A multi-centre open trial of
Buserelin, a
luteinizing hormone-releasing hormone (
LHRH) analogue, was conducted in 13 children with
central precocious puberty. Eleven children (eight girls and three boys), aged 3.4-10.2 years at commencement, completed the required 12 month period of treatment. Initially all patients received the
drug by intranasal spray in a dose of 1200 micrograms/day, but by the end of the 12 month period two were having daily
subcutaneous injections and three were receiving an increased dose intranasally. The first month of treatment was associated in one boy with increased aggression and masturbation, and in the girls with an increase in the prevalence of
vaginal bleeding. Thereafter, however, both behavioural abnormalities and menstruation were suppressed. Median bone age increased significantly during the study, but without any significant change in the ratio of height age to bone age. The median predicted adult height for the group therefore did not alter significantly over the twelve months of the study.
Buserelin treatment caused a reduction in the peak
luteinizing hormone and
follicle-stimulating hormone (FSH) responses to
LHRH, mostly to prepubertal levels, and also suppressed basal FSH. In the first weeks of treatment, the girls' serum
oestradiol levels rose significantly and then fell to prepubertal or early pubertal levels. A similar pattern was seen for serum
testosterone levels. Serum
somatomedin-C levels, however, showed little fluctuation over the course of the study.
Buserelin treatment was safe and well accepted, and offers the promise of improved linear growth potential in
precocious puberty.