Safety of GnRH Agonist in Female Children and Adolescents with Central Precocious Puberty
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Keywords
Early puberty, gonadotropin-releasing hormone agonists, Saudi Arabia
Abstract
Central Precocious Puberty (CPP) is characterized by the premature activation of the hypothalamic-pituitary-gonadal axis, causing early puberty in children. Gonadotropin-releasing hormone analog (GnRH-a) has been approved for treating CPP. However, limited studies have evaluated its safety among Saudi residents. Thus, our goal is to assess the safety of this treatment for Saudi female children and adolescents aged 6 to 14 years.
Methods: From September 2022 to March 2023, a cross-sectional study was carried out at the Pediatric Endocrine Clinic at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. The study involved 148 female participants, aged 6-14, who were administered GnRH-a. The main objective was to assess the most prevalent adverse drug reaction (ADR) in children dealing with CPP.
Results: Out of 148 patients, 18.9% reported no ADRs from GnRH-a treatment. The most common ADRs were injection site pain (50.7%) and mood swings (45.3%), followed by weight gain (35.8%), increased appetite (29.7%), and abdominal pain (18.2%). Bone pain affected 14.9% of the patients. Allergic reactions, vaginal bleeding, and bruising were less commonly reported, affecting 9.5%, 2.0%, and 2.7% of patients, respectively.
Conclusion: While GnRH-a has several ADRs, none of the patients perceive these effects as determining their treatment course. However, factors like the high cost and limited availability of the medication prevented some from completing the therapy.
References
2. Raju GAR, Chavan R, Deenadayal M, et al. Luteinizing hormone and follicle-stimulating hormone synergy: A review of role in controlled ovarian hyper-stimulation. J Hum Reprod Sci. 2013;6(4). doi:10.4103/0974-1208.126285
3. Latronico AC, Brito VN, Carel JC. Causes, diagnosis, and treatment of central precocious puberty. Lancet Diabetes Endocrinol. 2016;4(3):265-274. doi:10.1016/S2213-8587(15)00380-0
4. Al Agha AE. Early Puberty and its Effect on Height in Young Saudi Females: A Cross-Sectional Study. Pediatrics & Therapeutics. 2015;05(01). doi:10.4172/2161-0665.1000233
5. Bouvattier C, Coste J, Rodrigue D, et al. Lack of effect of GnRH agonists on final height in girls with advanced puberty: A randomized long-term pilot study. Journal of Clinical Endocrinology and Metabolism. 1999;84(10). doi:10.1210/jcem.84.10.6032
6. Narayanan Namboothiri G, Chacko VI, Rashmi A, Sathyanath S, Anil M. Factors influencing age at menarche – A school based cross sectional study. Indian J Community Health. 2020;32(2). doi:10.47203/ijch.2020.v32i02.025
7. Wozniak M, Murias M. [Xenoestrogens: endocrine disrupting compounds]. Ginekol Pol. 2008;79(11):785-790.
8. Kim YJ, Kwon A, Jung MK, et al. Incidence and Prevalence of Central Precocious Puberty in Korea: An Epidemiologic Study Based on a National Database. J Pediatr. 2019;208:221-228. doi:10.1016/j.jpeds.2018.12.022
9. Ortmann O, Weiss JM, Diedrich K. Gonadotrophin-releasing hormone (GnRH) and GnRH agonists: mechanisms of action. Reprod Biomed Online. 2002;5 Suppl 1:1-7. doi:10.1016/s1472-6483(11)60210-1
10. Lee JW, Kim HJ, Choe YM, et al. Significant adverse reactions to long-acting gonadotropin-releasing hormone agonists for the treatment of central precocious puberty and early onset puberty. Ann Pediatr Endocrinol Metab. 2014;19(3):135. doi:10.6065/apem.2014.19.3.135
11. Luo X, Hou L, Zhong Y, et al. An open label, multicenter clinical trial that investigated the efficacy and safety of leuprorelin treatment of central precocious puberty in Chinese children. Medicine (United States). 2021;100(51):E28158. doi:10.1097/MD.0000000000028158
12. De Sanctis V, Soliman AT, Di Maio S, Soliman N, Elsedfy H. Long-term effects and significant adverse drug reactions (ADRs) associated with the use of gonadotropin-releasing hormone analogs (GnRHa) for central precocious puberty: A brief review of literature. Acta Biomedica. 2019;90(3):345-359. doi:10.23750/abm.v90i3.8736
13. Yeshaya A, Kauschansky A, Orvieto R, Varsano I, Nussinovitch M, Ben-Rafael Z. Prolonged vaginal bleeding during central precocious puberty therapy with a long-acting gonadotropin-releasing hormone agonist. Acta Obstet Gynecol Scand. 1998;77(3):327-329.
14. Lee SJ, Yang EM, Seo JY, Kim CJ. Effects of Gonadotropin-Releasing Hormone Agonist Therapy on Body Mass Index and Height in Girls with Central Precocious Puberty. Chonnam Med J. 2012;48(1):27. doi:10.4068/cmj.2012.48.1.27
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