Bioethics Blogs

Lupron: Déjà Vu All Over Again

Alice Dreger raises concerns about a pervasive pattern of non-evidence based assumptions driving practices in pediatric endocrinology.

__________________________________________

You’d think that the pediatric specialty that may have given cancer to women treated with estrogen because as girls they were ‘at risk’ of growing up tall might be pretty careful with other drugs. You’d think that it would be especially cautious about treating kids with hormone blockers because they are ‘at risk’ of growing up short.

Pediatric endocrinology, I’m talking to you.

Susan Cohen and Christine Cosgrove have done a fine job tracking the history of using estrogen to prevent tallness in girls, so I won’t review it here. But their work is inevitably brought to mind because of a report published last week in California Healthline by Christina Jewett.

Jewett relays mounting health concerns among women who were given the drug Lupron as girls to stop or slow down puberty. Some were treated as children specifically to try to get them to grow taller. Lupron may increase a child’s ultimate height by lengthening the span of years in which the long bones are growing.

Leuprolide

The U.S. Food and Drug Administration (FDA) has approved Lupron (leuprolide), a hormone-blocking agent, for the treatment of precocious puberty, endometriosis, and advanced prostate cancer. Last week, Denise Grady reported in the New York Times new oncology research which suggests it can prolong the lives of some men with prostate cancer.

But in all these uses, the drug is known sometimes to cause serious side effects. As one oncologist quoted in Grady’s article put it, the side effects are serious enough, “you’d better have some decent justification” to use it.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.