Use of letrozole to augment height outcome in pubertal boys: a retrospective chart review
Author:
Likki Snigdha R.1, Allen Holley F.1, Knee Alexander2, Tonyushkina Ksenia N.1ORCID
Affiliation:
1. Division of Pediatric Endocrinology and Diabetes , Baystate Children’s Hospital , Springfield , MA , USA 2. Epidemiology/Biostatistics Research Core, Office of Research , Baystate Medical Center , Springfield , MA , USA
Abstract
Abstract
Objectives
We describe growth patterns and predicted adult height (PAH) in pubertal boys treated with letrozole and evaluate the potential predictors of growth responses.
Methods
We performed a retrospective analysis of data from 2002 to 2020. All subjects were treated for ≥6 months and had at least 3 height measurements to calculate the growth velocity (GV) before and during treatment. We evaluated growth measurements, bone age, and biochemical parameters before, during and after treatment.
Results
A total of 59 subjects aged 12.7 (± 1.7) years old were included. At treatment initiation, bone age was 13.1 (± 1.5) years and predicted adult height (PAH) was 163.8 (± 9.9) cm compared to mid-parental height of 172.4 (± 5.8) cm. Growth velocity decreased during letrozole therapy and rebounded after completion. Sub-analysis of 26 subjects with bone age data available at baseline and at least 1 year later showed a trend to modest increase in PAH. In boys simultaneously receiving growth hormone (rhGH), the change in PAH was significantly more (3.2 cm, p<0.05) compared to those treated with letrozole alone.
Conclusions
We show that letrozole appropriately slows down skeletal maturation and GV responses are variable. Possible negative predictors include lower baseline GV and advanced bone age. A small positive trend in PAH with letrozole therapy is augmented by simultaneous use of rhGH. Future randomized controlled trials are needed to better understand which group of patients will benefit from treatment.
Publisher
Walter de Gruyter GmbH
Subject
Endocrinology,Endocrinology, Diabetes and Metabolism,Pediatrics, Perinatology and Child Health
Reference31 articles.
1. Collett-Solberg, PF, Ambler, G, Backeljauw, PF, Bidlingmaier, M, Biller, BMK, Boguszewski, MCS, et al.. Diagnosis, genetics, and therapy of short stature in children: a growth hormone research society international perspective. Horm Res Paediatr 2019;92:1–14. https://doi.org/10.1159/000502231. 2. Sisley, S, Trujillo, MV, Khoury, J, Backeljauw, P. Low incidence of pathology detection and high cost of screening in the evaluation of asymptomatic short children. J Pediatr 2013;163:1045–51. https://doi.org/10.1016/j.jpeds.2013.04.002. 3. Baron, J, Sävendahl, L, De Luca, F, Dauber, A, Phillip, M, Wit, JM, et al.. Short and tall stature: a new paradigm emerges. Nat Rev Endocrinol 2015;11:735–46. https://doi.org/10.1038/nrendo.2015.165. 4. Greulich, W, Pyle, S. Radiographic atlas of skeletal development of the hand and wrist, 2nd ed. Stanford, California: Stanford University Press; 1959. 5. Wehkalampi, K, Vangonen, K, Laine, T, Dunkel, L. Progressive reduction of relative height in childhood predicts adult stature below target height in boys with constitutional delay of growth and puberty. Horm Res Paediatr 2007;68:99–104. https://doi.org/10.1159/000101011.
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