To investigate the efficacy and safety of aromatase inhibitors (AI) combined with recombinant human growth hormone (r-hGH) in improving the final height (FH) of boys in late puberty.

Clinical data of pubertal boys with growth deceleration, consecutively admitted to the Department of Child Growth and Development, Zhangzhou Affiliated Hospital of Fujian Medical University between February 2017 and December 2022, were collected. According to different treatment regimens, the patients were divided into the GH group, the AI+GH group, and the control group. The GH group received r-hGH monotherapy[dose 0.18-0.2 U/(kg·d)] until the growth velocity was less than 0.5 cm/3 months. The AI+GH group received anastrozole 1 mg/d or letrozole 2.5 mg/d combined with r-hGH[dose 0.18-0.2 U/(kg·d)]; AI was discontinued after 1 year, while r-hGH was continued until the growth velocity was less than 0.5 cm/3 months. The control group did not receive any height-promoting drugs. All patients were followed up outpatient every 3 months until FH was reached, monitoring growth development indicators and adverse reactions. The efficacy and safety were compared between the GH group and the AI+GH group.

A total of 69 pubertal boys meeting the inclusion and exclusion criteria were enrolled, including 28 in the GH group, 17 in the AI+GH group, and 24 in the control group. There were no statistically significant differences among the three groups in terms of height, bone age, height standard deviation score for bone age (HtSDS_BA), target height (TH), and predicted adult height for bone age (PAH_BA) (all P > 0.05). All 69 cases were followed up to FH. The FH was (165.54±2.06)cm in the GH group, with FH-PAH_BA being (3.45±1.20)cm; the FH was (167.57±2.20)cm in the AI+GH group, with FH-PAH_BA being (5.60±1.32)cm; and the FH was (163.78±2.63)cm in the control group, with FH-PAH_BA being (1.49±2.57)cm. The differences in FH and FH-PAH_BA among the three groups were statistically significant (all P < 0.05). Compared with the other two groups, the AI+GH group resulted in better improvement of FH(both P < 0.001). Regarding adverse reactions, the incidence in the AI+GH group was higher than that in the GH group (P < 0.001), primarily manifested as weight gain.

Combination therapy with AI and r-hGH can effectively improve the FH of boys in late puberty, but adverse reactions require close monitoring during treatment.