Gonadotropin-releasing hormone analog therapies for children with central precocious puberty in the United States

Frontiers in Pediatrics - Tập 10
Jadranka Popović1, Mitchell E. Geffner2, Alan D. Rogol3, Lawrence A. Silverman4, Paul B. Kaplowitz5, Nelly Mauras6, Philip Zeitler7, Erica A. Eugster8, Karen Oerter Klein9
1Department of Pediatric Endocrinology, Pediatric Institute, Allegheny Health Network, United States
2Department of Pediatric Endocrinology, Diabetes and Metabolism, The Saban Research Institute, Children's Hospital Los Angeles, Keck School of Medicine of the University of Southern California, United States
3Department of Pediatric Diabetes and Endocrinology, University of Virginia, United States
4Department of Pediatric Endocrinology, Goryeb Children's Hospital Atlantic Health, United States
5Department of Endocrinology, Children's National Hospital, United States
6Department of Pediatrics, Nemours Children's Health System, United States
7Department of Pediatric Endocrinology, University of Colorado School of Medicine, United States
8Department of Pediatric Endocrinology, Riley Hospital for Children at Indiana University Health, United States
9Department of Pediatrics, Rady Children's Hospital, University of California, San Diego, United States

Tóm tắt

Gonadotropin-releasing hormone agonists (GnRHa's) are the standard treatment for children with central precocious puberty (CPP). We aim to present data on available GnRHa options with an easy-to-review table and discuss factors that influence treatment selection. Five GnRHa's are currently FDA-approved and prescribed in the US and published data suggest similar safety and efficacy profiles over the first year of treatment. One- and 3-month intramuscular (IM) leuprolide acetate (LA) have long-term safety and efficacy data and allow for flexible dosing. Six-month IM triptorelin pamoate offers a longer duration of treatment, but without long-term efficacy and outcome data. Six-month subcutaneous (SQ) LA combines a SQ route of injection and long duration of action but lacks long-term efficacy and outcome data. The 12-month SQ histrelin acetate implant avoids injections and offers the longest duration of action, but requires a minor surgical procedure with local or general anesthesia. Factors in treatment selection include route of administration, needle size, injection volume, duration of action, and cost. The current GnRHa landscape provides options with varying benefits and risks, allowing physicians and caregivers to select the most appropriate therapy based on the specific needs and concerns of the child and the caregiver. Agents have different advantages and disadvantages for use, with no one agent displaying superiority.

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Frontiers in Pediatrics

Tập 10

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