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1787 citation(s) found for "Ma, Stephanie".

Adipose‐derived and bone marrow aspirate concentrate injections for osteoarthritis: A scoping review
OLIVEIRA, LEONARDO P. , Lear, Aaron , Stokes, Derek , Chamberlain, Rachel, Agnew, Megan, Kliethermes, Stephanie, Sund, Sarah , Shapiro, Shane, Mautner, Kenneth, Stokes, Derek , Tiu, Timothy , Mautner, Kenneth R , Elphingstone, Joseph W. , Chamberlain, Rachel, Price, David, Agnew, Megan, Kliethermes‌, Stephanie , Christensen, Leslie , Mautner, Kenneth

PM&R | May 2, 2026 | Volume: 18 | Issue: S2 | Pages: No page available

10.1002/pmrj.70147 | PMID 42068232 Get It

Abstract Background Osteoarthritis is a leading cause of disability worldwide, and cell‐based treatments including adipose‐derived and bone marrow aspirate have been sought by the lay and medical community as treatment options. Objective To perform a scoping review of published literature on cell‐based injections allowed by the U.S. Food and Drug Administration for the treatment of osteoarthritis to synthesize existing evidence and identify research gaps for future evaluation. Methods A comprehensive search of five databases was executed from inception through January 2, 2025. Studies that met the inclusion criteria were original research studies written in English on Food and Drug Administration‐allowed cell‐based treatments in adults with osteoarthritis of any joint. Results The database search yielded 4257 unique records. After screening, 84 studies met the inclusion criteria, encompassing 9996 patients and a total of 10,508 procedures. The primary research study designs were cohort studies ( n = 62), focused on treatment of knee osteoarthritis ( n = 63), and described bone marrow aspirate ( n = 42) and adipose‐derived ( n = 42) treatments. Postprocedure monitoring ranged from 6 weeks to 5 years, with most studies ≤1 year ( n = 59). Patient‐reported outcomes were reported in 83 of 84 studies; few provided imaging outcomes including magnetic resonance imaging ( n = 9) or radiographs ( n = 2). Conclusion This review identified limited randomized controlled trials, limited studies outside the knee, limited description of cell‐based treatments, and treatment protocols, along with inconsistent patient‐reported outcomes limited to 1 year in most studies. We propose establishing reporting guidelines in research on cell‐based therapies.
Haplotype-resolved genome assemblies of BJ and IMR-90 human fibroblast cell lines reveal extensive structural variation and enable reanalysis of historical sequencing data
Ranallo-Benavidez, T Rhyker, Hao, Yue , Volpe, Emilia, Fukushima, Noelle, Stephens, Zachary, Mbegbu, Ogechukwu, Ungaro, Matteo Tommaso , Reiman, Rebecca, Molnar, Jessica, Murphy, Danyael, Paredes, Dorothy Marie, Wong, Shukmei , Karaniuk, Kara, Buchholtz, Stephanie, Kocher, Jean-Pierre, Keats, Jonathan, Paten, Benedict, Barthel, Floris P, Ranallo-Benavidez, T. Rhyker , Hao, Yue , Ranallo-Benavidez, T Rhyker , Stephens, Zachary D, Kocher, Jean-Pierre A , Paten, Benedict , Barthel, Floris P , Jehangir, Maryam , Fukushima, Noelle H., Paredes, Dorothy Marie, Keats, Jonathan J. , Machiela, Mitchell J. , Kolmogorov, Mikhail , Giunta, Simona

Nucleic Acids Research | April 29, 2026 | Volume: 54 | Issue: 8 | Pages: No page available

10.1093/nar/gkag333 | PMID 42049241 Get It

Abstract We present chromosome-level, phased diploid genome assemblies of two widely used human fibroblast cell lines: BJ (46,XY) and IMR-90 (46,XX). Using Oxford Nanopore, PacBio HiFi, and Hi-C sequencing data, we generated assemblies spanning 5.9 and 6.0 Gbp with diploid quality values exceeding QV 60. To validate structural integrity, we developed KaryoScope, an alignment-free tool for generating computational karyograms from k-mer feature databases. We identify >50 000 structural variants relative to T2T-CHM13v2.0, the majority of which are heterozygous and cell-line-specific. Combining reference-based and de novo gene annotation, we uncover a previously unreported 1 Mbp homozygous duplication at the 16p11.2 locus in BJ, demonstrating that even karyotypically normal cell lines can harbor clinically relevant submicroscopic rearrangements. We show that mapping publicly available short-read, RNA-seq, and ChIP-seq data to sample-matched diploid assemblies substantially improves read alignment and enables haplotype phasing of 23%–28% of short reads. The BJ and IMR-90 assemblies and associated variant calls are publicly available as a resource for the research community.
Healthcare Resource Utilization and Costs for Patients With Eosinophilic Granulomatosis With Polyangiitis in the United States: A Retrospective Analysis of Health Insurance Claims Data
Dolin, Paul, Keogh, Karina A., Rowell, Jennifer, Edmonds, Chris, Kielar, Danuta, MEYERS, JULIANA, Nham, Tram , Chen, Stephanie , Rowell, Jennifer , Edmonds, Chris, Kielar, Danuta , Esterberg, Elizabeth J. , Chen, Stephanie

No container title available | April 27, 2026 | Volume: No volume available | Issue: No issue available | Pages: No page available

10.64898/2026.04.24.26351614 Get It

Abstract Purpose We evaluated healthcare resource utilization (HCRU) and costs in patients with eosinophilic granulomatosis with polyangiitis (EGPA). Methods Patients with newly diagnosed EGPA (2017–2021), ≥12 months’ pre-diagnosis health plan enrollment, and ≥1 inpatient or ≥2 outpatient claims with an EGPA diagnosis were included. Follow-up was from EGPA diagnosis until disenrollment or database end. HCRU and health insurer payment costs during follow-up were compared with those for matched cohorts of general insured patients without EGPA (comparison A) and without EGPA but with severe uncontrolled asthma (SUA; comparison B). Results In comparison A, all-cause HCRU was higher in the EGPA cohort (n = 213) versus matched patients (n = 779) for all clinical encounters/pharmacy claim types; annualized, mean total all-cause costs were 16-fold higher ($117,563/patient) versus matched patients ($7,520/patient). In comparison B, all-cause HCRU was higher for the EGPA cohort (n = 182) versus the matched SUA cohort (n = 640) for all clinical encounters/pharmacy claim types, with 5-fold higher mean total all-cause costs ($118,127/patient vs $22,286/patient). In both EGPA cohorts, HCRU and associated costs increased between the baseline and follow-up periods. Conclusions These findings highlight the need for more effective treatments to reduce the clinical and economic burden of EGPA.
AMCP Market Insights: Getting to the heart of hard-to-control hypertension in managed care
Flavin, Bridget, Wolff, Denise, Gandhi, Gaurang, Pourarsalan, Hiva, Rader, Florian, Richardson, T, Shannon, Michael, Spence, Stephanie, Wescott, Susan, Flavin, Bridget M., Gandhi, Gaurang, Rader, Florian , Richardson, Terry, Shannon, Michael H.

Journal of Managed Care & Specialty Pharmacy | April 27, 2026 | Volume: 32 | Issue: 5-a Suppl | Pages: S1-S10

10.18553/jmcp.2026.32.5-a.s1 | PMID 42044060 Get It

Postapproval Study for Brain-Responsive Neurostimulation for Drug-Resistant Focal Epilepsy
Eliashiv, Dawn , Rao, Vikram R. , Jobst, Barbara C. , Szaflarski, Jerzy P. , Rolston, John D., Kaye, Lesley , Bullinger, Katie L. , Dugan, Patricia , Burdette, David E. , Peters, Angela , Sheikh, Atif, Haas, Kevin F., Mnatsakanyan, Lilit , Bensalem‐Owen, Meriem, Study, for the RNS System PAS, Doherty, Michael J., Razavi, Babak, Fisher, Tiffany , Modur, Pradeep N., Constantino, Tawnya, Salanova, Vicenta , Taraschenko, Olga , Rivera‐Cruz, Angélica , Balabanov, Antoaneta, Aboumatar, Sami, Fried, Itzhak , Drees, Cornelia , Shin, Hae Won, Jaisani, Zeenat , Maciver, Stephanie , Patra, Sanjay , Chang, Edward F. , Gwinn, Ryder, Stoub, Travis , Crabtree, Tami , Seale, Cairn G. , McFadden, Sharon C. , Norman, Jacob F. , Johnson, Lise, Elisevich, Kort, Peng, Emory, Mazumder, Rajashi, Jennings, Tara, Esparza, Melissa Johnston, Harid, Nitish, Farooque, Pue , Hirsch, Lawrence, Gerrard, Jason, Wabulya, Angela , Riley, Kristen, Pati, Sandipan, Johnson, Jessica, Kirchoffer, Kaitlyn, Bamps, Yvan , Rolston, John D. , Rolston, John D , Kaye, Lesley C , Ganguly, Taneeta Mindy , Bullinger, Katie , Dugan, Patricia C , Burdette, David E , Peters, Angela Y , Sheikh, Atif , Haas, Kevin F , Nair, Dileep R , Mnatsakanyan, Lilit , Quraishi, Imran H , Bensalem-Owen, Meriem K , Doherty, Michael J , Razavi, Babak , Fisher, Tiffany L. , Skidmore, Christopher , Modur, Pradeep N , Constantino, Tawnya M , Cole, Andrew J , Taraschenko, Olga , Rivera-Cruz, Angelica , Wheless, James W , Tandon, Nitin , Balabanov, Antoaneta , Aboumatar, Sami , Fried, Itzhak , Drees, Cornelia , Shin, Hae Won , Jaisani, Zeenat , MacIver, Stephanie E , Patra, Sanjay E , Chang, Edward F , Willie, Jon T , Gwinn, Ryder , Stoub, Travis , Stern, John M , Crabtree, Tami , McFadden, Sharon C , Norman, Jacob F , Johnson, Lise , Morrell, Martha J , Jobst, Barbara , Rao, Vikram R , Ganguly, Taneeta M. , Nair, Dileep , Skidmore, Christopher , Cole, Andrew J. , Wheless, James W. , Tandon, Nitin , Gwinn, Ryder P. , Stern, John M. , Morrell, Martha J. , Pellinen, Jacob , Herlopian, Aline , Sivaraju, Adithya , Damisah, Eyiyemisi C. , Gerrard, Jason L. , Bentley, J. Nicole , Pati, Sandipan Bankim Behari

Neurology | April 24, 2026 | Volume: 106 | Issue: 9 | Pages: No page available

10.1212/wnl.0000000000214875 | PMID 42030518 Get It

A systematic review supporting the Endocrine Society clinical practice guidelines on central precocious puberty
Firwana, Mohammed , Ramachandran, Neha , Allababidi, Adel Kabbara , Billstein, Laura , Shah, Vishal P. , Bandi, Satya Sai Sri, Bagewadi, Shubhangi, Aldin, Sameh Taki, Basha, Ayla Shamsi , Nofal, Alaa Al , Roberts, Stephanie , Billstein, Laura E, Al Nofal, Alaa , Latronico, Ana Claudia , Roberts, Stephanie A , Murad, M Hassan , Firwana, Mohammed M , Bagewadi, Shubhangi , Prokop, Larry J. , Latronico, Ana Cláudia , Murad, M. Hassan

The Journal of Clinical Endocrinology & Metabolism | April 18, 2026 | Volume: 111 | Issue: 8 | Pages: 2145-2153

10.1210/clinem/dgag169 | PMID 42287191 Get It

Abstract Context Central precocious puberty (CPP). Objective To summarize the available supporting evidence for the Endocrine Society guidelines about the management of CPP. Methods Multiple databases (MEDLINE, EMBASE, Scopus) were searched to identify studies that addressed the Endocrine Society Guideline Development Panel's 10 clinical questions. Identified studies were selected and appraised, and data were extracted by pairs of independent trained reviewers. Results The systematic review yielded 3796 citations, of which 32 citations were included. The systematic review and meta-analysis demonstrate that in children with CPP, with no central nervous system symptoms, the rate of magnetic resonance imaging identification of pathogenic lesions (ie, hamartomas and brain tumors) was 6% (35 noncomparative studies with 5541 children with CPP). For girls with idiopathic CPP, gonadotropin-releasing hormone agonist (GnRHa) treatment was associated with +2.7 cm adult height gain compared to those who did not receive treatment (21 comparative observational studies with 1835 girls [mean age 8.20 ± 1.08 years]). The review did not identify any studies that assessed the clinical questions on: benefits of additional evaluation in cases of early thelarche, differentiation of slowly vs rapidly progressing CPP, order of biochemical testing to establish and monitor the diagnosis of CPP, genetic testing for individuals diagnosed with CPP, and chronological age and/or bone age for discontinuation of GnRHa treatment. Conclusion This systematic review addresses various aspects of CPP evaluation and treatment of CPP and will support the development of the Endocrine Society guidelines.
Abstract CT022: First data disclosure of the Phase I trial of the first in class combination of WEE1 inhibitor zedoresertib with PKMYT1 inhibitor lunresertib in patients with advanced solid tumors harboring CCNE1, FBXW7, or PPP2R1A genomic alterations
Yap, Timothy A., Aggarwal, Rahul, Carneiro, Benedito A. , Duska, Linda, LoRusso, Patricia, Lheureux, Stéphanie , Mathews, Cara, Weiss, Mia , Tymon-Rosario, Joan, Colón‐Otero, Gerardo , Garrido-Laguna, Ignacio, Lee, Elisabeth K., Wessen, Jonathan, Piggott, Luke, Dozio, Vito , Luong, Noemie, Yap, Timothy Anthony , Aggarwal, Rahul , Fontana, Elisa , Højgaard, Martin , LoRusso, Patricia , Yadav, Siddhartha , Mathews, Cara Amanda , Moy, Ryan H. , Lakhani, Nehal J. , Tymon‐Rosario, Joan , Garrido‐Laguna, Ignacio , Imedio, Esteban Rodrigo , Piggott, Luke , Mas, Christophe , Schram, Alison M.

Cancer Research | April 17, 2026 | Volume: 86 | Issue: 8_Supplement | Pages: CT022-CT022

10.1158/1538-7445.am2026-ct022 Get It

Abstract Background: Zedoresertib (zedo) and lunresertib (lunre) are oral, highly selective WEE1 and PKMYT1 inhibitors, respectively. Inhibition of these targets leads to premature mitotic entry, and in the presence of high replication stress causes mitotic catastrophe. In preclinical models, the combination of the zedo and lunre is synthetically lethal, supporting this first-in-class trial combination (NCT04855656). Methods: In this Phase 1 trial, patients (pts) with advanced solid tumors with CCNE1 amplification (amp), or FBXW7 or PPP2R1A deleterious mutations (mut) were treated with zedo (daily dosing) plus lunre (3 days on/4 days off), guided by preclinical modelling of the pharmacological contributions of WEE1 and PKMYT1 inhibition in achieving tumor regression. Objectives included safety, tolerability, recommended doses (RD), pharmacokinetics (PK), pharmacodynamics (PDy), antitumor activity and molecular response rate (MRR; ≥50% decline in circulating tumor DNA). Results: As of 18 Nov 2025, 54 pts (55.6% female ; prior lines of therapy 1 - 9, main cancer types: ovarian (OC) (35.2%), colorectal (31.5%), pancreatic (7.4%) and breast (5.6%)) were treated at 5 dose levels (DL) from 150 mg to 260 mg of zedo plus 60 mg or 80 mg of lunre. The most common ≥G3 treatment related adverse events (TRAEs) were anemia (9.3%), neutropenia (7.4%) and Palmar Plantar Erythrodysesthesia (PPE) (7.4%). There were no G5 TRAEs. 4 (9.3%) of 54 pts had a dose-limiting toxicity (G3 pain in extremity and G1 rash in same pt (zedo 150 mg / lunre 60 mg), G3 rash (200 mg / 80 mg), G3 PPE (260 mg / 60 mg), G3 vomiting (260 mg / 60 mg)). PK/PDy analyses showed dose-dependent exposures for both zedo and lunre and target engagement in most pts, with reductions in pCDK1 Thr14 and Tyr15 and yH2AX induction. 24 (55.5%) of 44 RECIST v1.1 evaluable pts showed tumor shrinkage (3 cCR, 5 uPR, 15 SD and 1 PD). Of 16 evaluable pts with advanced OC (12 platinum resistant , 2 unknown and 2 platinum sensitive) with CCNE1 amp (13 pts) or FBXW7 mut (3 pts), 13 (81.3%) showed tumor shrinkage (3 cCR, 3 uPR and 7 SD); clinical benefit rate (pts with CR, PR or SD) was 93.8%; 7 (43.8%) OC pts were on treatment for at least 16 weeks; 4 (25%) OC pts achieved GCIG CA-125 responses. Of 23 pts with a post baseline ctDNA analysis, a MRR of 39% was seen across all DLs. Conclusion: We report the first disclosure of clinical data of the first-in-field synthetic lethal combination of WEE1 and PKMYT1 inhibitors in a molecularly defined pt population. The safety profile of zedo and lunre was expected and manageable. Promising antitumor activity was observed in pts with CCNE1 amp or FBXW7 mut solid tumors, especially pts with OC. Further dose optimization of this combination is ongoing. Citation Format: Timothy A. Yap, Rahul Aggarwal, Elisa Fontana, Martin Hojgaard, Benedito A. Carneiro, Linda Duska, Patricia LoRusso, Siddhartha Yadav, Stephanie Lheureux, Cara Mathews, Ryan H. Moy, Nehal Lakhani, Mia Weiss, Joan Tymon-Rosario, Gerardo Colon-Otero, Ignacio Garrido-Laguna, Elisabeth K. Lee, Esteban Rodrigo Imedio, Jonathan Wessen, Luke Piggott, Vito Dozio, Noemie Luong, Christophe Mas, Alison M. Schram. First data disclosure of the Phase I trial of the first in class combination of WEE1 inhibitor zedoresertib with PKMYT1 inhibitor lunresertib in patients with advanced solid tumors harboring CCNE1, FBXW7, or PPP2R1A genomic alterations [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(8_Suppl):Abstract nr CT022.
Association of Tight Blood Pressure Control with PRES Prevention in Pediatric SCD Undergoing HSCT
Rao, Anandini , Miller, Holly, Salzberg, Dana, Beebe, Kristen , Adams, Roberta H. , Hsieh, Stephanie , Ngwube, Alexander, Miller, Holly, Hsieh, Stephanie, Ngwube, Alexander

Pediatric Hematology and Oncology | April 15, 2026 | Volume: 43 | Issue: 3-4 | Pages: 193-197

10.1080/08880018.2026.2659153 | PMID 41984572 Get It

Historical outcomes for patients with stage IA NLPHL: Global NLPHL One Working Group retrospective analyses
Flerlage, Jamie E. , Eichenauer, Dennis A. , Fuchs, Michael, Hartmann, Sylvia , Eich, Hans Theodor, Savage, Kerry J. , Skinnider, Brian, Akhtar, Saad , Steiner, R., Milgrom, Sarah A., Vega, Francisco, Alomari, Mohammed , Zhang, Xiaoyin , Collins, Graham P., Advani, Ranjana H, Kumar, Priyadarshini , Wirth, Andrew, Tsang, Richard, Smith, SD, Hendrickson, Peter G. , Hopkins, David, McKay, Pamela, Ng, Andrea K. , Koenig, Julie L. , Sakthivel, Gukan, Baron, Jonathan A, Roberts, Kenneth B. , Gao, Sarah, Alkendi, Jalila , Rahbi, Nasser Al, Balogh, Alexander George, Ricardi, Umberto, Sridhar, Akshay, Torka, Pallawi , Specht, Lena , Silva, Ravi De , Shah, Nimish, Osborne, Wendy , Henry, Michael, Chang, Isabela , Halperin, Daniel, Miall, Fiona , Brady, J.L. , Mikhaeel, G., Brennan, Bernadette , Penn, Anthony, Reeves, Marie, Terezakis, Stephanie A, Pepa, R Della, Picardi, Marco, Kirova, Youlia, Fergusson, Paige, Hawkes, Eliza A. , Lee, Denise , Ku, Matthew , Hamad, Nada, Mutsando, Howard , Tedjaseputra, Aditya , Gilbertson, Michael, Marconi, Tamara , Viiala, Nicholas , Palese, Monica , Kelly, Kara M, Borchmann, P, Hoppe, Richard T. , Advani, Ranjana H. , Hopkins, David , Baron, Jonathan , Vega, Francisco , Kumar, Priyadarshini , Dickinson, Michael , Smith, Sonali M , McKay, Pamela , Koenig, Julie , Casulo, Carla , Al Kendi, Jalila , Levis, Mario , Torka, Pallawi , Specht, Lena , De Silva, Ravindu , Pickard, Keir , Smith, Christine M , Brady, Jessica , Senchenko, Maria Anatolevna , Volchkov, Egor Vasilevich , Hoppe, Bradford S , Hawkes, Eliza , Lee, Denise , Doo, Nicole Wong , Barraclough, Allison , Cheah, Chan Yoon , Salvaris, Ross , Ku, Matthew , Hamad, Nada , Tedjaseputra, Aditya , Shankar, Ananth , Maurer, Matthew , Natkunam, Yasodha , Hoppe, Richard T , Binkley, Michael Sargent , Savage, Kerry J , Advani, Ranjana H , Hopkins, David , Baron, Jonathan , Eichenauer, Dennis A , Flerlage, Jamie E , Fuchs, Michael, Eich, Hans Theodor, Hodgson, David C. , Skinnider, Brian, Rauf, M. Shahzad , Maghfoor, Irfan , Pinnix, Chelsea C. , Alomari, Mohammed, Collins, Graham P. , Dickinson, Michael , Tsang, Richard , Prica, Anca A. , Major, Ajay , Kelsey, Chris R. , Constine, Louis S , Casulo, Carla , Plastaras, John Peter , Balogh, Alexander G., Levis, Mario , Ricardi, Umberto , Sridhar, Akshay, Shah, Nimish , Pickard, Keir , Blazin, Lindsay , Henry, Michael, Smith, Christine M. , Hoppe, Bradford S. , Talaulikar, Dipti , Pepa, Roberta Della , Picardi, Marco , Kirova, Youlia , Northend, Michael , Doo, Nicole Wong , Barraclough, Allison , Opat, Stephen , Cheah, Chan Y. , Hamad, Nada , Gilbertson, Michael , Maurer, Matthew J. , Natkunam, Yasodha , Kelly, Kara M. , Borchmann, Peter , Binkley, Michael S.

Blood Advances | April 14, 2026 | Volume: 10 | Issue: 15 | Pages: 5338-5347

10.1182/bloodadvances.2026020012 | PMID 41979337 Get It

Abstract We evaluated outcomes by management type for patients with stage IA nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) in the Global NLPHL One Working Group retrospective database of 2243 patients with stages I to IV disease diagnosed from 1992 to 2021 at 38 international institutions. A total of 779 patients had stage IA disease with median age of 35 years (range, 3-89) and median follow-up of 6.1 years. The 6-year progression-free survival (PFS) and overall survival were 86.3% and 97.7%, respectively. Outcomes were analyzed for the 2 groups: complete resection and unresected disease. Patients with a complete resection and observation alone (n = 99) had a 6-year PFS of 65.5% vs 90.5% for those who received radiotherapy (RT) (n = 53). Patients with unresected disease (n = 627; 80.5%) had a 6-year PFS of 62.0% for rituximab alone (n = 31), 89.6% for RT alone (n = 325), 76.8% for ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) alone (n = 40), and 94.3% for ABVD plus RT (n = 130). A total of 127 patients relapsed (16.3%), of which 25 (19.7%) had transformation. Our analysis suggests the following: (1) RT improves the PFS in patients with completely resected disease; (2) rituximab or ABVD alone does not appear to achieve a durable response; and (3) chemotherapy was not observed to add additional PFS benefit when used in combination with RT. Thus, for stage IA NLPHL, RT alone is likely sufficient for definitive treatment.
Central precocious puberty: an Endocrine Society clinical practice guideline
Latronico, Ana Cláudia , Roberts, Stephanie , Alonzo, Morgan , Argente, Jesús , Carel, Jean‐Claude , Cassorla, Fernando , Charmandari, Evangelia , Eugster, Erica A. , Greenspan, Louise C., Hawse, Elizabeth C, Juul, Anders , Kaplowitz, Paul B. , Murad, M Hassan, Walker, Vayana, Roberts, Stephanie A , Canton, Ana Pinheiro Machado , Carel, Jean-Claude , Cassorla, Fernando , Charmandari, Evangelia , Eugster, Erica A , Grandone, Anna , Juul, Anders , Kaplowitz, Paul B , Street, Maria E , McCartney, Christopher R , Latronico, Ana Claudia , Murad, M Hassan, McCartney, Christopher R.

The Journal of Clinical Endocrinology & Metabolism | April 14, 2026 | Volume: 111 | Issue: 8 | Pages: 2101-2144

10.1210/clinem/dgag168 | PMID 42287186 Get It

Abstract Background Central precocious puberty (CPP), which is traditionally defined as the development of secondary sexual characteristics before age 8 years in girls and age 9 years in boys, results from the premature activation of the hypothalamic–pituitary–gonadal (HPG) axis. CPP can be associated with short adult stature, adverse psychosocial outcomes, and increased cardiometabolic and cancer risks in adulthood. Gonadotropin-releasing hormone (GnRH) agonists can effectively suppress premature activation of the HPG axis and have the potential to increase adult height as well as improve psychosocial and long-term health outcomes among patients with CPP. However, as secular trends have continued to shift toward earlier age of pubertal onset, some subpopulations of children with CPP, as it is currently defined, may not require the same extent of diagnostic evaluation and treatment. Objective Develop evidence-based recommendations related to the diagnosis and treatment of CPP. Methods A multidisciplinary panel of clinical experts, along with experts in guideline methodology and systematic literature review, used the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach to address 10 clinical questions related to the diagnosis and treatment of CPP. Systematic reviews of health-related benefits and harms were conducted for each clinical question. The guideline development panel (GDP) also used the GRADE evidence-to-decision (EtD) framework to address stakeholder values and preferences, costs and required resources, cost-effectiveness, acceptability, feasibility, and potential impacts on health equity. Results In girls with thelarche (Tanner stage B2) between ages 7.0 and 8.0 years, the GDP suggests watchful waiting via periodic physical examinations (every 4-6 months) rather than immediately performing evaluation with laboratory testing or radiologic imaging. In addition, the GDP suggests that all girls with breast development (ie, Tanner stage B2) before age 7 years should first be observed for 4 to 6 months to differentiate unsustained or slowly progressive puberty vs rapidly progressive puberty. These recommendations are largely based on evidence that girls with slowly progressive puberty attain a normal adult height without treatment. When hormonal evaluation is performed to confirm central (GnRH-dependent) activation as the cause of precocious puberty, the GDP suggests starting the evaluation with ultrasensitive basal luteinizing hormone (LH) concentration rather than routine GnRH/GnRH agonist (GnRHa) stimulation testing for all patients. While brain magnetic resonance imaging has been a traditional part of CPP evaluation, the GDP suggests that it should not be routinely performed in girls ages 6.0 to 8.0 years and boys ages 8.0 to 9.0 years without central nervous system (eg, neuro-ophthalmologic) symptoms, largely based on a low prevalence of pathologic intracranial findings in these age groups. The GDP suggests against routine genetic testing for patients with CPP, although they judged that genetic testing (eg, MKRN3 sequencing) should be considered for patients with familial CPP through a shared decision-making process. The GDP suggests GnRHa treatment for many children with CPP, although available evidence suggests that some patient subgroups (eg, older girls with slowly progressive CPP) may be less likely to receive a net benefit with this treatment. Rather than always starting GnRHa treatment with a monthly injectable formulation, the GDP suggests that treatment should be initiated with the formulation (such as a longer-acting formulation) that is anticipated to be used long-term. The GDP suggests against routine addition of growth hormone therapy to increase adult height. They also suggest against the routine biochemical testing (eg, LH, sex steroids) to monitor pubertal suppression while receiving GnRHa, instead reserving biochemical testing to confirm clinically suspected treatment failure. Finally, the GDP suggests against routinely continuing GnRHa treatment beyond chronologic age 10.0 to 11.0 years (girls) or 11.0 to 12.0 years (boys) and/or bone age 11.0 to 12.0 years (girls) or 12.0 to 13.0 years (boys). Conclusion These clinical recommendations were developed to address important uncertainties in the diagnosis and treatment of children with CPP. They are based on the best available scientific evidence regarding clinical outcomes judged to be most important to patients and families. The GDP's overarching goal was to suggest diagnostic and therapeutic strategies that will most likely provide net clinical benefits while simultaneously considering important contextual factors such as cost and feasibility. The guideline-development process highlighted important knowledge gaps and the substantial need for additional research.