Journal
HORMONE RESEARCH IN PAEDIATRICS
Volume 81, Issue 5, Pages 289-297Publisher
KARGER
DOI: 10.1159/000358195
Keywords
Turner syndrome; Oxandrolone; Growth hormone treatment; Final height; Guidelines
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Funding
- Pfizer for this research
- Scottish Executive Chief Scientist Office
- British Society for Paediatric Endocrinology and Diabetes
- Child Growth Foundation
- Eli Lilly Co.
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There has been no consensus regarding the efficacy and safety of oxandrolone (Ox) in addition to growth hormone (GH) in girls with Turner syndrome (TS), the optimal age of starting this treatment, or the optimal dose. This collaborative venture between Dutch, UK and US centers is intended to give a summary of the data from three recently published randomized, placebo-controlled, double-blind studies on the effects of Ox. The published papers from these studies were reviewed within the group of authors to reach consensus about the recommendations. The addition of Ox to GH treatment leads to an increase in adult height, on average 2.3-4.6 cm. If Ox dosages <0.06 mg/kg/day are used, side effects are modest. The most relevant safety concerns are virilization (including clitoromegaly and voice deepening) and a transient delay of breast development. We advise monitoring signs of virilization breast development and possibly blood lipids during Ox treatment, in addition to regular follow-up assessments for TS. In girls with TS who are severely short for age, in whom very short adult stature is anticipated, or in whom the growth rate is modest despite good compliance with GH, adjunctive treatment with Ox at a dosage of 0.03-0.05 mg/kg/day starting from the age of 8-10 years onwards can be considered. (C) 2014 S. Karger AG, Basel
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