Adding Letrozole to Growth Hormone and Gonadotropin-Releasing Hormone analogous May Further Increase Height in Girls with Short Stature: a hospital record-based retrospective study

Background There have been rare data in Letrozole for height promotion in girls.This study aims to clarify the efficacy and safety of combination therapy with human recombinant growth hormone, GnRHa and letrozole in improving the height of girls with short stature and advanced bone age. Methods This is a retrospective record-based study. Follow-up was conducted on girls with short stature who received rhGH,GnRHa and letrozole treatment at outpatient clinics in our hospital.The treatment group included a total of 29 participants. Prior to treatment, the average age of the patients was 11.17 years, and an average treatment duration of 17.31 months.The control group consisted of 29 short-statured girls who received rhGH/GnRHa treatment, with an average age of 12.43 years, and an average treatment duration of 16.59 months. Results The predicted adult height(PAH) before treatment was 155.38 cm, and the PAH after treatment was 161.32cm ( p<0.001). The ΔPAH in the treatment group is 4 cm higher than that of the control group (5.85cm VS 1.82cm, P<0.001). There was a significant difference in the height SDS of Bone age before and after treatment ( P<0.001).And there was a significant difference in the height SDS of chronological age (P=0.003).There was a increasing BMI during therapy (P=0.039). The height gain was 8.71±4.46 cm, and the growth rate was 6.78±3.84cm per year. Conclusions Combined treatment with GH,GnRHa and letrozole can enhance the adult height(AH)and PAH in short-stature girls and no significant side effects were reported.