MON-231 - Final Adult Height Outcomes in Adolescents with Short Stature: A Retrospective Comparison of GnRHa, AI, and rhGH Monotherapy in a Northern Tier - 1 City of China

Objective:
To evaluate the impact of different treatment regimens—specifically Gonadotropin-Releasing Hormone Agonist (GnRHa), Aromatase Inhibitor (AI), and recombinant Human Growth Hormone (rhGH) monotherapy—on final adult height (FAH) and height gain in adolescents with pubertal short stature.

Methods:
This was a single-center, retrospective comparative study involving 93 adolescents with short stature. Inclusion criteria included age ≥10 years (girls) or ≥12 years (boys), bone age (BA) exceeding chronological age (CA) by ≥1 year, height below the 3rd percentile, and evidence of puberty onset (e.g., LH peak ≥5.0 U/L, testicular volume ≥4 mL, or uterine/ovarian enlargement). Patients were categorized into three groups: Group 1: GnRHa + rhGH, Group 2: AI + rhGH, and Group 3: rhGH monotherapy. Auxological parameters, including total height gain, annualized height velocity (HV), and predicted adult height (PAH), were analyzed. Statistical comparisons were performed using t-tests and ANOVA where appropriate.

Results:
The cohort consisted of 93 patients (mean baseline age 13.11±2.42 years; 45 males).
Height Velocity:
The rhGH monotherapy group demonstrated a significantly higher annualized height velocity compared to the combined groups 8.83cm/yearvs.6.97cm/year,p < 0.05, driven primarily by a marked difference in boys 9.40cm/yearvs.6.85cm/year.
Final Height:
Despite the higher annual velocity in the monotherapy group, there was no statistically significant difference in final adult height between the groups at the last follow-up (rhGH mono: 160.76 cm vs. Combined [GnRHa+AI]: 163.51 cm, p>0.05).
Treatment Duration & BA:
The GnRHa+rhGH and AI+rhGH groups had a longer treatment duration and a slower rate of bone age advancement compared to the rhGH monotherapy group (Baseline BA: 12.74y vs. 15.67y vs. 13.08y respectively). The total height gain over the entire treatment period was greatest in the rhGH monotherapy group (10.69±6.6 cm).
Gender Analysis:
Male patients had a significantly higher baseline age, bone age, and genetic target height compared to females (all p< 0.001). However, the total height gain between genders showed no statistical difference (Boys: 7.65±5.75 cm vs. Girls: 8.29±6.5 cm, p=0.618).

Conclusion:
While rhGH monotherapy achieves a superior annualized growth velocity, combination therapies (GnRHa or AI with rhGH) result in comparable final adult heights. This suggests that although combination therapy may slow bone age progression and extend the treatment window, the initial baseline bone age differences significantly influence the overall height outcome. The choice of regimen should be tailored based on the patient’s pubertal stage, bone age advancement, and individual growth potential.

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