[Therapeutic effectiveness of the gonadotropin releasing hormone analogue D-Trp-6-LHRH in the treatment of precocious puberty].

Efficacy and safety of a superactive gonadotrophin-releasing hormone analogue (D-Trp-6-LHRH, decapeptyl) was assessed in seven girls, aged two to seven years with precocious puberty (four idiopathic, two associated to McCune-Albright syndrome and one with myelomeningocele). A further case of a seven year old male was treated with a delayed release formulation of the analogue combined with cyproterone acetate for the first two weeks of therapy. Three cases had previously been unsuccessfully treated with cyproterone acetate (2% or medroxyprogesterone (1) but this conventional therapy was discontinued three months prior entering the trial. Decapeptyl was given at a dose of 100 mcg sc daily for 10 days, followed by a dose of 1-2 mcg/kg daily thereafter. One patient required a sustained dose of 7 mcg/kg for effective control. The male patient received a biodegradable depot preparation of decapeptyl at a dose of 1.5 mg IM monthly, calculated to release circa 100 mcg of the analogue daily. He was also treated with cyproterone acetate. 100 mg/m2/day 15 days before and for two weeks during decapeptyl administration. Treatment was well tolerated without significant side effects. After six months on treatment, both LH and FSH levels were undetectable and showed no response to LHRH. Plasma oestradiol levels were reduced from 230 +/- 40 to 13 +/- 4 pg/ml. Total testosterone in the male patient was suppressed from 7 ng/ml to undetectable levels. This was accompanied by a cessation in the progression of the development of secondary sexual characteristics. All female patients developed amenorrhoea and their Tanner stage regressed to I or prepubertad after treatment.(ABSTRACT TRUNCATED AT 250 WORDS)