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长效聚乙二醇化重组人生长激素(金赛增)用于生长激素缺乏症儿童:II期和III期多中心随机研究

Long-acting PEGylated recombinant human growth hormone (Jintrolong) for children with growth hormone deficiency: phase II and phase III multicenter, randomized studies.

作者信息

Luo Xiaoping, Hou Ling, Liang Li, Dong Guanping, Shen Shuixian, Zhao Zhuhui, Gong Chun Xiu, Li Yuchuan, Du Min-Lian, Su Zhe, Du Hongwei, Yan Chaoying

机构信息

Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

Department of Endocrinology, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.

出版信息

Eur J Endocrinol. 2017 Aug;177(2):195-205. doi: 10.1530/EJE-16-0905. Epub 2017 May 31.

Abstract

OBJECTIVE

We assessed the efficacy and safety of a weekly pegylated human growth hormone (PEG-rhGH) (Jintrolong) vs daily rhGH for children with growth hormone deficiency (GHD).

DESIGN

Phase II and III, multicenter, open-label, randomized controlled trials.

METHODS

108 and 343 children with treatment-naive GHD from 6 hospitals in China were enrolled in the phase II and III studies respectively. Patients in the phase II study were randomized 1:1:1 to weekly Jintrolong (0.1 mg/kg/week PEG-rhGH complex), weekly Jintrolong (0.2 mg/kg/week PEG-rhGH complex) or daily rhGH (0.25 mg/kg/week) for 25 weeks. Patients in the phase III study were randomized in a 2:1 ratio to weekly Jintrolong (0.2 mg/kg/week) or daily rhGH (0.25 mg/kg/week) for 25 weeks. The primary endpoint for both studies was height velocity (HV) increase at the end of treatment. Other growth-related parameters, safety and compliance were also monitored.

RESULTS

The phase II study established the preliminary efficacy, safety and recommended dose of Jintrolong PEG-rhGH. In the phase III study, we demonstrated significantly greater HV increases in patients receiving Jintrolong treatment (from 2.26 ± 0.87 cm/year to 13.41 ± 3.72 cm/year) vs daily rhGH (from 2.25 ± 0.82 cm/year to 12.55 ± 2.99 cm/year) at the end of treatment ( < 0.05). Additionally, significantly greater improvement in the height standard deviation scores was associated with Jintrolong throughout the treatment ( < 0.05). Adverse event rates and treatment compliance were comparable between the two groups.

CONCLUSION

Jintrolong PEG-rhGH at a dose of 0.2 mg/kg/week for 25 weeks is effective and safe for GHD treatment and is non-inferior to daily rhGH.

摘要

目的

我们评估了每周一次聚乙二醇化人生长激素(PEG-rhGH)(金赛增)与每日一次重组人生长激素(rhGH)治疗生长激素缺乏症(GHD)儿童的疗效和安全性。

设计

II期和III期多中心、开放标签、随机对照试验。

方法

来自中国6家医院的108例和343例初治GHD儿童分别纳入II期和III期研究。II期研究的患者按1:1:1随机分为三组,分别接受每周一次金赛增(0.1mg/kg/周PEG-rhGH复合物)、每周一次金赛增(0.2mg/kg/周PEG-rhGH复合物)或每日一次rhGH(0.25mg/kg/周)治疗25周。III期研究的患者按2:1的比例随机分为两组,分别接受每周一次金赛增(0.2mg/kg/周)或每日一次rhGH(0.25mg/kg/周)治疗25周。两项研究的主要终点均为治疗结束时的身高增长速度(HV)。还监测了其他与生长相关的参数、安全性和依从性。

结果

II期研究确立了金赛增PEG-rhGH的初步疗效、安全性和推荐剂量。在III期研究中,我们证明,治疗结束时,接受金赛增治疗的患者(从2.26±0.87cm/年增至13.41±3.72cm/年)的HV增长显著高于每日一次rhGH治疗的患者(从2.25±0.82cm/年增至12.55±2.99cm/年)(P<0.05)。此外,在整个治疗过程中,金赛增组的身高标准差得分改善也显著更大(P<0.05)。两组的不良事件发生率和治疗依从性相当。

结论

每周一次剂量为0.2mg/kg、持续25周的金赛增PEG-rhGH治疗GHD有效且安全,且不劣于每日一次rhGH。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7adf/5488390/97766184b843/eje-177-195-g001.jpg

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