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TOPLINE:

Treatment with an aromatase inhibitor, either alone or in combination with growth hormone (GH), slowed bone advancement and enhanced adult height in mid-pubertal boys with a short predicted adult height due to advanced bone age or idiopathic short stature (ISS).

METHODOLOGY:

• Mid-pubertal boys with short stature and a predicted adult height (PAHt) below the third percentile present a therapeutic challenge, but aromatase inhibitors may delay estrogen-driven epiphyseal fusion and potentially increase adult height.
• Researchers conducted a retrospective study to examine the effects of aromatase inhibitor treatment on the final height in mid-pubertal boys with a short PAHt due to advanced bone age or ISS.
• Two treatment groups were evaluated: In one group, 27 pubertal boys with relatively early and fast puberty and advanced bone age were treated with an aromatase inhibitor alone and compared with matched untreated control individuals; in the other, 16 boys with extreme ISS and slightly advanced bone age were treated with GH plus an aromatase inhibitor and compared with matched control individuals treated with GH alone.
• Patients were monitored through clinic visits every 4 months for anthropometric measurements and pubertal assessments, with laboratory tests performed yearly. Bone age was assessed at the beginning of aromatase inhibitor treatment and annually thereafter.

TAKEAWAY:

• The median duration of aromatase inhibitor treatment was 2.8 years for the aromatase inhibitor–only group and 2.0 years for the combined GH and aromatase inhibitor group.
• At the end of aromatase inhibitor treatment, the aromatase inhibitor–only group achieved significantly taller adult height than the control group (mean height, 166.6 cm vs 163.4 cm; P = .003), with a more pronounced difference between adult height and PAHt in the aromatase inhibitor group (mean difference, 3.8 cm vs −0.3 cm; P = .001).
• Individuals treated with both GH and aromatase inhibitor achieved taller adult height than those treated with GH alone (mean height, 167.3 cm vs 164.9 cm).
• Compared with their respective control groups, both aromatase inhibitor–only and combined GH plus aromatase inhibitor groups showed significant slowing of bone age (P = .009 and P = .029, respectively) and improvements in PAHt (P = .003 and P = .037, respectively).

IN PRACTICE:

“While the effectiveness of AIs [aromatase inhibitors] in GH-treated adolescents is well-established, our findings emphasize their potential benefit specifically for mid-pubertal adolescents with advanced BA [bone age] and reduced predicted AHt [adult height],” the authors wrote.

SOURCE:

This study was led by Michal Yackobovitch-Gavan, PhD, Schneider Children’s Medical Center, Petach Tikva, Israel. It was published online on April 07, 2025, in The Journal of Clinical Endocrinology & Metabolism.

LIMITATIONS:

The retrospective design of this study was a major limitation. Estradiol levels were not measured in all participants before or during the aromatase inhibitor treatment period, as routine testing was not mandated by institutional policy. Additionally, the relatively small sample size may have limited the generalizability of the findings.

DISCLOSURES:

This study did not receive any funding. The authors declared no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.