Diagnosing Central Precocious Puberty

Prior to initiating treatment for central precocious puberty, the following are used to confirm a clinical diagnosis:1

  • Laboratory tests to measure
    • Total sex steroids
    • Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) following stimulation with a GnRH analog
    • Human chorionic gonadotropin levels (to rule out a chorionic gonadotropin secreting tumor)
    • Adrenal steroid panel to exclude congenital adrenal hyperplasia
  • Hand/wrist x-ray to assess bone age versus chronological age
  • Height and weight measurements
  • Diagnostic imaging of the brain (to rule out intracranial tumor)
  • Pelvic/testicular/adrenal ultrasound (to assess size and rule out steroid secreting tumors)

 

Reference:
1. SUPPRELIN® LA [package insert]. Chadds Ford, PA: Endo Pharmaceuticals Solutions Inc; 2011.

Next: About SUPPRELIN® LA

Indication

SUPPRELIN® LA (histrelin acetate) subcutaneous implant is indicated for the treatment of children with central precocious puberty (CPP).

Important Safety Information

  • SUPPRELIN LA is contraindicated in women who are or may become pregnant, and in patients who are hypersensitive to GnRH or GnRH agonist analogs. Safety and effectiveness in pediatric patients under the age of 2 years has not been established.

  • SUPPRELIN LA, like other GnRH agonists, initially causes a transient increase in serum concentrations of estradiol in females and testosterone in both sexes during the first week of treatment, with worsening or onset of new symptoms during this period. Within 4 weeks of therapy, gonadal steroid suppression occurs and manifestations of puberty decrease.

  • Implant insertion and removal is a surgical procedure and should utilize aseptic technique. Careful adherence to the recommended insertion and removal procedures is recommended. On occasion, localizing and/or removal of implant products have been difficult and imaging techniques were used, including ultrasound, CT, or MRI (this implant is not radiopaque).

  • Rare events of spontaneous extrusion have been observed in clinical trials.

  • LH, FSH and estradiol or testosterone should be monitored at 1 month post implantation then every 6 months. Every 6-12 months, height and bone age should also be assessed.

  • In clinical trials, the most common adverse reactions involved the implant site and included bruising, pain, soreness, erythema and swelling.

Please see the accompanying full Prescribing Information.