 0.8) and 5.06 cm/year (s.e.m. = 0.5) were observed at 18, 24 and 30 months, respectively, compared with the pretreatment value ( P < 0.001). With treatment, the increased rate of skeletal maturation normalized. In 10 patients who had completed 2 years of treatment, the height standard deviation score for bone age improved from a pretreatment value of ‐2.42 ± 0.42 to ‐1.6 ± 0.42 after 2 years of treatment ( P < 0.01), indicating an improvement in height prognosis. It is concluded that i.n. Buserelin at a dose of 1800 μg/day is effective in the treatment of most but not all patients with precocious puberty.