低出生体重児(SGA)の小児におけるソマパシタン:第2相試験の4年間結果
Anders Juul1,2, Michael Højby3, Masanobu Kawai4
1Department of Growth and Reproduction, Copenhagen University Hospital-Rigshospitalet, Copenhagen 2100, Denmark.
Objective:
Evaluate long-term efficacy, safety, tolerability of once-weekly somapacitan, a long-acting GH derivative, in children born small for gestational age (SGA) with short stature, including after switching from daily GH.
Design:
REAL5 (NCT03878446) is a global, randomized, open-label, controlled phase 2 study comprising a 26-week main phase, 26-week extension I, and an ongoing four-year extension II.
Methods:
Sixty-two children born SGA with short stature were recruited at 38 clinics across 12 countries and randomized (1:1:1:1:1) to somapacitan (0.16, 0.20 or 0.24 mg/kg/week) or daily GH (0.035 or 0.067 mg/kg/day) until week 52 (inclusive main phase and extension I). Sixty participants entered extension II. Forty-eight participants switched to somapacitan 0.24 mg/kg/week from cohorts randomized to daily GH or lower somapacitan doses. Fifty-five children completed 208 weeks of treatment. Novel safety and efficacy results from week 52 to 208 are presented here.
Results:
Across all treatment arms, continuous increases in height standard deviation scores were observed from week 52 to week 208, including after switch to somapacitan 0.24 mg/kg/week. The safety and tolerability profile for somapacitan 0.24 mg/kg/week was similar to the well-established safety and tolerability profile for daily GH in SGA. Patient preference questionnaire results indicate that most respondents (87%) prefer somapacitan over daily GH. Most respondents (80%) answered they expect to be more adherent to treatment with somapacitan.
Conclusions:
These results support long-term continuous efficacy, safety, and tolerability of GH therapy with somapacitan 0.24 mg/kg/week for up to four years in children born SGA, including after switching from daily GH.
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