Abstract
Daily administration of LHRH analogues (agonists) has been documented to decrease biochemical findings and clinical signs of true precocious puberty. We have treated 10 girls, age 14 months to 9 years, with true idiopathic precocious puberty by intranasal inhalation of Nafarelin Acetate ([D-Nal(2)6]LHRH), 800-1500 μ g/day for 4 to 11 months. 9 girls showed decelerated growth velocity (from 9.7 ± .8 to 5.8 ± .8 cm/yr. p < 0.005, paired t test, n=8). 4 of these 9 girls were menstruating prior to therapy and all girls stopped menses subsequent to therapy. These 9 girls' estradiol levels also decreased significantly (from 46.3 ± 12.3 to 9.3 ± 1.8 pg/ml, p < 0.01, paired t test) as well as their 24 hour urinary LH levels (from 7.5 ± 1.8 to 2.7 ± 0.5 iu/day, p < 0.01, paired t test). The girl who did not respond to nasal inhalation therapy was administered subcutaneous injections of the same LHRH analogue. All children received intranasal inhalation without any observed side effects. These results suggest that most girls with true precocious puberty can be treated with intranasal administration of Nafarelin Acetate, a new LHRH analogue. (Supported in part by USPH Grant RR-00188 from the General Clinical Research Centers Branch, National Institutes of Health).
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