Kawai Masanobu, Murakami Nobuyuki, Horikawa Reiko, Muroya Koji, Fujisawa Yasuko, Hoshino Yuko, Okayama Akifumi, Sato Takahiro, Ebata Nozomi, Ogata Tsutomu
Department of Gastroenterology, Nutrition and Endocrinology, Osaka Women's and Children's Hospital, Izumi 594-1101, Japan.
Department of Pediatrics, Dokkyo Medical University Saitama Medical Center, Koshigaya 343-8555, Japan.
Endocr J. 2025 Aug 1;72(8):925-935. doi: 10.1507/endocrj.EJ24-0659. Epub 2025 May 28.
Recombinant human growth hormone (GH; somatropin) treatment has beneficial effects on body composition in patients with Prader-Willi syndrome (PWS). However, this treatment option is limited to children in most countries and to children with short stature in countries such as the USA and Japan. The aim of this multicohort study was to evaluate the effect of somatropin on body composition and to assess its safety in Japanese pediatric and adult participants with PWS. GH-naïve pediatric participants (n = 6) received somatropin 0.245 mg/kg/week, GH-treated pediatric participants (n = 7) received somatropin 0.084 mg/kg/week, and adult participants (n = 20) received somatropin 0.042 mg/kg/week for 1 month, followed by 0.084 mg/kg/week. The study met its primary endpoint in the adult cohort because the least squares mean (95% CI) of the change from baseline to Month 12 in lean body mass (LBM) (%) was greater than the prespecified efficacy criterion of 0. LBM (%) was higher at 12 months in GH-naïve pediatric participants, while GH-treated pediatric participants showed little deterioration in LBM despite reduced GH dosage. Treatment-emergent adverse events (TEAEs) were experienced by five (83.3%), five (71.4%), and 19 (95.0%) participants in the GH-naïve pediatric cohort, GH-treated pediatric cohort, and adult cohort, respectively. Most TEAEs were mild or moderate in severity. Three participants reported four serious TEAEs, and none were treatment related. Somatropin improved body composition in adult participants, enabled maintenance of body composition in pediatric participants, and demonstrated a favorable safety and tolerability profile in all PWS cohorts. (ClinicalTrials.gov ID: NCT04697381).
重组人生长激素(GH;生长激素)治疗对普拉德-威利综合征(PWS)患者的身体成分有有益影响。然而,在大多数国家,这种治疗选择仅限于儿童,在美国和日本等国家则仅限于身材矮小的儿童。这项多队列研究的目的是评估生长激素对身体成分的影响,并评估其在日本患有PWS的儿科和成人参与者中的安全性。未接受过生长激素治疗的儿科参与者(n = 6)每周接受0.245 mg/kg的生长激素,接受过生长激素治疗的儿科参与者(n = 7)每周接受0.084 mg/kg的生长激素,成人参与者(n = 20)每周接受0.042 mg/kg的生长激素,持续1个月,随后每周接受0.084 mg/kg。该研究在成人队列中达到了其主要终点,因为去脂体重(LBM)从基线到第12个月变化的最小二乘均值(95% CI)(%)大于预先设定的疗效标准0。未接受过生长激素治疗的儿科参与者在12个月时LBM(%)更高,而接受过生长激素治疗的儿科参与者尽管生长激素剂量减少,但LBM几乎没有恶化。未接受过生长激素治疗的儿科队列、接受过生长激素治疗的儿科队列和成人队列中分别有5名(83.3%)、5名(71.4%)和19名(95.0%)参与者经历了治疗中出现的不良事件(TEAE)。大多数TEAE的严重程度为轻度或中度。三名参与者报告了四项严重TEAE,且均与治疗无关。生长激素改善了成人参与者的身体成分,使儿科参与者的身体成分得以维持,并在所有PWS队列中显示出良好的安全性和耐受性。(ClinicalTrials.gov标识符:NCT04697381)