Combined Treatment with Gonadotropin-releasing Hormone Analog and Anabolic Steroid Hormone Increased Pubertal Height Gain and Adult Height in Boys with Early Puberty for Height

Twenty-one boys with a height of 135 cm or less at onset of puberty were treated with acombination of GnRH analog and anabolic steroid hormone, and their pubertal height gainand adult height were compared with those of untreated 29 boys who enter puberty below 135cm. The mean age at the start of treatment with a GnRH analog, leuprorelin acetate depot(Leuplin^®) was 12.3 yr, a mean of 1.3 yr after the onset of puberty, and GnRHanalog was administered every 3 to 5 wk thereafter for a mean duration of 4.1 yr. Theanabolic steroid hormone was started approximately 1 yr after initiation of treatment withthe GnRH analog. The mean pubertal height gain from onset of puberty till adult height wassignificantly greater in the combination treatment group (33.9 cm) than in the untreatedgroup (26.4 cm) (p<0.0001). The mean adult height was significantly greater in thecombination treatment group (164.3 cm) than in the untreated group (156.9 cm)(p<0.0001). The percentage of subjects with an adult height of 160 cm or taller was90.5% (19/21) in the combination treatment group, and it was 13.8% (4/29) in the untreatedgroup (p<0.0001). Since growth of the penis and pubic hair is promoted by the anabolicsteroid hormone, no psychosocial problems arose because of delayed puberty. No clinicallysignificant adverse events appeared. Combined treatment with GnRH analog and anabolicsteroid hormone significantly increased height gain during puberty and adult height inboys who entered puberty with a short stature, since the period until epiphyseal closurewas extended due to deceleration of the bone age maturation by administration of the GnRHanalog and the growth rate at this time was maintained by the anabolic steroidhormone.