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- Title
Efficacy and Safety of Oxandrolone in Growth Hormone-Treated Girls with Turner Syndrome.
- Authors
Menke, Leonie A.; Sas, Theo C. J.; de Muinck Keizer-Schrama, Sabine M. P. F.; Zandwijken, Gladys R. J.; de Ridder, Maria A. J.; Odink, Roelof J.; Jansen, Maarten; Delemarre-van de Waal, Henriëtte A.; Stokvis-Brantsma, Wilhelmina H.; Waelkens, Johan J.; Westerlaken, Ciska; Reeser, H. Maarten; Paul van Trotsenburg, A. S.; Gevers, Evelien F.; van Buuren, Stef; DeJonckere, Philippe H.; Hokken-Koelega, Anita C. S.; Otten, Barto J.; Wit, Jan M.
- Abstract
Context and Objective: GH therapy increases growth and adult height in Turner syndrome (TS). The benefit to risk ratio of adding the weak androgen oxandrolone (Ox) to GH is unclear. Design and Participants: A randomized, placebo-controlled, double-blind, dose-response study was performed in 10 centers in The Netherlands. One hundred thirty-three patients with TS were included in age group 1 (2–7.99 yr), 2 (8 –11.99 yr), or 3 (12–15.99 yr). Patients were treated with GH (1.33 mg/m2 . d) frombaseline, combinedwithplacebo (Pl)orOxinlow (0.03mg/kg . d)or conventional (0.06 mg/kg . d)dose from the ageof 8 yr and estrogens from the ageof 12 yr.Adultheightgain (adultheight minus predicted adult height) and safety parameters were systematically assessed. Results: Compared with GH+Pl, GH+Ox 0.03 increased adult height gain in the intention-to-treat analysis (mean ± SD, 9.5 4.7 vs. 7.2 ± 4.0 cm, P = 0.02) and per-protocol analysis (9.8 ± 4.9 vs. 6.8 ± 4.4 cm, P = 0.02). Partly due to accelerated bone maturation (P < 0.001), adult height gain on GH+Ox 0.06 was not significantly different from that on GH+Pl (8.3 ± 4.7 vs. 7.2 ± 4.0 cm, P 0.3). Breast development was slower on GH+Ox (GH+Ox 0.03, P = 0.02; GH+Ox 0.06, P = 0.05), and more girls reported virilization on GH+Ox 0.06 than on GH+Pl (P < 0.001). Conclusions: In GH-treated girls with TS, we discourage the use of the conventional Ox dosage (0.06 mg/kg . d) because of its low benefit to risk ratio. The addition of Ox 0.03 mg/kg . d modestly increases adult height gain and has a fairly good safety profile, except for some deceleration of breast development.
- Publication
Journal of Clinical Endocrinology & Metabolism, 2010, Vol 95, Issue 3, p1151
- ISSN
0021-972X
- Publication type
Article
- DOI
10.1210/jc.2009-1821