Randomized Clinical Trial of Two Different Initial Growth Hormone Doses in Children

Growth Clinical Trial

Official title:

A Randomized Clinical Trial of Two Different Initial Growth Hormone Doses in Children With Growth Hormone Deficiency in the First Year of Treatment

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT06103513
• Other study ID #: 23-0027
• Status: Recruiting
• Phase: Phase 3
• Start date: December 10, 2023
• Est. completion date: December 10, 2025

Study information

• Verified date: October 2023
• Source: Northwell Health
• Contact: Jennifer Apsan, MD
• Phone: 516-472-3750
• Email: japsan[@]northwell.edu
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

A prospective, randomized, open-label single-blinded study of 50 subjects with growth hormone deficiency, ages 5 to 15 years in which 25 subjects will initiate rhGH therapy at 0.3mg/kg/week and the remaining 25 subjects will initiate their rhGH treatment at 0.2 mg/kg/week for the first 12 months of treatment. Safety parameters, height velocity, and adult height prediction by bone age determination will be assessed at 4-month intervals for 1 year following the initiation of rhGH therapy.

Description:

Investigators propose a prospective randomized, open-label single-blinded study of 50 subjects with growth hormone deficiency, ages 5 to 15 years. 25 subjects will be randomized to initiate a dose of 0.3 mg/kg/week (0.28-0.32 mg/kg/week) and the remaining 25 subjects will initiate their rhGH treatment at 0.2 mg/kg/week (0.18-0.22 mg/kg/week) for the first 12 months of treatment. Safety parameters, height velocity, and adult height prediction by bone age determination will be assessed at 4-month intervals for 1 year following the initiation of rhGH therapy.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 50
• Est. completion date: December 10, 2025
• Est. primary completion date: June 10, 2025
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 5 Years to 15 Years

Eligibility

Inclusion Criteria:

1. Provision of signed and dated informed consent form

2. Stated willingness to comply with all study procedures and availability for the duration of the study

3. Male or female, aged 5-15 years

4. In good general health as evidenced by medical history or diagnosed with growth hormone deficiency

5. Ability to take subcutaneous GH injections nightly

Exclusion Criteria:

Subjects will be excluded if they have GH resistance, or syndromic short stature such as Prader Willi syndrome and Turner syndrome. Patients will also be excluded if they have active malignancies, or systemic illnesses such as heart failure, kidney failure, or liver failure.

Related Conditions & MeSH terms

• Failure to Thrive
• Growth
• Growth Disorders
• Growth Failure
• Growth Hormone Treatment

Intervention

Drug:
• Somatropin
The treatment of children with subcutaneous recombinant human growth hormone (rhGH) is the current gold standard of care for children with diagnosed GHD. This study will serve only to investigate the optimal dose of treatment in the first year of treatment with rhGH.

Locations

Country	Name	City	State
United States	Northwell Health	New York	New York

Sponsors (1)

Lead Sponsor	Collaborator
Northwell Health

Country where clinical trial is conducted

United States, 

References & Publications (19)

Backelijaw P, Dattani M, Cohen P Rosenfeld R, (2014).Chapter 10: Disorders of Growth Hormone/ Insulin Like Growth Factor Secretion and Action. Shreiner, J (Ed.). Pediatric Endocrinology: Marc Sperling. (chapter 10, page 364, 366). Philadelphia, Saunders

Blethen SL, MacGillivray MH. A risk-benefit assessment of growth hormone use in children. Drug Saf. 1997 Nov;17(5):303-16. doi: 10.2165/00002018-199717050-00003. — View Citation

Boguszewski CL, Meister LH, Zaninelli DC, Radominski RB. One year of GH replacement therapy with a fixed low-dose regimen improves body composition, bone mineral density and lipid profile of GH-deficient adults. Eur J Endocrinol. 2005 Jan;152(1):67-75. doi: 10.1530/eje.1.01817. — View Citation

Cho WK, Ahn MB, Kim EY, Cho KS, Jung MH, Suh BK. Predicting First-Year Growth in Response to Growth Hormone Treatment in Prepubertal Korean Children with Idiopathic Growth Hormone Deficiency: Analysis of Data from the LG Growth Study Database. J Korean Med Sci. 2020 May 18;35(19):e151. doi: 10.3346/jkms.2020.35.e151. — View Citation

Christ ER, Cummings MH, Jackson N, Stolinski M, Lumb PJ, Wierzbicki AS, Sonksen PH, Russell-Jones DL, Umpleby AM. Effects of growth hormone (GH) replacement therapy on low-density lipoprotein apolipoprotein B100 kinetics in adult patients with GH deficiency: a stable isotope study. J Clin Endocrinol Metab. 2004 Apr;89(4):1801-7. doi: 10.1210/jc.2003-031474. — View Citation

de Ridder MA, Stijnen T, Hokken-Koelega AC. Prediction of adult height in growth-hormone-treated children with growth hormone deficiency. J Clin Endocrinol Metab. 2007 Mar;92(3):925-31. doi: 10.1210/jc.2006-1259. Epub 2006 Dec 19. — View Citation

Grumbach MM, Bin-Abbas BS, Kaplan SL. The growth hormone cascade: progress and long-term results of growth hormone treatment in growth hormone deficiency. Horm Res. 1998;49(# Suppl 2):41-57. No abstract available. — View Citation

Hardin DS. Treatment of short stature and growth hormone deficiency in children with somatotropin (rDNA origin). Biologics. 2008 Dec;2(4):655-61. doi: 10.2147/btt.s2252. — View Citation

Kristrom B, Aronson AS, Dahlgren J, Gustafsson J, Halldin M, Ivarsson SA, Nilsson NO, Svensson J, Tuvemo T, Albertsson-Wikland K. Growth hormone (GH) dosing during catch-up growth guided by individual responsiveness decreases growth response variability in prepubertal children with GH deficiency or idiopathic short stature. J Clin Endocrinol Metab. 2009 Feb;94(2):483-90. doi: 10.1210/jc.2008-1503. Epub 2008 Nov 11. — View Citation

Kristrom B, Dahlgren J, Niklasson A, Nierop AF, Albertsson-Wikland K. The first-year growth response to growth hormone treatment predicts the long-term prepubertal growth response in children. BMC Med Inform Decis Mak. 2009 Jan 12;9:1. doi: 10.1186/1472-6947-9-1. — View Citation

Locatelli V, Bianchi VE. Effect of GH/IGF-1 on Bone Metabolism and Osteoporsosis. Int J Endocrinol. 2014;2014:235060. doi: 10.1155/2014/235060. Epub 2014 Jul 23. — View Citation

MacGillivray MH, Baptista J, Johanson A. Outcome of a four-year randomized study of daily versus three times weekly somatropin treatment in prepubertal naive growth hormone-deficient children. Genentech Study Group. J Clin Endocrinol Metab. 1996 May;81(5):1806-9. doi: 10.1210/jcem.81.5.8626839. — View Citation

Radetti G, Buzi F, Paganini C, Pilotta A, Felappi B. Treatment of GH-deficient children with two different GH doses: effect on final height and cost-benefit implications. Eur J Endocrinol. 2003 May;148(5):515-8. doi: 10.1530/eje.0.1480515. — View Citation

Ranke MB, Lindberg A, Chatelain P, Wilton P, Cutfield W, Albertsson-Wikland K, Price DA. Derivation and validation of a mathematical model for predicting the response to exogenous recombinant human growth hormone (GH) in prepubertal children with idiopathic GH deficiency. KIGS International Board. Kabi Pharmacia International Growth Study. J Clin Endocrinol Metab. 1999 Apr;84(4):1174-83. doi: 10.1210/jcem.84.4.5634. — View Citation

Ranke MB, Schweizer R, Wollmann HA, Schwarze P. Dosing of growth hormone in growth hormone deficiency. Horm Res. 1999;51 Suppl 3:70-4. doi: 10.1159/000053165. — View Citation

Reiter EO, Price DA, Wilton P, Albertsson-Wikland K, Ranke MB. Effect of growth hormone (GH) treatment on the near-final height of 1258 patients with idiopathic GH deficiency: analysis of a large international database. J Clin Endocrinol Metab. 2006 Jun;91(6):2047-54. doi: 10.1210/jc.2005-2284. Epub 2006 Mar 14. — View Citation

Straetemans S, Thomas M, Craen M, Rooman R, De Schepper J; BESPEED. Poor growth response during the first year of growth hormone treatment in short prepubertal children with growth hormone deficiency and born small for gestational age: a comparison of different criteria. Int J Pediatr Endocrinol. 2018;2018:9. doi: 10.1186/s13633-018-0064-3. Epub 2018 Oct 22. — View Citation

Sudfeld H, Kiese K, Heinecke A, Bramswig JH. Prediction of growth response in prepubertal children treated with growth hormone for idiopathic growth hormone deficiency. Acta Paediatr. 2000 Jan;89(1):34-7. doi: 10.1080/080352500750029022. — View Citation

Wit JM, Ranke MB, Albertsson-Wikland K, Carrascosa A, Rosenfeld RG, Van Buuren S, Kristrom B, Schoenau E, Audi L, Hokken-Koelega AC, Bang P, Jung H, Blum WF, Silverman LA, Cohen P, Cianfarani S, Deal C, Clayton PE, de Graaff L, Dahlgren J, Kleintjens J, Roelants M. Personalized approach to growth hormone treatment: clinical use of growth prediction models. Horm Res Paediatr. 2013;79(5):257-70. doi: 10.1159/000351025. Epub 2013 May 28. — View Citation

* Note: There are 19 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Annualized Growth Velocity (GV) in the first year after treatment	Height (cm) at 0- month visit; height (cm) at 12-month visit	I year
Secondary	IGF1- 0,4,8,12 months	IGF-1 will be collected at timepoints - 0,4,8,12 months	12 Months
Secondary	IGFBP3 - 0,4,8,12 months	IGFBP3 will be collected at timepoints - 0,4,8,12 months	12 Months
Secondary	HbA1c - 4,8,12 months	HbA1c will be collected at timepoints 4,8,12 months	12 Months
Secondary	Total T4 or Free T4 - 0,12 months	Total T4 or Free T4 will be collected at timepoints 0,12 months	12 Months
Secondary	TSH - 0, 12 months	TSH will be collected at timepoints 0, 12 months	12 Months