Real-World Adult Height Outcomes in Girls with Central Precocious Puberty Receiving GnRHa Monotherapy or Combined with Growth Hormone: A Cohort Study in China

INTRODUCTION: Although gonadotropin-releasing hormone analogs (GnRHa) are the standard treatment for central precocious puberty (CPP), the efficacy of GnRHa monotherapy in older children (around 8 years) and that of combination therapy with recombinant human growth hormone (rhGH) both remain unclear. This study aims to evaluate the real-world efficacy of each regimen. METHODS: This retrospective cohort study enrolled Chinese girls with CPP. Two groups were formed: GnRHa monotherapy and GnRHa + rhGH combination therapy. Outcomes included adult height gain [AHG, final adult height (FAH) standard deviation score (SDS)- predicted adult height (PAH) SDS]，genetic height gain [GHG, FAH SDS-target height (Tht) SDS], and change in height (FAH SDS - baseline height SDS). RESULTS: In the GnRHa group, the mean age at treatment initiation was 8.87 ± 0.87 years. After 17.87 months of treatment, the AHG was 1.33 SDS (0.82, 2.00). In the GnRHa + rhGH group, the mean age at treatment initiation was 9.01 ± 0.80 years. After 23.02 months of GnRHa treatment and 14.02 months of rhGH treatment, the group showed significantly greater AHG [1.72 SDS (1.24, 2.59)]. CONCLUSIONS: GnRHa monotherapy initiated after age 8 may still provide meaningful height gains, and adding rhGH is associated with improved FAH in patients with severe baseline height impairment.