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一种生物类似物重组生长激素在成年生长激素缺乏患者中的安全性和有效性:来自国际上市后监测研究PATRO Adults的最终数据分析

Safety and Effectiveness of a Biosimilar Recombinant Growth Hormone in Adults with Growth Hormone Deficiency: Analysis of Final Data from PATRO Adults, an International Post-Marketing Surveillance Study.

作者信息

Beck-Peccoz Paolo, Höybye Charlotte, Simsek Suat, Stalla Günter, Murray Robert D, Esmael Altaher, Urosevic Dragan, Boldea Anca, Zabransky Markus

机构信息

Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.

Department of Endocrinology and Department of Molecular Medicine and Surgery, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden.

出版信息

Drug Des Devel Ther. 2024 Dec 5;18:5729-5741. doi: 10.2147/DDDT.S471967. eCollection 2024.

Abstract

PURPOSE

Long-term studies are needed to investigate the safety of recombinant human growth hormone (rhGH) for the treatment of growth hormone deficiency (GHD) in routine practice. The objective of this study was to evaluate the safety and effectiveness of biosimilar rhGH (somatropin; Omnitrope) in adults with GHD.

METHODS

PAtients TReated with Omnitrope (PATRO) Adults was a post-marketing surveillance study conducted across Europe. The primary objective was the safety of biosimilar rhGH in adults, particularly the occurrence of glucose intolerance or diabetes mellitus and malignancies. All adverse events (AEs) were recorded throughout treatment. Treatment effectiveness was a secondary objective.

RESULTS

By December 2021, 1527 patients (50.3% male) were enrolled from 84 centers in 10 European countries. Most patients had adult-onset GHD (n = 1243; 81.4%) and 771 (50.5%) were rhGH-naïve at study entry. Median (interquartile range) treatment duration was 4.4 (1.90-7.30) years. Overall, 1181 patients (77.3%) reported 6667 AEs. Treatment-related AEs were reported in 143 patients (9.4%; 216 AEs); arthralgia was most common (n = 24). There were 49 confirmed diabetes mellitus events; 44 in newly diagnosed patients. Overall, 84 malignancies were reported. There were 46 treatment-related serious AEs in 39 patients (2.6%). The most frequently reported treatment-related serious AE was "metabolism and nutrition disorders" (n = 12). In rhGH-naïve patients, an increase in mean insulin-like growth factor-1 (IGF-1) standard deviation score (SDS) was observed from -2.03 at baseline to +0.28 at 5 years. An increase in IGF-1 SDS was also observed in previously treated patients from -0.71 to +0.35. Body mass index remained stable while blood lipid levels improved from baseline to 5 years.

CONCLUSION

Final data from PATRO Adults confirm that biosimilar rhGH (Omnitrope) is not associated with any unexpected safety signals, with no evidence of increased diabetogenic or carcinogenic risk, and is effective in real-world clinical practice.

摘要

目的

需要进行长期研究以调查重组人生长激素(rhGH)在常规临床实践中治疗生长激素缺乏症(GHD)的安全性。本研究的目的是评估生物类似物rhGH(生长激素;奥曲肽)在成年GHD患者中的安全性和有效性。

方法

奥曲肽治疗成人患者(PATRO)是一项在欧洲开展的上市后监测研究。主要目的是生物类似物rhGH在成人中的安全性,特别是葡萄糖不耐受或糖尿病以及恶性肿瘤的发生情况。在整个治疗过程中记录所有不良事件(AE)。治疗有效性是次要目的。

结果

截至2021年12月,来自欧洲10个国家84个中心的1527例患者(50.3%为男性)入组。大多数患者为成人起病的GHD(n = 1243;81.4%),771例(50.5%)在研究开始时未使用过rhGH。中位(四分位间距)治疗时长为4.4(1.90 - 7.30)年。总体而言,1181例患者(77.3%)报告了6667次不良事件。143例患者(9.4%;216次不良事件)报告了与治疗相关的不良事件;关节痛最为常见(n = 24)。确诊糖尿病事件49例;44例发生在新诊断患者中。总体报告了84例恶性肿瘤。39例患者(2.6%)发生了46次与治疗相关的严重不良事件。最常报告的与治疗相关的严重不良事件是“代谢和营养紊乱”(n = 12)。在未使用过rhGH的患者中,观察到平均胰岛素样生长因子-1(IGF-1)标准差评分(SDS)从基线时的-2.03增加到5年时的+0.28。在既往接受过治疗的患者中也观察到IGF-1 SDS从-0.71增加到+0.35。体重指数保持稳定,而血脂水平从基线到5年有所改善。

结论

PATRO成人研究的最终数据证实,生物类似物rhGH(奥曲肽)与任何意外的安全信号无关,没有证据表明致糖尿病或致癌风险增加,并且在实际临床实践中有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6872/11628864/c066d770feaf/DDDT-18-5729-g0001.jpg

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