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新型生长激素缓释制剂LB03002在生长激素缺乏症儿童中的药代动力学和药效学特征

Pharmacokinetic and pharmacodynamic profile of a new sustained-release GH formulation, LB03002, in children with GH deficiency.

作者信息

Peter Ferenc, Savoy Conrad, Ji Hyi-Jeong, Juhasz Mihaly, Bidlingmaier Martin, Saenger Paul

机构信息

Buda Children's Hospital, Budapest, Hungary BioPartners GmbH, Baar, Switzerland.

出版信息

Eur J Endocrinol. 2009 Mar;160(3):349-55. doi: 10.1530/EJE-08-0703. Epub 2008 Dec 12.

Abstract

OBJECTIVE

LB03002 is a novel, sustained-release recombinant human GH, developed for once-a-week s.c. injection. To evaluate the suitability for long-term GH replacement therapy in children with GH deficiency (GHD), the present study assessed the pharmacokinetic (PK) and pharmacodynamic (PD) profiles of LB03002 at three doses.

STUDY DESIGN AND PATIENTS

The randomised, comparator-controlled, assessor-blinded, phase II study assessed 37 (24 boys, 13 girls) pre-pubertal, GH-naïve children with GHD, in 11 European centres, for PK and PD analyses. GH, IGF1 and IGFBP3 concentrations were measured following the last daily GH dose and the first and 13th once-a-week administration of LB03002 at doses of 0.2, 0.5 or 0.7 mg/kg.

RESULTS

GH C(max) values after the three doses of LB03002 were increased up to fourfold, with a clear dose proportionality. For each LB03002 dose, GH area under the concentration versus time curve did not increase from the first to 13th (month 3) administration, indicating no accumulation of circulating GH. IGF1 C(max) showed a progressive increase during LB03002 administration. Conversely, IGFBP3 showed a rapid increase in C(max). IGF1 SDS were fully normalised after 3 months of treatment, whereas IGFBP3 SDS were already in the normal range for all the three LB03002 dosages after 1 week.

CONCLUSIONS

At the doses used, LB03002 has a suitable profile for long-term treatment to promote growth in children with GHD. The quantitative changes in IGF1 and IGFBP3 indicate adequate stimulation of the IGF system by LB03002 and the pattern of increase is comparable with that seen in GHD children in a standard IGF1 generation test using daily GH.

摘要

目的

LB03002是一种新型的长效重组人生长激素,设计用于每周一次皮下注射。为评估其在生长激素缺乏症(GHD)儿童中长期生长激素替代治疗的适用性,本研究评估了三种剂量的LB03002的药代动力学(PK)和药效学(PD)特征。

研究设计与患者

这项随机、对照、评估者盲法的II期研究在11个欧洲中心对37名(24名男孩,13名女孩)青春期前、未接受过生长激素治疗的GHD儿童进行了PK和PD分析。在末次每日生长激素剂量后以及首次和第13次每周一次给予0.2、0.5或0.7mg/kg剂量的LB03002后,测量生长激素、胰岛素样生长因子1(IGF1)和胰岛素样生长因子结合蛋白3(IGFBP3)的浓度。

结果

三种剂量的LB03002给药后的生长激素C(max)值增加了四倍,具有明显的剂量相关性。对于每种LB03002剂量,从首次给药到第13次(第3个月)给药,生长激素浓度-时间曲线下面积没有增加,表明循环生长激素没有蓄积。在给予LB03002期间,IGF1 C(max)呈逐渐增加趋势。相反,IGFBP3的C(max)迅速增加。治疗3个月后,IGF1标准差评分(SDS)完全恢复正常,而对于所有三种LB03002剂量,IGFBP3 SDS在1周后即已处于正常范围内。

结论

在所使用的剂量下,LB03002具有适合长期治疗以促进GHD儿童生长的特征。IGF1和IGFBP3的定量变化表明LB03002对IGF系统有充分的刺激作用,其增加模式与在标准每日生长激素治疗的IGF1生成试验中GHD儿童的情况相当。

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