Monitoring Therapy for Central Precocious Puberty

To the Editor. — We read with great interest the article by Bhatia, Neely, and Wilson1 published in Pediatrics. The article suggests a simple and accurate method for assessing efficacy of gonadotropin-releasing hormone (GnRH) analog treatment of central precocious puberty (CPP). Although the GnRH stimulation test, intravenous or subcutaneous, is still considered the standard method for assessing therapeutic efficacy of CPP treatment, it is expensive, time-consuming, and uncomfortable for the patient. Therefore, in addition to clinical follow-up, in the last few years several alternative laboratory methods of monitoring therapeutic efficacy for children receiving GnRH agonist treatment have been proposed. A few years ago we demonstrated that a single blood sample, obtained 12 hours after home injection of long-acting triptorelin, in children treated for CPP, provides a simple, convenient, comfortable, and inexpensive method for assessing efficacy of the treatment.2 We were disappointed when we read the author’s comments, referring to our article, stating “sampling 12 hours after the treatment dose is inconvenient as well as unnecessary.” Our …