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普拉德-威利综合征患儿的生长激素治疗:来自PATRO儿童研究的安全性和有效性数据。

Growth hormone treatment in children with Prader-Willi syndrome: safety and effectiveness data from the PATRO Children study.

作者信息

Lämmer Constanze, Backeljauw Philippe, Tauber Maite, Kanumakala Shankar, Loche Sandro, Otfried Schwab Karl, Pfäffle Roland, Höybye Charlotte, Lundberg Elena, Dahlgren Jovanna, Ek Anna E, Battelino Tadej, Kriström Berit, Esmael Altaher, Zabransky Markus

机构信息

Department of Pediatrics, KJF Josefinum, Joseph-Mayer-Straße 1, Augsburg 86154, Germany.

Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.

出版信息

Ther Adv Endocrinol Metab. 2024 Sep 29;15:20420188241264343. doi: 10.1177/20420188241264343. eCollection 2024.

Abstract

BACKGROUND

Recombinant human growth hormone (rhGH, somatropin) therapy is approved in children with Prader-Willi syndrome (PWS).

OBJECTIVES

To report safety and effectiveness data for children with PWS treated with biosimilar rhGH (Omnitrope, Sandoz) in the PAtients TReated with Omnitrope (PATRO) Children study.

DESIGN

PATRO Children was a multicenter, non-interventional, postmarketing surveillance study.

METHODS

Children with PWS received Omnitrope according to standard clinical practice. Adverse events (AEs) were monitored for the duration of Omnitrope treatment. Effectiveness outcomes were also assessed, including height standard deviation (SD) scores (HSDS).

RESULTS

As of July 2020 (study completion), 235 patients with PWS had been enrolled. At baseline, 95.7% ( = 225) of patients were prepubertal and 86.4% ( = 203) were rhGH treatment-naïve. At analysis, the median (range) treatment duration in the study was 56.8 (2.9-155.8) months. AEs were reported in 192 patients (81.7%) and were suspected as treatment-related in 39 patients (16.6%). Serious AEs (SAEs) were reported in 96 patients (40.9%) and were suspected as treatment-related in 22 patients (9.4%). The most frequent treatment-related SAEs were sleep apnea syndrome ( = 11; 4.7%), tonsillar hypertrophy ( = 4; 1.7%), and adenoidal hypertrophy ( = 4; 1.7%). Development of scoliosis was considered treatment-related in two patients; development of impaired glucose tolerance in one patient and type 2 diabetes mellitus in another patient were considered treatment-related. Effectiveness outcomes were primarily assessed in 153 patients who completed 3 years of treatment. Among the 151 prepubertal patients (135 treatment-naïve), mean (SD) change from baseline in HSDS after 3 years was +1.50 (1.07) across all patients and +1.57 (1.07) for treatment-naïve patients.

CONCLUSION

These data suggest that biosimilar rhGH is well tolerated and effective in patients with PWS managed in real-life clinical practice. Patients with PWS should continue to be closely monitored for well-known safety issues (including respiratory, sleep, and glucose metabolism disorders, and scoliosis) during rhGH treatment.

摘要

背景

重组人生长激素(rhGH,生长激素)疗法已被批准用于普拉德-威利综合征(PWS)患儿。

目的

报告在接受奥曲肽(Omnitrope,山德士公司生产)治疗的PWS患儿的PAtients TReated with Omnitrope(PATRO)儿童研究中的安全性和有效性数据。

设计

PATRO儿童研究是一项多中心、非干预性的上市后监测研究。

方法

PWS患儿按照标准临床实践接受奥曲肽治疗。在奥曲肽治疗期间监测不良事件(AE)。还评估了有效性指标,包括身高标准差(SD)评分(HSDS)。

结果

截至2020年7月(研究完成),已纳入235例PWS患者。基线时,95.7%(n = 225)的患者处于青春期前,86.4%(n = 203)的患者未接受过rhGH治疗。分析时,研究中的中位(范围)治疗持续时间为56.8(2.9 - 155.8)个月。192例患者(81.7%)报告了AE,其中39例患者(16.6%)怀疑与治疗相关。96例患者(40.9%)报告了严重不良事件(SAE),其中22例患者(9.4%)怀疑与治疗相关。最常见的与治疗相关的SAE是睡眠呼吸暂停综合征(n = 11;4.7%)、扁桃体肥大(n = 4;1.7%)和腺样体肥大(n = 4;1.7%)。2例患者的脊柱侧凸发展被认为与治疗相关;1例患者糖耐量受损的发展和另1例患者2型糖尿病的发展被认为与治疗相关。有效性指标主要在153例完成3年治疗的患者中进行评估。在151例青春期前患者(135例未接受过治疗)中,所有患者3年后HSDS较基线的平均(SD)变化为 +1.50(1.07),未接受过治疗的患者为 +1.57(1.07)。

结论

这些数据表明,在现实临床实践中管理的PWS患者中,生物类似物rhGH耐受性良好且有效。在rhGH治疗期间,应继续密切监测PWS患者是否存在已知的安全问题(包括呼吸、睡眠和糖代谢紊乱以及脊柱侧凸)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5ae/11450727/e141ddc93013/10.1177_20420188241264343-fig1.jpg

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