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Horm Res Paediatr. 2019 Jul 18:1-16. doi: 10.1159/000501336. [Epub ahead of print]

Use of Gonadotropin-Releasing Hormone Analogs in Children: Update by an International Consortium.

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Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, Penn State Hershey Medical Center, Hershey, PA, USA.
Department of Pediatrics, Indiana University School of Medicine and Riley Hospital for Children, Indianapolis, IN, USA.
Department of Pediatrics, University of Virginia, Charlottesville, VA, USA.
University of California, San Diego and Rady Children’s Hospital, San Diego, CA, USA.
Division of Pediatric Endocrinology, Pediatric Alliance, Pittsburgh, PA, USA.
Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, GA, USA.
Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, “Aghia Sophia” Children’s Hospital, Athens, Greece.


This update, written by authors designated by multiple pediatric endocrinology societies (see List of Participating Societies) from around the globe, concisely addresses topics related to changes in GnRHa usage in children and adolescents over the last decade. Topics related to the use of GnRHa in precocious puberty include diagnostic criteria, globally available formulations, considerations of benefit of treatment, monitoring of therapy, adverse events, and long-term outcome data. Additional sections review use in transgender individuals and other pediatric endocrine related conditions. Although there have been many significant changes in GnRHa usage, there is a definite paucity of evidence-based publications to support them. Therefore, this paper is explicitly not intended to evaluate what is recommended in terms of the best use of GnRHa, based on evidence and expert opinion, but rather to describe how these drugs are used, irrespective of any qualitative evaluation. Thus, this paper should be considered a narrative review on GnRHa utilization in precocious puberty and other clinical situations. These changes are reviewed not only to point out deficiencies in the literature but also to stimulate future studies and publications in this area.


Adolescents; Children; Gonadotropin-releasing hormone analogs; Precocious puberty; Transgender


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