Efficacy of 24-weekly versus 12-weekly decapeptyl SR treatment in central precocious puberty: a UK, multicentre retrospective cohort study

Objective

To evaluate the efficacy of 24-weekly decapeptyl SR (Triptorelin) treatment, compared with the 12-weekly regimen, in children with central precocious puberty (CPP).

Methods

A multicenter retrospective cohort study was conducted on patients with CPP treated with gonadotropin-releasing hormone analog (GnRHa) therapy between September 2008 and December 2024. Participants were recruited from 3 tertiary pediatric endocrinology centers in the United Kingdom: the Royal London Hospital (Barts Health NHS Trust), Sheffield Children's Hospital (Sheffield Children's NHS Foundation Trust), and the Royal Victoria Infirmary (Newcastle upon Tyne Hospitals NHS Foundation Trust). Patients received either Decapeptyl SR 11.25 mg every 12 weeks or 22.5 mg every 24 weeks. Clinical, biochemical, and radiological data were collected at baseline and follow-up to assess hypothalamic–pituitary–gonadal (HPG) axis suppression and pubertal progression.

Results

Of 247 patients reviewed (220 girls and 27 boys), 164 were eligible for analysis: 69 in Group 1 (12 weekly) and 95 in Group 2 (24 weekly). Both regimens achieved effective HPG axis suppression, with no significant differences in luteinizing hormone, follicle-stimulating hormone, or sex steroid concentrations. Clinical outcomes, including height velocity, body mass index, and Tanner staging, were comparable. The 24-weekly preparation was well-tolerated and demonstrated equivalent suppression of pubertal progression. Among patients who expressed a preference, all favored the 24-weekly schedule.

Conclusion

This UK multicenter study provides evidence that 24-weekly Decapeptyl SR is both efficacious and well-tolerated for the management of CPP, with comparable outcomes to the standard 12-weekly regimen. This is the first comparative analysis to establish clinical equivalence between these 2 regimens, which is particularly important given the reduced frequency of clinical monitoring in the longer-acting preparation. Fewer injections may improve adherence and patient satisfaction, alongside potential cost savings.