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Systematic review of the treatment with GnRH analog in girls with onset of puberty aged 7-10 years

Grant number: 15/23447-6
Support type:Scholarships in Brazil - Scientific Initiation
Effective date (Start): March 01, 2016
Effective date (End): February 28, 2018
Field of knowledge:Health Sciences - Medicine - Medical Clinics
Principal researcher:Vania dos Santos Nunes Nogueira
Grantee:Italo Antunes Franzini
Home Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil


Girls with precocious puberty mostly present an increased growth rate, accelerated bone maturation and may also have a compromised adult stature, in addition to psychosocial embarrassment. There is the term early puberty, which is defined by a slightly premature puberty. The question that is still outstanding is whether this condition is a normality variation or it is a pathologic process. Thinking in the second hypothesis, and with the possibility of these children do not reach their target height, some girls have been treated with GnRH analogue. The studies that evaluated the GnRH analogue in early puberty are controversial on defining if the treated girls have a final height gain compared to those who were not treated. Our hypothesis is there is no difference. Our intention is to make a systematic review of literature according to Cochrane collaboration evaluating if the treatment of girls with early puberty using GnRH analogue provides a final height improvement compared to untreated girls. The inclusion criteria for the study are: a) Participants (P): girls with early puberty who presented the larche between 7-10 years old (Tanner stage 2 or 3); b) Intervention (I): GnRH analogue treatment; c) Comparison (C): no treatment; d) Outcomes (O): primary: final height average; secondary: adverse events, psychosocial impact; e) Study Design (S): randomized clinical trials (RCTs) and, in absence of thereof, controlled clinical trials will be included. Three research strategies will be taken on the major health-related electronic databases: Embase, Pubmed and Cochrane Library. When data from more than one study are homogeneous, suitable according to the methodology employed, and with similar clinical outcomes, they will be set into a meta-analysis using the Review Manager 5.3 software.

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
FRANZINI, I. A.; YAMAMOTO, F. M.; BOLFI, F.; ANTONINI, S. R.; NUNES-NOGUEIRA, V. S. GnRH analog is ineffective in increasing adult height in girls with puberty onset after 7 years of age: a systematic review and meta-analysis. EUROPEAN JOURNAL OF ENDOCRINOLOGY, v. 179, n. 6, p. 381-390, DEC 2018. Web of Science Citations: 1.

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