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Auxological outcome and time to menarche following long-acting goserelin therapy in girls with central precocious or early puberty

Paterson, W.F. and McNeill, E. and Young, D. and Donaldson, M.D.C. (2004) Auxological outcome and time to menarche following long-acting goserelin therapy in girls with central precocious or early puberty. Clinical Endocrinology, 61 (5). pp. 626-634. ISSN 0300-0664

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Abstract

Following a successful clinical trial in 1996, the long-acting GnRH analogue goserelin (Zoladex LA 10·8 mg; Astra Zeneca) has been our preferred treatment for central early (CEP) or precocious puberty (CPP). However, some female patients have expressed concern about perceived weight gain during therapy and delay in the onset or resumption of menses on completion of therapy. The primary aim of this study was to investigate these concerns by determining the auxological parameters and timing of menarche or re-menarche in all girls with CEP/CPP who have completed a course of Zoladex LA treatment. The secondary aim was to assess auxological outcome in girls who have attained final height. Our cohort of 46 girls treated with long-acting goserelin was already considerably overweight at the start of therapy and became fatter during treatment. However, adiposity appeared to return to pretreatment levels in the 11 girls followed up to final height. Most of the girls who have attained final height are within or above their expected target range. The relatively long time interval to menarche of 1·5 years after stopping treatment is unexplained but may reflect a residual suppressive effect on the hypothalamo-pituitary axis of this long-acting GnRH analogue. Anticipation of the timing of menarche has proved to be of value in planning when to stop therapy in girls in whom treatment is mainly for practical and/or psychological reasons.