Anastrozole vs Letrozole to Augment Height in Pubertal Males With Idiopathic Short Stature: A 3-Year Randomized Trial.

Autor:	Zegarra W; Division of Pediatric Endocrinology and Diabetes, Stanford University School of Medicine, Stanford, CA 94305-5660, USA., Ranadive S; Pediatric Endocrinology, Palo Alto Medical Foundation, Palo Alto, CA 94301, USA., Toulan D; Pediatric Endocrinology, Palo Alto Medical Foundation, Palo Alto, CA 94301, USA., Neely EK; Division of Pediatric Endocrinology and Diabetes, Stanford University School of Medicine, Stanford, CA 94305-5660, USA.
Jazyk:	angličtina
Zdroj:	Journal of the Endocrine Society [J Endocr Soc] 2024 Aug 27; Vol. 8 (10), pp. bvae141. Date of Electronic Publication: 2024 Aug 27 (Print Publication: 2024).
DOI:	10.1210/jendso/bvae141
Abstrakt:	Context: Insufficient efficacy and safety data for off-label use of aromatase inhibitors to augment height in boys with short stature. Objective: To compare anastrozole and letrozole in treatment of idiopathic short stature in pubertal boys. Design: Open-label trial with 2 treatment arms. Setting: Pediatric Endocrine Clinic at Stanford. Participants: A total of 79 pubertal males ≥10 years with bone age (BA) ≤ 14 years, predicted adult height (PAH) < 5th percentile or >10 cm below mid-parental height. Intervention: Anastrozole 1.0 mg or letrozole 2.5 mg daily for up to 3 years. Main Outcome Measures: Annual hormone levels and growth parameters during treatment and a year posttherapy; annual BA and PAH (primary outcome measure); spine x-rays and dual energy X-ray absorptiometry at baseline and 2 years. Results: Compared with anastrozole (n = 35), letrozole (n = 30) resulted in higher testosterone levels, lower estradiol and IGF-1 levels, and slower growth velocity and BA advance. The PAH increase observed at year 1 in both groups did not persist at years 2 and 3. Change in PAH from baseline was not different between treatment groups. In groups combined, PAH gain over 3 years vs baseline was +1.3 cm ( P = .043) in linear mixed models. Conclusion: Letrozole caused greater deviations than anastrozole in hormone levels, growth velocity, and BA advancement, but no group differences in PAH or side effects were found. Change in PAH after 2 to 3 years of treatment was minimal. The efficacy of AI as monotherapy for height augmentation in pubertal boys with idiopathic short stature may be limited, and safety remains an issue. (© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society.)
Databáze:	MEDLINE
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