Aromatase inhibitors: an effective and safe option for height increment in boys with growth hormone deficiency?


Akın Kağızmanlı G., Özalp Kızılay D., Besci Ö., Yüksek Acinikli K., Özen S., Demir K., ...Daha Fazla

61st Annual ESPE (ESPE 2023), The Hague, Hollanda, 21 - 23 Eylül 2023, ss.89

  • Yayın Türü: Bildiri / Özet Bildiri
  • Basıldığı Şehir: The Hague
  • Basıldığı Ülke: Hollanda
  • Sayfa Sayıları: ss.89
  • Dokuz Eylül Üniversitesi Adresli: Evet

Özet

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.