TY - JOUR

T1 - Consensus statement on the use of gonadotropin-releasing hormone analogs in children

AU - Carel, Jean-Claude

AU - Eugster, Erica A

AU - Rogol, Alan

AU - Ghizzoni, Lucia

AU - Palmert, Mark R

AU - ESPE-LWPES GnRH Analogs Consensus Conference Group

AU - Antoniazzi, Franco

AU - Berenbaum, Sheri

AU - Bourguignon, Jean-Pierre

AU - Chrousos, George P

AU - Coste, Joël

AU - Deal, Sheri

AU - de Vries, Liat

AU - Foster, Carol

AU - Heger, Sabine

AU - Holland, Jack

AU - Jahnukainen, Kirsi

AU - Juul, Anders

AU - Kaplowitz, Paul

AU - Lahlou, Najiba

AU - Lee, Mary M

AU - Lee, Peter

AU - Merke, Deborah P

AU - Neely, E Kirk

AU - Oostdijk, Wilma

AU - Phillip, Moshe

AU - Rosenfield, Robert L

AU - Shulman, Dorothy

AU - Styne, Dennis

AU - Tauber, Maïthé

AU - Wit, Jan M

N1 - Keywords: Adolescent; Body Height; Bone Density; Child; Female; Gonadotropin-Releasing Hormone; Humans; Hypothyroidism; Luteinizing Hormone; Nafarelin; Organ Size; Ovary; Polycystic Ovary Syndrome; Puberty, Precocious; Uterus

PY - 2009

Y1 - 2009

N2 - OBJECTIVE: Gonadotropin-releasing hormone analogs revolutionized the treatment of central precocious puberty. However, questions remain regarding their optimal use in central precocious puberty and other conditions. The Lawson Wilkins Pediatric Endocrine Society and the European Society for Pediatric Endocrinology convened a consensus conference to review the clinical use of gonadotropin-releasing hormone analogs in children and adolescents. PARTICIPANTS: When selecting the 30 participants, consideration was given to equal representation from North America (United States and Canada) and Europe, an equal male/female ratio, and a balanced spectrum of professional seniority and expertise. EVIDENCE: Preference was given to articles written in English with long-term outcome data. The US Public Health grading system was used to grade evidence and rate the strength of conclusions. When evidence was insufficient, conclusions were based on expert opinion. CONSENSUS PROCESS: Participants were put into working groups with assigned topics and specific questions. Written materials were prepared and distributed before the conference, revised on the basis of input during the meeting, and presented to the full assembly for final review. If consensus could not be reached, conclusions were based on majority vote. All participants approved the final statement. CONCLUSIONS: The efficacy of gonadotropin-releasing hormone analogs in increasing adult height is undisputed only in early-onset (girls <6 years old) central precocious puberty. Other key areas, such as the psychosocial effects of central precocious puberty and their alteration by gonadotropin-releasing hormone analogs, need additional study. Few controlled prospective studies have been performed with gonadotropin-releasing hormone analogs in children, and many conclusions rely in part on collective expert opinion. The conference did not endorse commonly voiced concerns regarding the use of gonadotropin-releasing hormone analogs, such as promotion of weight gain or long-term diminution of bone mineral density. Use of gonadotropin-releasing hormone analogs for conditions other than central precocious puberty requires additional investigation and cannot be suggested routinely.

AB - OBJECTIVE: Gonadotropin-releasing hormone analogs revolutionized the treatment of central precocious puberty. However, questions remain regarding their optimal use in central precocious puberty and other conditions. The Lawson Wilkins Pediatric Endocrine Society and the European Society for Pediatric Endocrinology convened a consensus conference to review the clinical use of gonadotropin-releasing hormone analogs in children and adolescents. PARTICIPANTS: When selecting the 30 participants, consideration was given to equal representation from North America (United States and Canada) and Europe, an equal male/female ratio, and a balanced spectrum of professional seniority and expertise. EVIDENCE: Preference was given to articles written in English with long-term outcome data. The US Public Health grading system was used to grade evidence and rate the strength of conclusions. When evidence was insufficient, conclusions were based on expert opinion. CONSENSUS PROCESS: Participants were put into working groups with assigned topics and specific questions. Written materials were prepared and distributed before the conference, revised on the basis of input during the meeting, and presented to the full assembly for final review. If consensus could not be reached, conclusions were based on majority vote. All participants approved the final statement. CONCLUSIONS: The efficacy of gonadotropin-releasing hormone analogs in increasing adult height is undisputed only in early-onset (girls <6 years old) central precocious puberty. Other key areas, such as the psychosocial effects of central precocious puberty and their alteration by gonadotropin-releasing hormone analogs, need additional study. Few controlled prospective studies have been performed with gonadotropin-releasing hormone analogs in children, and many conclusions rely in part on collective expert opinion. The conference did not endorse commonly voiced concerns regarding the use of gonadotropin-releasing hormone analogs, such as promotion of weight gain or long-term diminution of bone mineral density. Use of gonadotropin-releasing hormone analogs for conditions other than central precocious puberty requires additional investigation and cannot be suggested routinely.

U2 - 10.1542/peds.2008-1783

DO - 10.1542/peds.2008-1783

M3 - Journal article

C2 - 19332438

VL - 123

SP - e752-62

JO - Pediatrics

JF - Pediatrics

SN - 0031-4005

IS - 4

ER -