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长效 FC 融合 rhGH(GX-H9)在 GH 缺乏症成人中具有每两月给药一次的潜力。

Long-acting FC-fusion rhGH (GX-H9) shows potential for up to twice-monthly administration in GH-deficient adults.

机构信息

Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.

Aix-Marseille Université, INSERM U1251, Marseille Medical Genetics, and AP-HM, Hôpital Conception, Marseille, France.

出版信息

Eur J Endocrinol. 2018 Sep;179(3):169-179. doi: 10.1530/EJE-18-0185. Epub 2018 Jul 4.

Abstract

OBJECTIVE

Hybrid Fc-fused rhGH (GX-H9) is a long-acting recombinant human growth hormone (GH) under clinical development for both adults and children with GH deficiency (GHD). We compared the safety, pharmacokinetics and pharmacodynamics of weekly and every other week (EOW) dosages of GX-H9 with those of daily GH administration in adult GHD (AGHD) patients.

DESIGN

This was a randomized, open-label, active-controlled and dose-escalation study conducted in 16 endocrinology centers in Europe and Korea.

METHODS

Forty-five AGHD patients with or without prior GH treatment were enrolled. Patients with prior GH treatments were required to have received the last GH administration at least 1 month prior to randomization. Subjects were sequentially assigned to treatment groups. Fifteen subjects were enrolled to each treatment group and randomly assigned to receive either GX-H9 or Genotropin (4:1 ratio). GX-H9 dosage regimens for Groups 1, 2 and 3 were 0.1 mg/kg weekly, 0.3 mg/kg EOW and 0.2 mg/kg EOW, respectively. All Genotropin-assigned subjects received 6 µg/kg Genotropin, regardless of treatment group. Main outcome analyses included measurements of serum insulin-like growth factor 1 (IGF-I), safety, pharmacokinetics, pharmacodynamics and immunogenicity.

RESULTS

Mean GX-H9 peak and total exposure increased with an increase in dose after a single-dose administration. The mean IGF-I response was sustained above baseline over the intended dose interval of 168 h for the weekly and 336 h for the EOW GX-H9 groups. Safety profiles and immunogenicity were not different across the treatment groups and with Genotropin.

CONCLUSIONS

GX-H9 has the potential for up to twice-monthly administration.

摘要

目的

正在临床开发中的融合 Fc 的长效重组人生长激素(GH)(GX-H9)适用于成人和儿童生长激素缺乏症(GHD)患者。我们比较了每周和每两周(EOW)剂量 GX-H9 与每日 GH 治疗成人 GHD(AGHD)患者的安全性、药代动力学和药效学。

设计

这是一项在欧洲和韩国的 16 个内分泌学中心进行的、随机、开放标签、阳性对照和剂量递增研究。

方法

共纳入 45 例有或无既往 GH 治疗的 AGHD 患者。有既往 GH 治疗的患者需要在随机分组前至少 1 个月最后一次接受 GH 治疗。受试者按顺序分组。每组 15 例,随机接受 GX-H9 或 Genotropin(4:1 比例)治疗。第 1、2 和 3 组 GX-H9 的剂量方案分别为每周 0.1mg/kg、EOW 0.3mg/kg 和 EOW 0.2mg/kg。所有接受 Genotropin 治疗的患者,不论治疗组如何,均给予 6μg/kg Genotropin。主要疗效分析包括血清胰岛素样生长因子 1(IGF-1)、安全性、药代动力学、药效学和免疫原性的测量。

结果

单次给药后,单次剂量给药时,GX-H9 的平均峰值和总暴露量随剂量增加而增加。每周和 EOW GX-H9 组的 IGF-I 反应均在 168 小时和 336 小时的预期给药间隔内持续高于基线。各治疗组间安全性概况和免疫原性无差异,且与 Genotropin 相比亦无差异。

结论

GX-H9 具有每两月给药一次的潜力。

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