Efficacy and safety of triptorelin 6-month formulation in patients with central precocious puberty

J Pediatr Endocrinol Metab. 2016 Nov 1;29(11):1241-1248. doi: 10.1515/jpem-2015-0376.

Abstract

Background: Triptorelin is an established treatment for central precocious puberty (CPP) as 1- and 3-month formulations. The current triptorelin 22.5 mg 6-month formulation is approved for prostate cancer therapy. This is the first study in patients with CPP.

Methods: The efficacy and safety of the triptorelin 6-month formulation in CPP were investigated. The primary objective was to evaluate the efficacy in achieving luteinizing hormone (LH) suppression to pre-pubertal levels at month 6. This was an international, non-comparative phase III study over 48 weeks. Eighteen medical centers in the US, Chile and Mexico participated. Forty-four treatment naïve patients (39 girls and five boys) aged at treatment start 2-8 years for girls and 2-9 years for boys with an advancement of bone age over chronological age ≥1 year were to be included. Triptorelin was administered im twice at an interval of 24 weeks. LH, follicle stimulating hormone (FSH) (basal and stimulated), estradiol (girls), testosterone (boys), auxological parameters, clinical signs of puberty and safety were assessed.

Results: Forty-one patients (93.2%) showed pre-pubertal LH levels (stimulated LH ≤5 IU/L) at month 6 and maintained LH suppression through month 12. The percentage of patients with LH suppression exceeded 93% at each time point and reached 97.7% at month 12. No unexpected drug-related adverse events were reported.

Conclusions: The triptorelin 6-month formulation was safe and effective in suppressing the pituitary-gonadal axis in children with CPP. The extended injection interval may improve compliance and increase comfort in the management of CPP.

Publication types

  • Clinical Trial, Phase III
  • Multicenter Study

MeSH terms

  • Biomarkers / blood
  • Child
  • Child Development / drug effects
  • Child, Preschool
  • Chile
  • Delayed-Action Preparations / administration & dosage
  • Delayed-Action Preparations / adverse effects
  • Delayed-Action Preparations / therapeutic use
  • Drug Administration Schedule
  • Estradiol / blood
  • Estradiol / chemistry
  • Estradiol / metabolism
  • Female
  • Follicle Stimulating Hormone, Human / antagonists & inhibitors
  • Follicle Stimulating Hormone, Human / blood
  • Follicle Stimulating Hormone, Human / metabolism
  • Gonadotropin-Releasing Hormone / agonists*
  • Humans
  • Luteinizing Hormone / antagonists & inhibitors*
  • Luteinizing Hormone / blood
  • Luteinizing Hormone / metabolism
  • Male
  • Mexico
  • Osteogenesis / drug effects
  • Puberty, Precocious / blood
  • Puberty, Precocious / drug therapy*
  • Puberty, Precocious / metabolism
  • Reproductive Control Agents / administration & dosage*
  • Reproductive Control Agents / adverse effects
  • Reproductive Control Agents / therapeutic use
  • Testosterone / antagonists & inhibitors
  • Testosterone / blood
  • Testosterone / metabolism
  • Triptorelin Pamoate / administration & dosage*
  • Triptorelin Pamoate / adverse effects
  • Triptorelin Pamoate / therapeutic use
  • United States

Substances

  • Biomarkers
  • Delayed-Action Preparations
  • Follicle Stimulating Hormone, Human
  • Reproductive Control Agents
  • Triptorelin Pamoate
  • Gonadotropin-Releasing Hormone
  • Testosterone
  • Estradiol
  • Luteinizing Hormone