The Combination of Aromatase Inhibitors and GH Treatment for Idiopathic Short Stature in Male Adolescents

Abstract Objective To evaluate the efficacy and safety in adolescent boys with idiopathic short stature (ISS) when treated with third-generation aromatase inhibitors (AIs), the combination of letrozole or anastrozole with recombinant human GH (rhGH), and compare adult height (AHt) augmentation following the treatment with rhGH combined with AIs or GnRH analog (GnRHa) in male adolescents with ISS. Method We collected data from adolescent boys with ISS and a bone age ≥ 13 years who received treatment at Tongji Hospital, Huazhong University of Science and Technology from May 2017 to June 2023. Patients were allocated into the combined letrozole and rhGH group, the combined anastrozole and rhGH group, and the combined GnRHa and rhGH group based on their treatment. Three groups were matched by propensity score matching. There were 32 cases in each group. Follow-up was conducted every 3 months until AHt. Adverse events were monitored throughout. Results The SD scores of AHt adjusted for target height in the letrozole, anastrozole, and GnRHa groups were 0.60 ± 0.28, 0.81 ± 0.34, and 0.48 ± 0.17, respectively. Compared with the letrozole and GnRHa groups, the anastrazole and rhGH combination group showed the most significant increase in AHt (P < .01). The abnormal monitoring indicators of the AIs group gradually returned to normal following the termination of treatment. Conclusion For adolescent males with ISS and a bone age ≥ 13 years, the combination of AI and rhGH significantly increased the AHt. Finally, our analyses showed that anastrozole exerts more significant effects with regard to augmenting AHt with fewer adverse reactions.