CONSENSUS STATEMENT ON THE USE OF GnRH ANALOGS IN CHILDREN

Key words: Precocious puberty, GnRH analogs, Development

The development of Gonadotropin Releasing Hormone analogs (GnRHa) revolutionized the treatment of central precocious puberty (CPP). However, questions remain regarding their optimal use in CPP and other conditions in children. The European Society for Paediatric Endocrinology and the Lawson Wilkins Pediatric Endocrine Society convened a Consensus conference to review the clinical use of GnRHa in children and adolescents. To optimize the generalizability of the statement, consideration was given to the representations from North America (United States and Canada) and Europe, an equal male/female ratio, and a balanced spectrum of professional seniority and expertise when selecting the 30 participants. The group came to the following unanimous conclusions: the efficacy of GnRHa to increase adult height is undisputed only in early onset CPP. Other key areas, such as the psychosocial effects of CPP and their modulation by GnRHa, need further study. Literature review and consensus process did not provide support for commonly voiced concerns regarding the use of GnRHa, such as promotion of weight gain or long-term diminution of bone mineral density. Use of GnRHa in conditions other than CPP requires further investigation and cannot be routinely suggested.