Use of anabolic agents in treatment of short children.

As indicated in previous sections of this review, all anabolic steroids produce acceleration in linear growth in children with short stature. However, the rapid masculinization induced by testosterone and other anabolic steroids and especially the disproportionately rapid epiphyseal maturation produced by these compounds have brought this form of therapy for short stature into disrepute. Not all investigators concur that testosterone therapy inevitably results in reduction of eventual adult height attainment and, depending on the age of onset of therapy and the dose employed, it has been reported that adult height attainment equals or exceeds the adult height prediction at the time of instituting therapy. Attempts to synthesize anabolic steroids with improved anabolic/androgenic ratios have been continuing for many years. Among currently available anabolic steroids it appears that the best separation of anabolic and androgenic properties has been attained with oxandrolone. This is reflected by the fact that most recent studies of growth promotion by anabolic steroids have employed this compound. From the results of these studies, it appears that doses of this drug capable of significant stimulation of growth generally do not cause excessive masculinization or unacceptably rapid acceleration of epiphyseal maturation and do not compromise eventual height attainment. Certain studies mentioned above suggest that it might be possible to devise therapeutic programmes employing other anabolic steroids which would produce equally satisfactory results. However, because of the more favourable anabolic/androgenic ratio of oxandrolone it seems likely that the increasing trend toward use of this drug for growth promotion will continue.