A narrative review: treatment outcomes of central precocious puberty (CPP)

Abstract

Background and Objective: Central precocious puberty (CPP) is defined as the onset of breast development (thelarche) before age 8 years in girls and testicular development (gonadarche) before age 9 years in boys due to early activation of the hypothalamic-pituitary-gonadal (HPG) axis. In most cases, the exact etiology of CPP is not known. In girls, CPP is commonly idiopathic. In contrast, CPP in boys is likely pathologic. Gonadotropin-releasing hormone agonists (GnRHa) are the gold standard treatment of CPP, with the main objective to halt the pubertal progression and delay skeletal maturation preserving final adult height. In this narrative review, our focus is to review the treatment outcomes of GnRHa on adult height, reproductive function, BMI, cardiovascular and bone health in patients with CPP after brief description of CPP, etiology, and diagnosis. Methods: Literature was searched from PubMed using appropriate search terms. A total of 61 articles published in English were included in this review. Key Content and Findings: We identified a total of 388 articles between 1990 and 2021. Of those, sixtyone articles were selected for inclusion based on their relevance to the aim of this article. Conclusions: While the safety and efficacy of GnRHa are well known, there continues to be conflicting data on long-term outcomes in treated patients. In general, long-term outcomes appear to be favorable with minimal adverse outcomes regarding menstrual and reproductive function, polycystic ovarian syndrome, metabolic concerns, and bone health.