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LBODP090 The Addition Of Anastrozole To Standard Testosterone Enanthate Treatment Significantly Improves Penile Size In Adolescent Boys With Micropenis

BACKGROUND: Micropenis is treated preferably in infancy (≤ 2 yrs) or at the onset οf puberty, usually with 3 (2-4) monthly testosterone enanthate I. M. injections at the dose of 100 mg/m2. This short-term therapy may temporarily advance bone maturation but with a concomitant increase in height veloc...

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Autores principales: Papadimitriou, Dimitrios T, Dermitzaki, Eleni, Papagianni, Maria, Papadimitriou, Anastasios, Vlahos, Nikos F, Mastorakos, George
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9625760/
http://dx.doi.org/10.1210/jendso/bvac150.1352
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author Papadimitriou, Dimitrios T
Dermitzaki, Eleni
Papagianni, Maria
Papadimitriou, Anastasios
Vlahos, Nikos F
Mastorakos, George
author_facet Papadimitriou, Dimitrios T
Dermitzaki, Eleni
Papagianni, Maria
Papadimitriou, Anastasios
Vlahos, Nikos F
Mastorakos, George
author_sort Papadimitriou, Dimitrios T
collection PubMed
description BACKGROUND: Micropenis is treated preferably in infancy (≤ 2 yrs) or at the onset οf puberty, usually with 3 (2-4) monthly testosterone enanthate I. M. injections at the dose of 100 mg/m2. This short-term therapy may temporarily advance bone maturation but with a concomitant increase in height velocity and no apparent change in predicted adult height. Bone maturation depends on locally produced estrogens by aromatization. Third generation aromatase inhibitors (AIs) are used as an off-label treatment to improve predicted adult height (PAH) in boys as well as in girls, either as monotherapy or in combination with growth hormone and/or puberty inhibition. They induce reverse binding inhibiting the activity of aromatase (a cytochrome P450 enzyme), which catalyzes the conversion of androstenedione and testosterone to estrone and estradiol, respectively, resulting in a substantial increase of the circulating testosterone concentrations. AIMS: To compare the traditional treatment of isolated - idiopathic - relative micropenis in boys with testosterone enanthate monotherapy to its combination with anastrozole 1 mg×1 p. o. METHODS: 164 boys with micropenis (stretched penile length ≤ -2 SD) received testosterone enanthate 100 mg/m2 I. M. /month either as monotherapy (n=63, mean age 10.8 yrs, group A) or in combination with anastrozole 1 mg/day (n=101, mean age 11 yrs, group B) for 3 months. Stretched penile length, bone maturation and auxological data were analyzed. All measurements were performed by the same examiner. The choice of therapeutic intervention was made randomly. Groups A and B did not differ in terms of age at intervention onset, bone age, target height or predicted adult height. They underwent a 6-month follow-up that included clinical examination, bone age X-ray evaluated by BoneXpert ver. 3.2. 0 (Visiana, Denmark), and laboratory tests at 8: 00hrs (LH, FSH, testosterone, estradiol, estrone), prior and under treatment. RESULTS: In both groups penile length normalized: for group A gain was +1.9 cm (+2. 08 SD) and for group B +2.24 cm (+2.3 SD), with group B attaining a greater length by +18% (p=0. 004) due to the higher testosterone concentrations attained by at least 50%. Group A presented a slight acceleration of height velocity with parallel advancement of their bone age maturation while group B with unchanged or lower estradiol and estrone concentrations maintained their height velocity with parallel movement of their bone age maturation. CONCLUSIONS: Addition of anastrozole 1 mg/day p. o. in testosterone enanthate treatment for idiopathic-isolated-relative micropenis at the beginning of puberty significantly improves penile length by almost 20% while the tempo of height velocity and bone maturation continue their previous track. Presentation: No date and time listed
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spelling pubmed-96257602022-11-14 LBODP090 The Addition Of Anastrozole To Standard Testosterone Enanthate Treatment Significantly Improves Penile Size In Adolescent Boys With Micropenis Papadimitriou, Dimitrios T Dermitzaki, Eleni Papagianni, Maria Papadimitriou, Anastasios Vlahos, Nikos F Mastorakos, George J Endocr Soc Reproductive Endocrinology BACKGROUND: Micropenis is treated preferably in infancy (≤ 2 yrs) or at the onset οf puberty, usually with 3 (2-4) monthly testosterone enanthate I. M. injections at the dose of 100 mg/m2. This short-term therapy may temporarily advance bone maturation but with a concomitant increase in height velocity and no apparent change in predicted adult height. Bone maturation depends on locally produced estrogens by aromatization. Third generation aromatase inhibitors (AIs) are used as an off-label treatment to improve predicted adult height (PAH) in boys as well as in girls, either as monotherapy or in combination with growth hormone and/or puberty inhibition. They induce reverse binding inhibiting the activity of aromatase (a cytochrome P450 enzyme), which catalyzes the conversion of androstenedione and testosterone to estrone and estradiol, respectively, resulting in a substantial increase of the circulating testosterone concentrations. AIMS: To compare the traditional treatment of isolated - idiopathic - relative micropenis in boys with testosterone enanthate monotherapy to its combination with anastrozole 1 mg×1 p. o. METHODS: 164 boys with micropenis (stretched penile length ≤ -2 SD) received testosterone enanthate 100 mg/m2 I. M. /month either as monotherapy (n=63, mean age 10.8 yrs, group A) or in combination with anastrozole 1 mg/day (n=101, mean age 11 yrs, group B) for 3 months. Stretched penile length, bone maturation and auxological data were analyzed. All measurements were performed by the same examiner. The choice of therapeutic intervention was made randomly. Groups A and B did not differ in terms of age at intervention onset, bone age, target height or predicted adult height. They underwent a 6-month follow-up that included clinical examination, bone age X-ray evaluated by BoneXpert ver. 3.2. 0 (Visiana, Denmark), and laboratory tests at 8: 00hrs (LH, FSH, testosterone, estradiol, estrone), prior and under treatment. RESULTS: In both groups penile length normalized: for group A gain was +1.9 cm (+2. 08 SD) and for group B +2.24 cm (+2.3 SD), with group B attaining a greater length by +18% (p=0. 004) due to the higher testosterone concentrations attained by at least 50%. Group A presented a slight acceleration of height velocity with parallel advancement of their bone age maturation while group B with unchanged or lower estradiol and estrone concentrations maintained their height velocity with parallel movement of their bone age maturation. CONCLUSIONS: Addition of anastrozole 1 mg/day p. o. in testosterone enanthate treatment for idiopathic-isolated-relative micropenis at the beginning of puberty significantly improves penile length by almost 20% while the tempo of height velocity and bone maturation continue their previous track. Presentation: No date and time listed Oxford University Press 2022-11-01 /pmc/articles/PMC9625760/ http://dx.doi.org/10.1210/jendso/bvac150.1352 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the Endocrine Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Reproductive Endocrinology
Papadimitriou, Dimitrios T
Dermitzaki, Eleni
Papagianni, Maria
Papadimitriou, Anastasios
Vlahos, Nikos F
Mastorakos, George
LBODP090 The Addition Of Anastrozole To Standard Testosterone Enanthate Treatment Significantly Improves Penile Size In Adolescent Boys With Micropenis
title LBODP090 The Addition Of Anastrozole To Standard Testosterone Enanthate Treatment Significantly Improves Penile Size In Adolescent Boys With Micropenis
title_full LBODP090 The Addition Of Anastrozole To Standard Testosterone Enanthate Treatment Significantly Improves Penile Size In Adolescent Boys With Micropenis
title_fullStr LBODP090 The Addition Of Anastrozole To Standard Testosterone Enanthate Treatment Significantly Improves Penile Size In Adolescent Boys With Micropenis
title_full_unstemmed LBODP090 The Addition Of Anastrozole To Standard Testosterone Enanthate Treatment Significantly Improves Penile Size In Adolescent Boys With Micropenis
title_short LBODP090 The Addition Of Anastrozole To Standard Testosterone Enanthate Treatment Significantly Improves Penile Size In Adolescent Boys With Micropenis
title_sort lbodp090 the addition of anastrozole to standard testosterone enanthate treatment significantly improves penile size in adolescent boys with micropenis
topic Reproductive Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9625760/
http://dx.doi.org/10.1210/jendso/bvac150.1352
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