%0 Clinical Trial
%T A pilot study proposing an algorithm for pubertal induction in cerebral palsy.
%A Trinh A
%A Lim A
%A Wong P
%A Brown J
%A Pitkin J
%A Wollenhoven B
%A Ebeling P
%A Fuller P
%A Milat F
%A Zacharin M
%J J Pediatr Endocrinol Metab
%V 37
%N 3
%D 2024 Mar 25
%M 38374118
%F 1.52
%R 10.1515/jpem-2024-0013
%X <B>OBJECTIVE: </B>To explore delayed puberty in cerebral palsy (CP) and to test the acceptability of an interventional puberty induction algorithm.<BR><B>METHODS: </B>A two phase cohort study in children and adolescents diagnosed with CP who have delayed puberty. Phase 1: Retrospective review of clinical records and interviews with patients who have been treated with sex-steroids and Phase 2: Prospective interventional trial of pubertal induction with a proposed algorithm of transdermal testosterone (males) or oestrogen (females). Phase 1 examined experiences with sex-steroid treatment. Phase 2 collected data on height adjusted bone mineral density (BMAD), fractures, adverse effects, mobility and quality of life over two years during the induction.<BR><B>RESULTS: </B>Phase 1, treatment was well tolerated in 11/20 treated with sex-steroids; phase 2, using the proposed induction algorithm, 7/10 treated reached Tanner stage 3 by nine months. One participant reached Tanner stage 5 in 24 months. Mean change in BMAD Z-scores was +0.27 % (SD 0.002) in those who could be scanned by dual-energy X-ray absorptiometry (DXA).<BR><B>CONCLUSIONS: </B>Delayed puberty may be diagnosed late. Treatment was beneficial and well tolerated, suggesting all patients with severe pubertal delay or arrest should be considered for sex hormone supplementation.