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Open Access Clinical Study

Results of a Second Year of Therapy with the 12-Month Histrelin Implant for the Treatment of Central Precocious Puberty

Samar Rahhal1, WilliamL Clarke2, GadB Kletter3, PeterA Lee14, EKirk Neely5, EdwardO Reiter6, Paul Saenger7, Dorothy Shulman8, Lawrence Silverman9 and EricaA Eugster1*

Author Affiliations

1 Department of Pediatrics, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN 46202, USA

2 Department of Pediatrics, University of Virginia Health Sciences Center, Charlottesville, VA 22908, USA

3 Department of Pediatrics, Seattle Childrens Hospital and Medical Center, Seattle, WA 98105-0371, USA

4 Department of Pediatrics, Pennsylvania State Children's Hospital, Hershey, PA 17033, USA

5 Department of Pediatrics, Stanford University Medical Center, Stanford, CA 94305, USA

6 Department of Pediatrics, Baystate Children's Hospital, Springfield, MA 01199, USA

7 Department of Pediatrics, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467, USA

8 Department of Pediatrics, University of South Florida and All Children's Hospital, St. Petersburg, FL 33701, USA

9 Department of Pediatrics, Goryeb Children's Hospital Atlantic Health, Morristown, NJ 07962, USA

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International Journal of Pediatric Endocrinology 2009, 2009:812517  doi:10.1155/2009/812517

Published: 17 February 2009

Abstract

Background. Gonadotropin releasing hormone analogs (GnRHas) are standard of care for central precocious puberty (CPP). The histrelin subcutaneous implant is safe and effective in the treatment of CPP for one year. Objective. The study evaluates a second year of therapy in children with CPP who received a new implant after one year of treatment. Methods. A prospective one-year study following an initial 12-month treatment period was conducted. Results. Thirty-one patients (29 girls) aged years received a second implant. Eighteen were naïve to GnRHa therapy at first implantation. Peak LH declined from  mIU/mL at 12 months to  mIU/mL at 24 months (< .0001) in naïve subjects, and from  mIU/mL at 12 months to  mIU/mL at 24 months () in previously treated subjects. Predicted adult height increased by 5.1 cm at 24 months (). Minor implant site reactions occurred in 61%, while minor difficulties with explantation occurred in 32.2% of subjects. Conclusion. The histrelin implant demonstrates profound hypothalamic-pituitary-gonadal axis suppression when a new implant is placed for a second year of treatment. Prospective follow-up of this therapeutic modality for the treatment of CPP is needed.