Precocious Puberty and GnRH Analogs: Current Treatment Practices and Perspectives among US Pediatric Endocrinologists
Authors' conclusion
The survey indicated there is more familiarity with older, shorter acting GnRHas, which are prescribed in greater numbers than newer, longer acting formulations. There is lack of consensus on the need for central nervous system (CNS) imaging in girls presenting with CPP between 6 and 8 years of age and use of laboratory testing to monitor response to treatment. Insurance requirements regarding CNS imaging and laboratory monitoring are highly variable. Despite having similar constituents and bioavailability, there are substantial cost differences between the pediatric and adult formulations and lack of evidence for safe use of these formulations in children. The survey-based analysis highlights the challenges faced by prescribers while reflecting on areas where further research is needed to provide evidence-based practice guidelines for pediatric endocrinologists.
Study context
- Population
- Pediatric endocrinologists practicing in the USA
- Participants
- 223 survey respondents
- Outcome
- GnRHa familiarity, preferences and practices for central precocious puberty (CPP)
Methodological detailssurvey of US pediatric endocrinologists, Pediatric Endocrine Society Drugs and Therapeutics Subcommittee
- Survey of US pediatric endocrinologists
- Pediatric Endocrine Society Drugs and Therapeutics Subcommittee
Main finding
As reported in the abstract
- Familiar with pediatric one-monthly preparation
- 88%
- Familiar with 3-month preparation
- 96%
- Familiar with histrelin implant (Supprelin®)
- 91%
- Familiar with 24-week triptorelin IM (Triptodur®)
- 65%
- Familiar with 6-month subcutaneous leuprolide (Fensolvi®)
- 45%
- Extremely familiar with availability of adult formulations
- 23%
- Completely unaware of cost differences between pediatric and adult GnRHa preparations
- 25%
- Implant the most preferred therapy
- 44%
- Family preference/ease of treatment as key determinant of GnRHa choice
- 87%
- Insurance coverage played a significant role in the decision
- 64%
Observational data: associations, not effects.
Original publication
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