Romer T, Peter F, Saenger P, Starzyk J, Koehler B, Korman E, Walczak M, Wasik R, Ginalska-Malinowska M, Solyom E, Berghout A
Department of Endocrinology, Children's Memorial Health Institute, Warsaw, Poland.
J Endocrinol Invest. 2007 Jul-Aug;30(7):578-89. doi: 10.1007/BF03346352.
We report 24-month interim results of two multicenter phase III studies in previously untreated children with growth failure secondary to GH deficiency (GHD) that were paramount to the development of a new recombinant human GH (rh- GH, somatropin), approved as the first 'biosimilar' in Europe. Study 1 consisted of 3 parts performed in 89 children. The objective was to compare efficacy and safety of the lyophilized formulation of the new somatropin [Somatropin Powder (Sandoz)] with a licensed reference rhGH preparation and the liquid formulation of the new somatropin [Somatropin Solution (Sandoz)] and to assess long-term efficacy and safety of this ready-to-use Somatropin Solution. Study 2 was performed in 51 children and designed to demonstrate efficacy and safety of Somatropin Powder and to confirm its low immunogenic potential; rhGH was given sc at a daily dose of 0.03 mg/kg. Primary [body height, height SD score (HSDS), height velocity, and height velocity (HV) SD score (HVSDS)] and secondary [IGF-I and IGF binding protein 3 (IGFBP-3)] efficacy endpoints and safety parameters were assessed regularly. In study 1, all treatments showed comparable increases in growth. The baseline-adjusted difference between Somatropin Powder and the reference rhGH product in mean HV was -0.20 cm/yr (95% confidence interval (CI) [-1.34;0.94]) and in mean HVSDS was 0.76 (95% CI [-0.57;2.10]) after 9 months. These very small differences demonstrate comparable therapeutic efficacy between the two treatments. The results of study 2 were consistent with those seen in study 1. Equivalent therapeutic efficacy and clinical comparability in terms of safety and immunogenicity between Somatropin Powder and the reference rhGH product and between Somatropin Powder and Somatropin Solution was demonstrated. The safety and immunogenicity profiles were similar and as expected from experience with rhGH preparations.
我们报告了两项多中心III期研究的24个月中期结果,这些研究针对既往未经治疗、因生长激素缺乏(GHD)导致生长障碍的儿童,这对一种新型重组人生长激素(rh-GH,生长激素)的研发至关重要,该生长激素在欧洲被批准为首个“生物类似药”。研究1由在89名儿童中开展的3部分组成。目的是比较新型生长激素冻干制剂[生长激素粉(山德士)]与已获许可的对照rhGH制剂以及新型生长激素液体制剂[生长激素溶液(山德士)]的疗效和安全性,并评估这种即用型生长激素溶液的长期疗效和安全性。研究2在51名儿童中进行,旨在证明生长激素粉的疗效和安全性,并确认其低免疫原性;rhGH皮下注射,每日剂量为0.03mg/kg。定期评估主要疗效终点[身高、身高标准差评分(HSDS)、身高增长速度和身高增长速度标准差评分(HVSDS)]以及次要疗效终点[胰岛素样生长因子-I(IGF-I)和胰岛素样生长因子结合蛋白3(IGFBP-3)]和安全性参数。在研究1中,所有治疗组的生长均有可比的增加。9个月后,生长激素粉与对照rhGH产品在平均身高增长速度方面的基线调整差异为-0.20cm/年(95%置信区间(CI)[-1.34;0.94]),在平均HVSDS方面为0.76(95%CI[-0.57;2.10])。这些非常小的差异表明两种治疗具有可比的治疗效果。研究2的结果与研究1一致。证明了生长激素粉与对照rhGH产品之间以及生长激素粉与生长激素溶液之间在疗效、安全性和免疫原性方面具有等效的治疗效果和临床可比性。安全性和免疫原性概况相似,与rhGH制剂的经验预期一致。