Clinical Efficacy And Safety Of Long-acting GnRHa In The Treatment Of Idiopathic Central Precocious Puberty In Girls

Objective: To compare the efficacy and safety of long-acting(11.25 mg,3months/time)and short-acting(3.75 mg,1 month/time)lepraline acetate(LA)in the treatment of idiopathic central precocious puberty(ICPP).Methods: A total of 74 girls diagnosed with ICPP and treated with LA for more than 6 months were collected from the Pediatric Center of the First Affiliated Hospital of Xinjiang Medical University from August 2020 to August 2022.They were divided into a short-acting group(54 children)and a long-acting group(20 children)according to the wishes of their families and the duration of treatment drugs.Height,body weight,mass index(BMI),Tanner stage(breast and vulva),gonadal volume(uterus and ovary),follicle number,bone age(BA),bone age index(BA/CA),predictive adult height(PAH),follicle stimulating hormone(FSH),luteinizing hormone(LH),and body mass index(BMI)were calculated after 3 months of initial diagnosis and treatment and 6 months after treatment.LH peak,LH peak /FSH peak and related adverse reactions after treatment were analyzed and compared.Results:1)There was no statistically significant difference between the two groups in general conditions before treatment;2)After 3 months of treatment,there was no statistically significant difference between the long-acting group and the short-acting group in LH,FSH,LH,and LH /FSH peaks(P>0.05),but the difference was significantly reduced from baseline(P<0.05);3)After 6 months of treatment,there were no statistically significant differences in sex hormone levels(LH and FSH),gonad volume(uterus and ovary)and BA/CA between the two groups(P>0.05),but significantly decreased compared with the baseline level,with statistically significant differences(P<0.05);4)After 6 months of treatment,there were statistically significant differences in PAH,BMI and number of follicles between the two groups(P<0.05),and the increase in PAH in the short-acting group was significantly higher than that in the long-acting group.The increase of BMI in the short-acting group was higher than that in the long-acting group,but all of them did not reach the obesity standard within the normal range.The number of follicles decreased more significantly in the short acting group.After 6 months of treatment,there was no progress in breast and vulva development in the two groups,but the proportion of breast stage B3 in the long-acting group was higher than that in the short-acting group,and the difference was statistically significant(P<0.05).There was no significant difference in BA between groups after treatment(P>0.05).There were adverse reactions such as fever,pain at the injection site,allergy,gastrointestinal dysfunction,liver and kidney function impairment after medication,and there was no statistical significance between the two groups(P>0.05).Conclusion: Both long-acting and short-acting LA are equally effective and safe in the treatment of ICPP children in terms of sex hormone inhibition,gonadal development inhibition and bone maturation inhibition.This study suggested that the short-acting group was superior to the long-acting group in improving PAHs,improving the development of breast stage B3 and inhibiting the number of follicles.