Efficacy of combined treatment with growth hormone and gonadotropin releasing hormone analogue in children with poor prognosis of adult height

Objective: This study was conducted to study the role of combination therapy of growth hormone and Gonadotropin-releasing hormone (GnRH) analogues in girls with idiopathic central precocious puberty (CPP) or idiopathic short stature (ISS). Methods: Five girls with CPP (median age 9.1 y, pubertal stage 2-3) (3 of them previously treated with GnRH analogue (GnRHa) for 16.2 ± 0.3 months) and 8 girls with ISS (median age 11.4 y, pubertal stage 2-3) (previously treated with GH for 10.95 ± 1.42 months), were treated with recombinant human GH (0.33mg/kg/week) and GnRHa (3.75 mg/28 days) for 22 months. Results: Height of girls with CPP improved from -1.3 to -0.2 SDS and height for BA from -2.1 to -0.6 SDS (P = 0.042). Predicted adult height (PAH) improved from -3.1 to -0.6 SDS (P = 0.042). In girls with ISS only PAH improved from -3.0 to -1.5 SDS (P = 0.025). Conclusion: Combined treatment improves height and PAH in CPP. Height in ISS is also improved however not significantly.