TREATMENT OF PRECOCIOUS PUBERTY WITH CYPROTERONE ACETATE

Abstract

Extract: Cyproterone acetate, an antiandrogenic steroid with inhibitory effects on gonadotropin secretion, was given to 13 girls and 6 boys with precocious puberty for periods of 1–3 years in a daily dose of 70 mg/m2 body surface area. Treatment was started at a mean chronologic age of 6.65 years in girls and 6.21 years in boys. No side effects were noted and the compound had a beneficial effect on the clinical signs of precocious puberty with the exception of increased growth velocity. Testicular size remained unchanged during treatment. In one boy high testosterone concentration in plasma was reduced to prepubertal levels. For analysis of the effect of treatment on growth the standard deviation score method was used. The data for height, bone age, height for bone age, and height prediction were compared with those obtained from 21 girls and 11 boys with precocious puberty who did not receive cyproterone acetate. No significant differences between treatment and control groups were found. It is concluded that cyproterone acetate in the dosage used is without effect on growth and would therefore be expected not to prevent short adult stature in patients with precocious puberty. Speculation: From the present study it is evident that cyproterone acetate at the dosage used does not diminish the rate of skeletal maturation, but that with other respects it is effective through its antiandrogenic and gonadotropin-inhibiting properties. This may indicate that in precocious puberty, bone maturation is more sensitive to the action of androgens and less suppressible than the secondary sex characteristics or behavioral changes. Whether earlier treatment and/or higher doses would also inhibit bone maturation remains uncertain.