Objectives To understand possible predictors of the onset of menses after gonadotropin-releasing hormone agonist treatment cessation in girls with central precocious puberty (CPP). Methods This exploratory post hoc analysis of a phase 3 and 4 trial of girls with CPP treated with once-monthly intramuscular leuprolide acetate examined onset of menses after treatment completion using a time-to-event analysis. Pretreatment and end-of-treatment chronologic age (CA), bone age (BA)/CA ratio, and Tanner breast stage; pretreatment menses status; and end-of-treatment BA and body mass index (BMI) were studied as potential factors influencing the onset of menses. Results Median time to first menses after stopping treatment was 18.3 months among 35 girls (mean age at onset of treatment, 6.8 years) examined. Of 26 girls experiencing menses, 11 (42 %) menstruated at 16–21 months after stopping treatment. Most girls with pretreatment BA/CA≥1.4 started menstruating very close to 18 months after stopping treatment; those with less advanced BA/CA experienced menses at 9–18 months. End-of-treatment BA/CA≥1.2 was associated with a quicker onset of menses (14.5 vs. 18.5 months for BA/CA<1.2, p=0.006). End-of-treatment BA≥12 years predicted longer time to menses. No relationship with time to menses was observed for pretreatment menarche status, pretreatment or end-of-treatment Tanner breast stage (<3/≥3) or CA (<6/≥6 or ≤11/>11), or end-of-treatment BMI percentiles (<85.6/≥85.6 and <92.6/≥92.6). Conclusions Pretreatment menarche status or CA do not appear to predict onset of menses, but pre- and end-of-treatment BA/CA may be helpful in anticipating time to first menses after stopping treatment.

中文翻译：

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GnRH激动剂治疗中枢性性早熟后月经开始的时间

目的 了解中枢性性早熟 (CPP) 女孩停止促性腺激素释放激素激动剂治疗后月经开始的可能预测因素。方法 这项探索性事后分析是对患有 CPP 的女孩进行的一项 3 期和 4 期试验的探索性事后分析，该试验采用每月一次肌肉注射醋酸亮丙瑞林的方法，使用事件时间分析检查治疗完成后的月经开始情况。治疗前和治疗结束时的实足年龄 (CA)、骨龄 (BA)/CA 比率以及 Tanner 乳房分期；治疗前月经状况；治疗结束时的 BA 和体重指数 (BMI) 作为影响月经开始的潜在因素进行了研究。结果 在 35 名接受检查的女孩（开始治疗的平均年龄为 6.8 岁）中，停止治疗后到第一次月经的中位时间为 18.3 个月。在 26 名经历月经的女孩中，有 11 名 (42%) 在停止治疗后 16-21 个月来月经。大多数治疗前 BA/CA≥1.4 的女孩在停止治疗后 18 个月左右开始月经； BA/CA 不太严重的患者在 9-18 个月时会经历月经。治疗结束时 BA/CA≥1.2 与月经来潮更快相关（BA/CA<1.2 时为 14.5 个月 vs. 18.5 个月，p=0.006）。治疗结束 BA≥12 年预计月经时间更长。未观察到治疗前初潮状态、治疗前或治疗结束时 Tanner 乳房分期 (<3/≥3) 或 CA (<6/≥6 或 ≤11/>11) 或治疗结束时与月经时间的关系。 -治疗BMI百分位（<85.6/≥85.6和<92.6/≥92.6）。结论 治疗前的初潮状态或 CA 似乎不能预测月经的开始，但治疗前和治疗结束时的 BA/CA 可能有助于预测停止治疗后首次月经的时间。