{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T12:39:23Z","timestamp":1786711163069,"version":"build-2736575974"},"reference-count":27,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009399","name":"Peking University Third Hospital","doi-asserted-by":"publisher","award":["BYSYZD2022016"],"award-info":[{"award-number":["BYSYZD2022016"]}],"id":[{"id":"10.13039\/501100009399","id-type":"DOI","asserted-by":"publisher"}]},{"award":["BYSYZD2022016"],"award-info":[{"award-number":["BYSYZD2022016"]}],"id":[{"id":"https:\/\/ror.org\/04wwqze12","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Beijing Integrative Medicine Association","award":["2025-3361"],"award-info":[{"award-number":["2025-3361"]}]},{"name":"National Institute of Hospital Administration, National Health Commission of China","award":["NIHAYS2412"],"award-info":[{"award-number":["NIHAYS2412"]}]},{"award":["NIHAYS2412"],"award-info":[{"award-number":["NIHAYS2412"]}],"id":[{"id":"https:\/\/ror.org\/00xdrzy17","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objectives: The therapeutic window for growth hormone (GH) therapy in late-pubertal males with advanced bone age (BA \u2265 15 years) is generally considered closed. Yet, open knee physes may indicate residual growth potential. This single-arm retrospective study evaluated the efficacy and safety of letrozole combined with GH in Chinese males with short stature, advanced BA (15 \u2013&lt; 18 years), and open knee physes. Methods: We included 139 male adolescents stratified by baseline BA: 15 \u2264 BA &lt; 16 (n = 24), 16 \u2264 BA &lt; 17 (n = 31), and 17 \u2264 BA &lt; 18 (n = 84). All received subcutaneous GH (0.05\u20130.07 mg\/kg\/day) and oral letrozole (2.5 mg\/day). The primary outcome was the change in final adult height (FAH) from baseline predicted adult height (PAH). Longitudinal changes in height velocity and height SDS-BA were also assessed. Results: Among 75 patients who reached FAH, combination therapy was associated with a mean gain of 6.58 \u00b1 3.46 cm over baseline PAH (p &lt; 0.001). The gain was inversely correlated with baseline BA; the largest gain occurred in the 15 \u2264 BA &lt; 16 subgroup (10.04 \u00b1 4.66 cm), significantly exceeding gains in the 16 \u2264 BA &lt; 17 (6.30 \u00b1 3.01 cm) and 17 \u2264 BA &lt; 18 (5.70 \u00b1 2.52 cm) subgroups (p &lt; 0.001). In the youngest subgroup, FAH exceeded mid-parental height. The safety profile was acceptable; acne was the most common adverse event (46.76%), and no severe metabolic or endocrine disorders were observed. Conclusions: Letrozole plus GH therapy may be associated with improved FAH in late-pubertal males with advanced BA and open knee physes, with gains varying by baseline skeletal maturity and being numerically greatest in those with BA 15 \u2013&lt; 16 years. Knee epiphyseal status may be a useful consideration when individualizing therapy in this population.<\/jats:p>","DOI":"10.3390\/children13081077","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T11:57:46Z","timestamp":1786708666000},"page":"1077","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Combined Letrozole and Growth Hormone Therapy in Late-Pubertal Males with Advanced Bone Age and Open Knee Physes"],"prefix":"10.3390","volume":"13","author":[{"given":"Hui","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Peking University Third Hospital, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1208-8217","authenticated-orcid":false,"given":"Pengxiang","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China"},{"name":"Institute for Drug Evaluation, Peking University Health Science Center, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunpu","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Peking University Third Hospital, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuemei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Peking University Third Hospital, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiqiang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Peking University Third Hospital, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinfang","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Peking University Third Hospital, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"Zhang","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Research Center, Peking University Third Hospital, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongsheng","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China"},{"name":"Institute for Drug Evaluation, Peking University Health Science Center, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tongyan","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Peking University Third Hospital, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinli","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Peking University Third Hospital, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Wang, W., Wang, Y., Xiao, Y., Cao, N., and Wang, Y. 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