Akademik Veri Yönetim Sistemi
61st Annual ESPE (ESPE 2023), The Hague, Hollanda, 21 - 23 Eylül 2023, ss.89
Background: Aromatase inhibitors (AIs) have been suggested
to slow down estrogen-dependent skeletal maturation in pubertal
boys with short stature. In the literature, few studies evaluate the
efficacy and safety of AIs in boys with growth hormone deficiency
(GHD).
Objective: To evaluate the auxologic effects and short-term
laboratory profiles of combined AI and rhGH therapy in adolescent
males with GHD.
Subjects and Methods: Male subjects between the ages of 10
and 16 with GHD from two different centers were included in the
study. Patients were divided into two groups: (i) those who only
used recombinant human growth hormone (rhGH) therapy for at
least 1 year (Group I; G-I) and (ii) those who also used AI therapy
(1 mg/day anastrozole or 2.5 mg/day letrozole) along with rhGH
for at least 1 year (Group II; G-II).
Results: Forty-one patients (G-I, 46%; G-II, 54%) were included
in the study. All of the subjects had isolated idiopathic GHD. At
the beginning of the treatment, the chronological ages (CAs) of the
patients in the G-I and G-II groups were 11.8 (10.9–13.7) and 12.8
(12.0–14.3) years, respectively. The ratios of bone age (BA)/CA for
the two groups were 0.8 (0.8–0.9) and 1.0 (0.9–1.1), respectively
(p<0.001). The daily dose of rhGH was similar in both groups
(p=0.08). After the treatment, the median height SD scores of
patients in the G-I group increased from -2.6 [(-3.4)-(-2.0)] to -1.8
[-2.1-(-1.3)], while subjects in the G-II group showed an increment
from -1.7 [(-2.1)-(-1.1)] to -1.2 [(-1.6)-(-0.8)]. The post-therapy
predicted adult height (PAH) significantly increased from
baseline in all subjects in the G-I and G-II groups (p<0.001;
p<0.001, respectively). There was no significant change in the ratio
of BA/CA post-therapy in the G-I group (p=0.1), while there was
a small but significant decrease in the G-II group (p<0.001). The
growth velocities of the patients in the G-I and G-II groups were
9.1 (7.4–10.1) cm/year [1.5 (0.8–5.0) SD score] and 8.7 (7.5–9.9)
cm/year [1.1 (0.3–3.1) SD score], respectively (p=0.6). While posttherapy
serum testosterone concentrations were seen to increase
in the G-II group, none of the patients exhibited hematocrit above
50 percent, and the fasting glucose concentrations were normal.
Conclusions: AIs were observed to promote growth potential
despite the advanced BA and puberty. AIs could be used as an additional
therapy for pubertal boys with GHD.