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A Study to Assess the Safety, Tolerability, and Efficacy of IONIS-GHR-LRx Administered in Patients With Acromegaly

Phase 2
Completed
Conditions
Acromegaly
Interventions
Drug: GHR-LRX
Registration Number
NCT04522180
Lead Sponsor
Ionis Pharmaceuticals, Inc.
Brief Summary

The purpose of this study was to determine the safety, tolerability, and efficacy of IONIS-GHR-LRx subcutaneous (SC) injection as monotherapy in patients with acromegaly.

Detailed Description

This was a multi-center, open-label, randomized, Phase 2 study of IONIS-GHR-LRx in up to 40 participants with acromegaly. Participants were randomized to 1 of 2 treatment groups to receive IONIS GHR-LRx monthly for 73 weeks. At the end of 73 weeks, participants entered a 14-week post-treatment (PT) evaluation period.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
34
Inclusion Criteria
  1. Males or females with a documented diagnosis of Acromegaly* who are 18 to 75 years old (inclusive) at the time of informed consent.

  2. Have had pituitary surgery (e.g. transsphenoidal) unless there was a contraindication to surgery and are either acromegaly medical treatment naïve, or who had not taken any other acromegaly medications prior to the screening visit as outlined below

    • bromocriptine: 2 weeks
    • cabergoline: 4 weeks
    • quinagolide: 4 weeks
    • octreotide daily injection (SC) or oral formulation: 4 weeks
    • pegvisomant: 4 weeks
    • octreotide LAR: 3 months
    • pasireotide LAR: 4 months
    • lanreotide (all formulations): 3 months
  3. At Screening, serum IGF-1 (performed at the central lab) between 1.3 to 5 × ULN, inclusive, adjusted for age and sex.

  4. Females must be non-pregnant and non-lactating, and either surgically sterile, post-menopausal, abstinent, or using 1 highly effective method of birth control

Exclusion Criteria
  1. Participants who received surgery for pituitary adenoma within the last 3 months before the trial, and/or planning to receive surgery during the trial
  2. Participants who received radiotherapy for pituitary adenoma within the last 2 years before the trial, and/or planning to receive radiotherapy during the trial
  3. Participants with a pituitary tumor that, per Investigator judgment, is worsening (e.g., either growing or at risk of compressing or abutting the optic chiasm or other vital structures) as assessed by pituitary/sellar MRI protocol at Screening or within 3 months of Screening. CT scan is allowed if MRI is contraindicated
  4. Evidence of decompensated cardiac function per medical judgement and/or New York Heart Association (NYHA) Class 3 or 4
  5. Clinical evidence of symptomatic hyperprolactinemia that would necessitate treatment
  6. Symptomatic cholelithiasis, and/or choledocholithiasis

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
GHR-LRX 120 mgGHR-LRXParticipants received GHR-LRX 120 mg subcutaneous (SC) injection once every month for 73 weeks with a booster dose administered on Day 15 (Week 3).
GHR-LRX 160 mgGHR-LRXParticipants received GHR-LRX 160 mg SC injection once every month for 73 weeks with a booster dose administered on Day 15 (Week 3).
Primary Outcome Measures
NameTimeMethod
Percent Change in Insulin-like Growth Factor I (IGF-1) From Baseline to Week 27Baseline to Week 27

IGF-1 is a hormone that manages the effects of growth hormone (GH) in the body. Baseline of IGF-1 is defined as the average value of Screening and Day 1. A negative percent change from Baseline indicated improvement.

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants Who Achieve Normalized IGF-1 Levels to Within 1.2 Times Gender and Age Limits at Day 183 (Week 27)At Week 27

Normalized IGF-1 level is defined as the ratio of the serum IGF-1 level and the participant's upper limit of normal (ULN).

Change From Baseline in Serum IGF-1 Over TimeUp to approximately 80 weeks

IGF-1 is a hormone that manages the effects of growth hormone (GH) in the body. A negative change from baseline indicated improvement.

Percent Change From Baseline in Serum IGF-1 Over TimeBaseline, Week 3, 5, 7, 9, 11, 13, 15, 17, 21, 25, 27, 29, 33, 37, 41, 45, 49, 53, 57, 61, 65, 69, 73

IGF-1 is a hormone that manages the effects of growth hormone (GH) in the body. A negative percent change from Baseline indicated improvement.

Percentage of Participants Who Achieve Normalized IGF-1 Levels to Within 1.0 Times Gender and Age Limits at Day 183 (Week 27)At Week 27

Normalized IGF-1 level is defined as the ratio of the serum IGF-1 level and the participant's ULN.

Trial Locations

Locations (22)

Cedars-Sinai Medical Center

🇺🇸

Los Angeles, California, United States

Vaidoto Urbanaviciaus Individuali imone

🇱🇹

Alytus, Lithuania

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano

🇮🇹

Milano, Italy

Pauls Stradins Clinical University Hospital

🇱🇻

Rīga, Latvia

I.M. Sechenov Moscow First State Medical University

🇷🇺

Moscow, Russian Federation

Memorial Sloan Kettering Cancer Center

🇺🇸

New York, New York, United States

Palm Research Center Inc.

🇺🇸

Las Vegas, Nevada, United States

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

Endocrinology Associates, Inc

🇺🇸

Columbus, Ohio, United States

Cleveland Clinic

🇺🇸

Cleveland, Ohio, United States

Oregon Health & Science University (OHSU)

🇺🇸

Portland, Oregon, United States

Tartu University Hospital

🇪🇪

Tartu, Estonia

Debreceni Egyetem Klinikai Kozpont

🇭🇺

Debrecen, Hungary

East-Tallinn Central Hospital

🇪🇪

Tallinn, Estonia

Fondazione Policlinico Universitario A. Gemelli IRCCS - Universita Cattolica del Sacro Cuore

🇮🇹

Roma, Italy

Hospital of Lithuanian University of Health Sciences (LSMU) Kauno klinikos

🇱🇹

Kaunas, Lithuania

Zespol Oddzialow Chorob Wewnetrznych, Endokrynologii i Diabetologii

🇵🇱

Warszawa, Poland

Centrum Badan Klinicznych Piotr Napora Lekarze Sp. p.

🇵🇱

Wrocław, Poland

Centrul Medical Unirea Bucuresti, Endocrinologie

🇷🇴

Bucharest, Romania

Clinical Center of Serbia

🇷🇸

Belgrade, Serbia

Uniwersytecki Szpital Kliniczny, im. Jana Mikulicza-Radeckiego we Wroclawiu,

🇵🇱

Wrocław, Poland

Clinical Center of Vojvodina

🇷🇸

Novi Sad, Serbia

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