Aromatase Inhibitors Treatment Alone or With GH Increases Final Height in Short-statured Pubertal Boys—Real-world Data

CONTEXT: Short-statured midpubertal boys with predicted adult height (PAHt) below the third percentile are a therapeutic challenge. Aromatase inhibitors (AI) delay estrogen-driven epiphyseal fusion and possibly enhance adult height (AHt). OBJECTIVE: To assess the efficacy of AI treatment on AHt in midpubertal boys with a short PAHt due to advanced bone age (BA) or idiopathic short stature (ISS). DESIGN: Retrospective study. SETTING: Tertiary pediatric endocrine referral center. PATIENTS AND METHODS: Two groups of midpubertal boys treated with AI were studied: 27 boys with fast puberty compared to matched untreated controls and 16 boys with ISS treated with GH and AI (GH&AI) compared to those treated with GH only. Anthropometric measurements, BA and PAHt, were tracked. AHt was compared across groups. MAIN OUTCOME MEASURES: Achieved AHt in AI-treated boys vs controls and the PAHt. RESULTS: The median duration of AI treatment was 2.8 years for the AI-only group and 2 years for the GH&AI group. Throughout treatment, AI-treated groups gained height similarly to controls and showed a decrease in BA SD score (AI only: P = .009; GH&AI: P = .029) and an improvement in PAHt (AI only: P = .003; GH&AI: P = .037). Compared to controls, AI-treated children achieved greater AHt (AI only: 166.6 ± 3.1 cm vs 163.4 ± 1.3 cm, P = .003; GH&AI: 167.3 ± 6.1 cm vs 164.9 ± 3.5 cm, P = .194). The difference between AHt and PAHt at baseline was more pronounced in the AI-treated groups (AI only: 3.8 ± 3.5 cm vs -0.3 ± 5.0 cm, P = .001; GH&AI: 7.5 ± 5.2 cm vs 4.3 ± 3.6 cm, P = .050). CONCLUSION: AI treatment extends the growth period, resulting in an AHt surpassing initial predictions. Our findings underscore the potential of AI treatment in midpubertal boys with a short PAHt due to advanced BA and in those treated with GH for ISS.