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生长激素缺乏症儿童从每日注射生长激素转换为每周注射洛那普索生长激素:fliGHt试验

Switching to Weekly Lonapegsomatropin from Daily Somatropin in Children with Growth Hormone Deficiency: The fliGHt Trial.

作者信息

Maniatis Aristides K, Nadgir Ulhas, Saenger Paul, Reifschneider Kent L, Abuzzahab Jennifer, Deeb Larry, Fox Larry A, Woods Katie A, Song Wenjie, Mao Meng, Chessler Steven D, Komirenko Allison S, Shu Aimee D, Casella Samuel J, Thornton Paul S

机构信息

Rocky Mountain Pediatric Endocrinology, Centennial, Colorado, USA.

Center of Excellence in Diabetes and Endocrinology, Sacramento, California, USA.

出版信息

Horm Res Paediatr. 2022;95(3):233-243. doi: 10.1159/000524003. Epub 2022 Mar 9.

Abstract

INTRODUCTION

The phase 3 fliGHt Trial evaluated the safety and tolerability of once-weekly lonapegsomatropin, a long-acting prodrug, in children with growth hormone deficiency (GHD) who switched from daily somatropin therapy to lonapegsomatropin.

METHODS

This multicenter, open-label, 26-week phase 3 trial took place at 28 sites across 4 countries (Australia, Canada, New Zealand, and the USA). The trial enrolled 146 children with GHD, 143 of which were previously treated with daily somatropin. All subjects received once-weekly lonapegsomatropin 0.24 mg human growth hormone/kg/week. The primary outcome measure was safety and tolerability of lonapegsomatropin over 26 weeks. Secondary outcome measures assessed annualized height velocity (AHV), height standard deviation score (SDS), and IGF-1 SDS at 26 weeks.

RESULTS

Subjects had a mean prior daily somatropin dose of 0.29 mg/kg/week. Treatment-emergent adverse events (AEs) reported were similar to the published AE profile of daily somatropin therapies. After switching to lonapegsomatropin, the least-squares mean (LSM) AHV was 8.7 cm/year (95% CI: 8.2, 9.2) at Week 26 and LSM height SDS changed from baseline to Week 26 of +0.25 (95% CI: 0.21, 0.29). Among switch subjects, the LSM for average IGF-1 SDS was sustained at Weeks 13 and 26, representing an approximate 0.7 increase from baseline (prior to switching from daily somatropin therapy). Patient-reported outcomes indicated a preference for weekly lonapegsomatropin among both children and their parents.

CONCLUSIONS

Lonapegsomatropin treatment outcomes were as expected across a range of ages and treatment experiences. Switching to lonapegsomatropin resulted in a similar AE profile to daily somatropin therapy.

摘要

引言

3期飞行试验评估了长效前体药物每周一次罗奈普索马促生长素在从每日生长激素治疗转换为罗奈普索马促生长素治疗的生长激素缺乏症(GHD)儿童中的安全性和耐受性。

方法

这项多中心、开放标签、为期26周的3期试验在4个国家(澳大利亚、加拿大、新西兰和美国)的28个地点进行。该试验招募了146名生长激素缺乏症儿童,其中143名之前接受过每日生长激素治疗。所有受试者接受每周一次的罗奈普索马促生长素,剂量为0.24毫克人生长激素/千克/周。主要结局指标是罗奈普索马促生长素在26周内的安全性和耐受性。次要结局指标评估了26周时的年化身高增长速度(AHV)、身高标准差评分(SDS)和IGF-1 SDS。

结果

受试者之前每日生长激素的平均剂量为0.29毫克/千克/周。报告的治疗中出现的不良事件(AE)与已发表的每日生长激素治疗的不良事件概况相似。转换为罗奈普索马促生长素后,第26周时的最小二乘均值(LSM)AHV为8.7厘米/年(95%置信区间:8.2,9.2),LSM身高SDS从基线到第26周变化了+0.25(95%置信区间:0.21,0.29)。在转换治疗的受试者中,平均IGF-1 SDS的LSM在第13周和第26周保持稳定,比基线(从每日生长激素治疗转换前)增加了约0.7。患者报告的结果表明,儿童及其父母都更倾向于每周一次的罗奈普索马促生长素。

结论

在一系列年龄和治疗经历中,罗奈普索马促生长素的治疗结果符合预期。转换为罗奈普索马促生长素后的不良事件概况与每日生长激素治疗相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdb1/9501775/4c5e08469028/hrp-0095-0233-g01.jpg

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