Startseite Use of letrozole to augment height outcome in pubertal boys: a retrospective chart review
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Use of letrozole to augment height outcome in pubertal boys: a retrospective chart review

  • Snigdha R. Likki , Holley F. Allen , Alexander Knee und Ksenia N. Tonyushkina ORCID logo EMAIL logo
Veröffentlicht/Copyright: 29. September 2022

Abstract

Objectives

We describe growth patterns and predicted adult height (PAH) in pubertal boys treated with letrozole and evaluate the potential predictors of growth responses.

Methods

We performed a retrospective analysis of data from 2002 to 2020. All subjects were treated for ≥6 months and had at least 3 height measurements to calculate the growth velocity (GV) before and during treatment. We evaluated growth measurements, bone age, and biochemical parameters before, during and after treatment.

Results

A total of 59 subjects aged 12.7 (± 1.7) years old were included. At treatment initiation, bone age was 13.1 (± 1.5) years and predicted adult height (PAH) was 163.8 (± 9.9) cm compared to mid-parental height of 172.4 (± 5.8) cm. Growth velocity decreased during letrozole therapy and rebounded after completion. Sub-analysis of 26 subjects with bone age data available at baseline and at least 1 year later showed a trend to modest increase in PAH. In boys simultaneously receiving growth hormone (rhGH), the change in PAH was significantly more (3.2 cm, p<0.05) compared to those treated with letrozole alone.

Conclusions

We show that letrozole appropriately slows down skeletal maturation and GV responses are variable. Possible negative predictors include lower baseline GV and advanced bone age. A small positive trend in PAH with letrozole therapy is augmented by simultaneous use of rhGH. Future randomized controlled trials are needed to better understand which group of patients will benefit from treatment.


Corresponding author: Ksenia N. Tonyushkina, MD, Division of Pediatric Endocrinology and Diabetes, Baystate Children’s Hospital, 50 Wason Avenue, 01199, Springfield, MA, USA, Phone: 413-794-3510, E-mail:

Acknowledgments

The authors thank Drs. Edward O. Reiter and Elizabeth Peacock – Chambers for helpful discussions along the study and critical reading of the manuscript.

  1. Research funding: None declared.

  2. Author contributions: SR collected, analyzed the data and drafted the manuscript. HA conceived the project, analyzed, and interpreted the data. AK contributed to design of the work and performed data analysis. KT contributed to data analysis, interpretation, and drafting of the manuscript. All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: The study was granted an exemption from requiring a written informed consent due to its retrospective nature.

  5. Ethical approval: This study protocol was reviewed and approved by the Institutional Review Board of Baystate Medical Center, approval number BH20-138.

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Received: 2022-03-31
Accepted: 2022-08-05
Published Online: 2022-09-29
Published in Print: 2022-10-26

© 2022 Walter de Gruyter GmbH, Berlin/Boston

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  4. Use of letrozole to augment height outcome in pubertal boys: a retrospective chart review
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