Outcomes of GnRH Agonist Therapy in Boys with Central Precocious Puberty: A Systematic Review of Final Height and Long-Term Health Effects.

Abstract

Background: Central precocious puberty (CPP) in boys can result in accelerated growth, early epiphyseal fusion, and reduced adult height. Gonadotropin-releasing hormone agonists (GnRHa) are commonly used to delay pubertal progression and preserve growth potential. However, data on their long-term effects on final height, bone health, and body mass index (BMI) remain limited. This systematic review aimed to evaluate the outcomes of GnRH agonist therapy in boys with CPP, focusing on final height and reported side effects.

Methods: A systematic literature search was conducted across five databases for studies published from 2000 to 2023. Studies included boys with idiopathic or non-idiopathic CPP treated with GnRH agonists, reporting outcomes related to final height, BMI, or bone health. Data were synthesized qualitatively.

Results: GnRH agonist therapy significantly improved final height outcomes, particularly in idiopathic CPP cases, with boys often achieving heights near or exceeding their genetic target. Non-idiopathic CPP cases showed more variable results. Bone health assessments were limited, and long-term impacts on bone mineral density (BMD) remain unclear. Transient increases in BMI were observed during therapy, with no substantial long-term risk of obesity.

Conclusions: In general, no serious side effects were reported. GnRH agonist therapy is effective in improving final height in boys with CPP, especially in idiopathic cases. However, more research is needed to understand its long-term effects on bone health and metabolic outcomes.