Triptorelin acetate in pediatric endocrinology: A retrospective analysis of treatment outcomes and long-term efficacy

Aims: This study aims to evaluate triptorelin acetate's efficacy in suppressing pubertal progression and stabilizing bone age advancement in Jordanian children with Central Precocious Puberty (CPP). It will also monitor regression of secondary sexual characteristics, evaluate bone age progression relative to chronological age, and assess improvements in predicted adult height. The study will provide insights into the real-world effectiveness of triptorelin acetate in a Middle Eastern pediatric population, guiding clinicians in tailoring treatment protocols and stratifying patients for optimal response. The findings may also inform future monitoring and follow-up strategies for children undergoing GnRH agonist therapy. Methods: The study analyzed the medical records of 79 children treated with medication at Queen Rania Abdallah Hospital for Children from January 2023 to December 2024. The children had to meet certain criteria, including being at least 13 years old, having a confirmed diagnosis of CPP, and having complete baseline and follow-up data. The data set included information about age, gender, and BMI, as well as clinical parameters like growth rate and pubertal staging. Hormonal tests were conducted to monitor puberty progression, and the Greulich-Pyle approach was used to evaluate bone age. Written information about the therapy was also collected. Statistical analysis was performed to identify useful information, using means, rates, paired t-tests, Wilcoxon signed-rank tests, multivariate regression analysis, and ROC curve analysis. A power of 80% was used to ensure clinically meaningful effects, and a p-value of less than 0.05 was considered statistically significant. The data was stored using conventional statistical programs. Results: A study on Central Premature Puberty in children found that triptorelin acetate effectively blocked gonadotropins, reducing levels of LH and FSH in 92.4% of patients. The treatment also decreased levels of FSH and sex steroids, indicating hormones' role in puberty regulation. Post-treatment, children's projected adult height (PAH) grew by an average of +4.2 ± 1.7 cm, and the bone age to chronological age ratio was significantly reduced. Younger age at the start and longer treatment period were significant indicators of better outcomes for PAH. The recommended cutoff age for the greatest treatment response was ≤8 years, emphasizing the need for early detection and treatment of CPP. Triptorelin acetate is generally well-tolerated with no notable side effects. Conclusion: Research shows triptorelin acetate can slow bone ageing, prevent puberty, and improve PAH in children as young as eight years old. However, more long-term studies are needed to determine its predictive characteristics and long-term results. Despite no damage found, the current CPP recommendations for early therapy for GnRHa are more credible.