Systematic review finds letrozole effective for peripheral precocious puberty in girls

A systematic review of 22 observational studies (151 girls) evaluated letrozole, an aromatase inhibitor used off-label, for peripheral precocious puberty, mostly in McCune-Albright syndrome. The review reported that letrozole slowed pubertal progression, reduced bone age advancement, and improved predicted adult height, with adverse events in 3.3% of patients and no clinically significant hyperandrogenism or hepatotoxicity; transition to central precocious puberty occurred in 41.3% during follow-up. The authors state that well-designed prospective studies are needed to establish optimal dosing, long-term safety, and final adult height outcomes.

Most relevant for: Girls with peripheral precocious puberty, particularly those with McCune-Albright syndrome, being considered for off-label aromatase inhibitor therapy.

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