Zadik Zvi, Zelinska Nataliya, Iotova Violeta, Skorodok Yulia, Malievsky Oleg, Mauras Nelly, Valluri Srinivas Rao, Pastrak Aleksandra, Rosenfeld Ron
Pediatric Endocrinology, Kaplan Medical Center, Rehovot, Israel.
Ukrainian Scientific and Practical Center of Endocrine Surgery, Transplantation Endocrine Organs and Tissues of the Ministry of Health of Ukraine, Kyiv, Ukraine.
J Pediatr Endocrinol Metab. 2023 Feb 3;36(3):261-269. doi: 10.1515/jpem-2022-0359. Print 2023 Mar 28.
Somatrogon is a long-acting recombinant human growth hormone (GH) employed as a once-weekly treatment for children with GH deficiency (GHD). A 12-month, phase 2 study of once-weekly somatrogon vs. once-daily GH (Genotropin) was initiated, after which participants could enroll into an open-label extension (OLE) evaluating the safety and efficacy of long-term somatrogon treatment.
There were five study periods, Periods I and II were 6 months each while Periods III, IV, and V were 12 months each. In the main study (Periods I and II), 53 prepubertal children with GHD were randomized to once-weekly somatrogon (0.25, 0.48, or 0.66 mg/kg/week) or once-daily Genotropin (0.034 mg/kg/day); 48 continued into the OLE, consisting of Period III (original somatrogon dose; Genotropin recipients randomized to one of three somatrogon doses), Period IV (somatrogon 0.66 mg/kg/week), and Period V (prefilled somatrogon pen [0.66 mg/kg/week]).
At the end of Period III, the mean ± SD annual height velocity (HV) for 0.25, 0.48, and 0.66 mg/kg/week somatrogon groups was 7.73 ± 1.89, 7.54 ± 1.28, and 8.81 ± 1.12 cm/year, respectively; HV was sustained during Periods IV/V. Height SD scores (SDS) showed progressive improvement throughout the OLE, regardless of initial cohort assignment, approaching the normal range (-0.69 ± SD 0.87) at the end of Period V Year 1. Mild or moderate treatment-emergent adverse events were reported in 81.3% of participants, most unrelated to study drug.
Up to 5 years of once-weekly somatrogon was well tolerated and resulted in sustained improvement in height SDS and delta height SDS in prepubertal short children with GHD.
索马促生长素是一种长效重组人生长激素(GH),用于每周一次治疗生长激素缺乏症(GHD)儿童。开展了一项为期12个月的2期研究,比较每周一次索马促生长素与每日一次生长激素(健高宁)的疗效,之后参与者可进入开放标签扩展研究(OLE),评估索马促生长素长期治疗的安全性和有效性。
共有五个研究阶段,第一阶段和第二阶段各为期6个月,第三阶段、第四阶段和第五阶段各为期12个月。在主要研究阶段(第一阶段和第二阶段),53名青春期前GHD儿童被随机分为接受每周一次索马促生长素(0.25、0.48或0.66毫克/千克/周)或每日一次健高宁(0.034毫克/千克/天)治疗;48名儿童继续进入OLE研究阶段,包括第三阶段(原索马促生长素剂量;接受健高宁治疗的儿童随机分配至三种索马促生长素剂量之一)、第四阶段(索马促生长素0.66毫克/千克/周)和第五阶段(预填充索马促生长素笔[0.66毫克/千克/周])。
在第三阶段结束时,索马促生长素0.25毫克/千克/周组、0.48毫克/千克/周组和0.66毫克/千克/周组的平均±标准差年身高增长速度(HV)分别为7.73±1.89、7.54±1.28和8.81±1.12厘米/年;在第四/五阶段HV保持稳定。身高标准差评分(SDS)在整个OLE研究阶段均呈现逐步改善,无论最初所属队列如何,在第五阶段第1年末接近正常范围(-0.69±标准差0.87)。81.3%的参与者报告了轻度或中度治疗中出现的不良事件,大多数与研究药物无关。
对于青春期前患有GHD的矮小儿童,长达5年的每周一次索马促生长素治疗耐受性良好,身高SDS和身高SDS差值持续改善。