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Cited by 216Hypothalamic control of reproductive hormonesGrowth Hormone and Insulin-like Growth FactorsSexual Differentiation and Disorders

A specific aromatase inhibitor and potential increase in adult height in boys with delayed puberty: a randomised controlled trial

Wickman, Sanna, Sipilä, Ilkka, Ankarberg-Lindgren, Carina, Norjavaara, Ensio, Dunkel, Leo·2001·The Lancet
DOI 10.1016/s0140-6736(00)04895-9
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Abstract

Background The role of oestrogens in the closure of growth plates in both sexes is unequivocal. We postulated that inhibition of oestrogen synthesis in boys with delayed puberty would delay maturation of the growth plates and ultimately result in increased adult height. Methods We did a randomised, double-blind, placebo-controlled study in which we treated boys with constitutional delay of puberty with testosterone and placebo, or testosterone and letrozole. Boys who decided to wait for the spontaneous progression of puberty without medical intervention composed the untreated group. Findings Letrozole effectively inhibited oestrogen synthesis and delayed bone maturation. Progression of bone maturation was slower in the letrozole group than in the placebo group. In 18 months, bone age had advanced 1.1 (SD 0.8) years in the untreated group and 1.7 (0.9) years in the group treated with testosterone and placebo, but only 0.9 (0.6) years in the letrozole group (p=0.03 between the treatment groups). Predicted adult height did not change significantly in the untreated group and in the placebo group, whereas in the group treated with letrozole the increase was 5.1 (3.7) cm (p=0.004). Interpretations Our findings suggest that if oestrogen action is inhibited in growing adolescents, adult height will increase. This finding provides a rationale for studies that aim to delay bone maturation in several growth disorders.

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  • A study in which anastrozole was added to the treatment with tamoxifen in men with idiopathic oligoasthenoteratozoospermia and a decreased testosterone over estradiol ratio after treatment with tamoxifen alone indicated an increased pregnancy rate compared with the group without the addition of the aromatase inhibitor.

    “More recently, a study in which anastrozole was added to the treatment with tamoxifen in men with idiopathic oligoasthenoteratozoospermia and a decreased testosterone over estradiol ratio after treatment with tamoxifen alone indicated an increased pregnancy rate compared with the group without the addition of the aromatase inhibitor [53].”

    From Aromatase inhibitors in men: effects and therapeutic options (2011) · cites this paper as [53]

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Authors
Wickman, S., Sipilä, I., Ankarberg-Lindgren, C., Norjavaara, E., & Dunkel, L.
Affiliations
  • University of Helsinki (FI)
  • University of Gothenburg (SE)
Corresponding author
Dunkel, Leo
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
2001-06
Volume
357
Issue
9270
Pages
1743-1748
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(00)04895-9
OpenAlex
W2048800355
Cited by
216
References
2
Citations by year
2026: 2 · 2025: 5 · 2024: 13 · 2023: 6 · 2022: 10 · 2021: 9 · 2020: 5 · 2019: 8 · 2018: 9 · 2017: 7 · 2016: 6 · 2015: 8 · 2014: 9 · 2013: 7 · 2012: 3
FWCI
12.21
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Sexual Differentiation and Disorders
Keywords
letrozole, aromatase inhibitors, constitutional delay of growth and puberty, delayed puberty, adult height, skeletal maturation, bone age, testosterone, estrogen synthesis, growth plate closure, growth disorders
MeSH terms
Letrozole, Adolescent, Body Height, Double-Blind Method, Drug Therapy, Combination, Humans, Male, Nitriles, Puberty, Delayed, Testosterone, Triazoles, Aromatase Inhibitors

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