Background: Early onset of puberty is frequently observed in adopted children. During treatment with a gonadotrophin releasing hormone agonist (GnRHa), a decrease in height velocity (HV) precludes height gain.
Objective and design: We studied the effect of the addition of GH to GnRHa treatment in a 3-year prospective randomized trial in 30 adopted children with early puberty.
Patients: Mean age (SD) at start of treatment was 9.6 (0.9) years in girls and predicted adult height (PAH) using a segmented bone age (BA) assessment method was 148.0 (5.3) cm.
Results: HV decreased gradually in both groups with a higher HV in the group with GH addition (group B). No significant difference between the rates of bone maturation [change in bone age (DeltaBA)/change in chronological age (DeltaCA)] of both treatment groups was observed. After 3 years of treatment, PAH increase was 5.7 (3.8) cm in group A (GnRHa alone) and 10.1 (3.8) cm in group B (P < 0.01). IGF-I levels were higher in group B. HV decreased slowly in both groups during treatment, unlike stabilization of IGF-I levels.
Conclusion: We conclude that, after 3 years of treatment, the addition of GH to GnRHa results in higher HV and a significant increase in PAH compared to GnRHa alone.