Pediatric endocrinology

Precocious Puberty and GnRH Analogs: Current Treatment Practices and Perspectives among US Pediatric Endocrinologists

Horm Res PaediatrPublished Cross-sectional survey study

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

Precocious Puberty and GnRH Analogs: Current Treatment Practices and Perspectives among US Pediatric Endocrinologists. Horm Res Paediatr. Published 8 May 2024. doi:10.1159/000539011

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