A Research Study in Chinese Children With a Low Level of Hormone to Grow. Treatment is Somapacitan Once a Week Compared to Norditropin® Once a Day.

Growth Hormone Deficiency in Children Clinical Trial

Official title:

A Trial Comparing the Efficacy and Safety of Once Weekly Dosing of Somapacitan With Daily Norditropin® in Chinese Children With Growth Hormone Deficiency

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04970654
• Other study ID #: NN8640-4468
• Secondary ID: U1111-1250-75302
• Status: Completed
• Phase: Phase 3
• Start date: July 22, 2021
• Est. completion date: December 18, 2023

Study information

• Verified date: April 2024
• Source: Novo Nordisk A/S
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The study compares two medicines for children with a low level of hormone to grow: somapacitan (a new medicine) given once a week and Norditropin® (a medicine doctors can already prescribe) given once a day. Researchers will test somapacitan to see how well it works, compared to the standard treatment with Norditropin®. The participants will either get Norditropin® once every day or somapacitan once every week - which treatment the participant gets is decided by chance. The participant and the study doctor will know which treatment the participant gets. The study includes a 52 week treatment period and a minimum of 30 days follow up period.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 110
• Est. completion date: December 18, 2023
• Est. primary completion date: November 17, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: N/A and older

Eligibility

Inclusion Criteria:

• Informed consent of parent or legally acceptable representative of participant and child assent, as age-appropriate must be obtained before any trial related activities

• The parent or legally acceptable representative of the child must sign and date the Informed consent form (according to local requirements)

• The child must sign and date child assent form or provide oral assent (if required according to local requirements)

• Prepubertal children: a) Boys: Age more than or equal to 2 years and 26 weeks and less than or equal to 11.0 years at the time of signing informed consent.

• Testis volume less than 4 ml. b) Girls: Age more than or equal to 2 years and 26 weeks and less than or equal to 10.0 years at the time of signing informed consent. Tanner stage 1 for breast development (no palpable glandular breast tissue)

• Confirmed diagnosis of growth hormone deficiency determined by two different growth hormone stimulation tests performed within 12 months prior to randomisation, defined as a peak growth hormone level of less than or equal to 10.0 ng/ml using the WHO International Somatropin 98/574 standard

• If only one growth hormone stimulation test is available before screening, then confirmation of growth hormone deficiency by second and different growth hormone stimulation test must be done

• For children with at least 2 additional pituitary hormone deficiencies (other than growth hormone deficiency) only one growth hormone stimulation test is needed

• Impaired height defined as at least 2.0 standard deviations below the mean height for chronological age and gender according to Chinese general population standards at screening

• Impaired height velocity defined as annualised height velocity at screening less than 7cm/year for subjects between 2.5 and 3 years old and less than 5 cm/year for subjects from 3 years and above calculated over a time span of minimum 3 months and maximum 18 months prior to screening according to Chinese guideline and expert consensus on children with short stature and GH therapy

• No prior exposure to growth hormone therapy or IGF-I treatment

• Bone age less than chronological age at screening

• Body Mass Index more than 5th and less than 95th percentile, Body Mass Index-for-age growth charts according to Chinese general population standards.

• IGF-I < -1.0 SDS at screening, compared to age and gender normalized range measured at central laboratory

• No intracranial tumour confirmed by magnetic resonance imaging or computer tomography scan. An image or scan taken within 9 months prior to screening can be used as screening data if the medical evaluation and conclusion is available

Exclusion Criteria:

• Known or suspected hypersensitivity to trial product(s) or related products.

• Previous participation in this trial. Participation is defined as randomisation.

• Receipt of any investigational medicinal product within 3 months before screening or participation in another clinical trial before randomisation

• Any known or suspected clinically significant abnormality likely to affect growth or the ability to evaluate growth with standing height measurements:

• Turner Syndrome (including mosaicisms)

• Chromosomal aneuploidy and significant gene mutations causing medical "syndromes" with short stature, including but not limited to Laron syndrome, Noonan syndrome, Prader-Willi Syndrome, abnormal SHOX-1 gene analysis or absence of GH receptors

• Significant spinal abnormalities including but not limited to scoliosis, kyphosis and spina bifida variants

• Congenital abnormalities (causing skeletal abnormalities), including but not limited to Russell-Silver Syndrome or skeletal dysplasias

• Family history of skeletal dysplasia

• Children born small for gestational age (birth weight 10th percentile of the recommended gender-specific birth weight for gestational age according to national standards in China5

• Children diagnosed with diabetes mellitus or screening values from central laboratory of

1. fasting plasma glucose more than or equal to 126 mg/dl (7.0 mmol/L) or

2. HbA1c more than or equal to 6.5 %

• Current inflammatory diseases requiring systemic corticosteroid treatment for longer than 2 consecutive weeks within the last 3 months prior to screening

• Children requiring inhaled glucocorticoid therapy at a dose greater than 400 µg/day of inhaled budesonide or equivalents for longer than 4 consecutive weeks within the last 12 months prior to screening

• Concomitant administration of other treatments that may have an effect on growth, e.g. but not limited to methylphenidate for treatment of attention deficit hyperactivity disorder (ADHD)

• Diagnosis of attention deficit hyperactivity disorder

• Prior history or presence of malignancy including intracranial tumours

• Prior history or known presence of active Hepatitis B or Hepatitis C (exceptions to this exclusion criterion is the presence of antibodies due to vaccination against Hepatitis B)

• Any clinically significant abnormal laboratory screening tests, as judged by the study doctor

• Any disorder which, in the opinion of the study doctor, might jeopardise Participant's safety or compliance with the protocol

• The participant or the parent/legally acceptable representative is likely to be non-compliant in respect to trial conduct, as judged by the study doctor

• Children with hypothyroidism and/or adrenal insufficiency not on adequate and stable replacement therapy for at least 90 days prior to randomisation.

Related Conditions & MeSH terms

• Dwarfism, Pituitary
• Growth Hormone Deficiency in Children

Intervention

Drug:
• somapacitan
Somapacitan (0.16 mg/kg/week) will be administered subcutaneously (s.c.; under the skin) once weekly by PDS290 pen-injector. Somapacitan can be injected any time during the once weekly dosing day. The dose will be calculated based on the subject's current body weight.
• Norditropin®
Norditropin® (0.034 mg/kg/day) will be administered s.c. once daily by FlexPro® pen-injector. Norditropin® should be injected daily in the evening. The dose will be calculated based on the subject's current body weight.

Locations

Country	Name	City	State
China	Beijing Children's Hospital,Capital Medical University	Beijing	Beijing
China	Capital Institute of Paediatrics	Beijing	Beijing
China	The First Hospital of Jilin University	Changchun	Jilin
China	Hunan Children's Hospital	Changsha	Hunan
China	The Second Xiangya Hospital of Central South University	Changsha	Hunan
China	Chengdu Women's and Children's central hospital	Chengdu	Sichuan
China	The First Affiliated Hospital , Sun Yat-sen University	Guangzhou	Guangdong
China	The Children's Hospital, Zhejiang University school of medicine	Hangzhou	Zhejiang
China	The Second Hospital of Anhui Medical University	Hefei	Anhui
China	The First Hospital of Jiaxing	Jiaxing	Jiangxi
China	Shandong Provincial Hospital	Jinan	Shandong
China	Jiangxi Provincial Children's Hospital	Nanchang	Jiangxi
China	Pingxiang Maternal and Child Health Care Hospital	Pingxiang	Jiangxi
China	Qingdao Women and Children's Hospital	Qingdao	Shandong
China	Qingdao Women and Children's Hospital	Qingdao	Shandong
China	The First Affiliated Hospital of Shaoyang University	Shaoyang	Hunan
China	Children's Hospital of Soochow University	Suzhou	Jiangsu
China	Tongji Hospital,Tongji Medical College of Huazhong University of Science &Technology	Wuhan	Hubei
China	Wuxi Children's Hospital	Wuxi	Jiangsu
China	Henan Children's Hospital	Zhengzhou	Henan
China	Henan Children's Hospital Zhengzhou Children's Hospital	Zhengzhou	Henan

Sponsors (1)

Lead Sponsor	Collaborator
Novo Nordisk A/S

Country where clinical trial is conducted

China, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Height velocity	Height velocity (HV) is measured in cm/year. HV = (height at 52 weeks visit - height at baseline)/(time from baseline to 52 weeks visit in years).	week 0 - 52
Secondary	Change in height Standard Deviation Score (SDS)	Measured in scores (-10 to +10). Height SDS will be derived using Centre for Disease Control and Prevention (CDC) standards.	from baseline (week 0) to week 52
Secondary	Change in height Velocity Standard Deviation Score	Measured in scores (-10 to +10). HV SDS will be derived using Prader standards as reference data.	from baseline (week 0) to week 52
Secondary	Change in bone age	Measured in years	from Visit 1 to Week 52
Secondary	Change in fasting plasma glucose	Measured in mmol/L.	from baseline (week 0) to week 52
Secondary	Change in glycated haemoglobin (HbA1c)	Measured in percentage	from baseline (week 0) to week 52
Secondary	Change in IGF-I Standard Deviation Score	Measured in scores (-10 to +10)	From baseline (week 0) to week 52
Secondary	Change in IGFBP-3 Standard Deviation Score	Measured in scores (-10 to +10)	From baseline (week 0) to week 52