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从原研重组人生长激素(健豪宁®)转换为生物类似药(瑞思替®):一项为期 6 个月、多中心、非劣效性、扩展试验的结果。

Switching from originator recombinant growth hormone (Genotropin™) to biosimilar (CRISCY™): Results from a 6-month, multicentric, non-inferiority, extension trial.

机构信息

Serviço de Endocrinologia, Hospital de Clínicas de Porto Alegre, UFRGS, Porto Alegre, RS, Brazil.

CEDOES, Vitória, ES, Brazil.

出版信息

Growth Horm IGF Res. 2021 Feb;56:101372. doi: 10.1016/j.ghir.2020.101372. Epub 2020 Nov 28.

Abstract

OBJECTIVE

A previous 12-month comparative trial with Criscy™ (r-hGH Cristália), a biosimilar recombinant growth hormone, demonstrated equivalent efficacy and safety to Genotropin™. This extension trial evaluated the effects of switching patients treated with Genotropin™ to the biosimilar Criscy™ over an additional 6-month treatment period, comparing efficacy, safety, and immunogenicity parameters with patients remaining in the Criscy™ arm.

DESIGN

This extension study included 11 research centers and 81 patients who participated in the CERES study (Czepielewski et al., 2019 [1]). Participants from the Genotropin™ arm (n = 39) had the drug replaced by Criscy™ and the remaining participants were kept in the Criscy™ arm (n = 42) for an additional 6-month period to evaluate immunogenicity, efficacy (growth rate, height SDS), and safety (laboratory tests, and adverse events).

RESULTS

Before the switch, both Criscy™ and Genotropin groups were similar concerning demographics, and auxological measures: age, sex, height, height SDS, weight, and BMI. Height velocity (HV) after 18 months of treatment was 8.7 ± 1.56 cm/year for Criscy™ group and 8.9 ± 1.36 cm/year for Genotropin™ group in the ITT population (p = 0.43). The auxological parameters and IGF-1 and IGFBP-3 SDS were comparable between both groups of patients. No participants were excluded from the study due to adverse events. There were no clinical or statistical relevant differences between the treatment groups concerning frequency, distribution, intensity, and AEs outcome. Similarly, no new anti-r-hGH (ADA) cases among patients that switched from Genotropin™ to Criscy™ were reported. No neutralizing antibody (nAb) was detected in either group.

CONCLUSIONS

This trial showed that switching from originator recombinant human growth hormone to Criscy™ had no impact on efficacy, safety, nor immunogenicity as compared to continued treatment with Criscy™. Growth rates and ADA incidence remained the same as seen before the switch.

摘要

目的

先前一项为期 12 个月的 Criscy(r-hGH Cristália)与 GenotropinTM 的比较试验显示,两者具有等效的疗效和安全性。本扩展试验评估了将接受 GenotropinTM 治疗的患者转换为生物类似药 CriscyTM 后的额外 6 个月治疗期间的效果,比较了疗效、安全性和免疫原性参数与继续使用 CriscyTM 的患者。

设计

本扩展研究包括 11 个研究中心和 81 名患者,他们参加了 CERES 研究(Czepielewski 等人,2019 [1])。来自 GenotropinTM 组(n=39)的患者用 CriscyTM 替代药物,其余患者继续留在 CriscyTM 组(n=42)进行额外的 6 个月评估免疫原性、疗效(生长速度、身高 SDS)和安全性(实验室检查和不良事件)。

结果

在转换之前,CriscyTM 和 Genotropin 组在人口统计学和生长学测量方面相似:年龄、性别、身高、身高 SDS、体重和 BMI。接受治疗 18 个月后的身高速度(HV)在 ITT 人群中 CriscyTM 组为 8.7±1.56cm/年,GenotropinTM 组为 8.9±1.36cm/年(p=0.43)。两组患者的生长学参数和 IGF-1 和 IGFBP-3 SDS 相似。由于不良事件,没有患者被排除在研究之外。治疗组之间在频率、分布、强度和不良事件结果方面没有临床或统计学上的显著差异。同样,在从 GenotropinTM 转换为 CriscyTM 的患者中,没有报告新的抗 r-hGH(ADA)病例。在任何一组中都没有检测到中和抗体(nAb)。

结论

这项试验表明,与继续使用 CriscyTM 相比,从原始重组人生长激素转换为 CriscyTM 对疗效、安全性或免疫原性没有影响。生长速度和 ADA 发生率与转换前相同。

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