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Investigating Efficacy and Safety of Once-weekly NNC0195-0092 Treatment Compared to Daily Growth Hormone Treatment (Norditropin® FlexPro®) in Growth Hormone Treatment naïve Pre-pubertal Children With Growth Hormone Deficiency

Phase 2
Completed
Conditions
Growth Hormone Disorder
Growth Hormone Deficiency in Children
Interventions
Registration Number
NCT02616562
Lead Sponsor
Novo Nordisk A/S
Brief Summary

This trial is conducted globally. The aim of the trial is to investigate efficacy and safety of once-weekly NNC0195-0092 treatment compared to daily growth hormone treatment (Norditropin® FlexPro®) in growth hormone treatment naïve pre-pubertal children with growth hormone deficiency.

The main trial period will consist of 26 weeks of treatment, followed by a 26 week extension period.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
74
Inclusion Criteria
  • Boys: Tanner stage 1 for pubic hair and testis volume below 4 ml , age at least 2 years and 26 weeks and below or equal to 10.0 years at screening
  • Girls: Tanner stage 1 for breast development (no palpable glandular breast tissue) and pubic hair, age at least 2 years and 26 weeks and below or equal to 9.0 years at screening
  • Confirmed diagnosis of GHD (growth hormone deficiency) within 12 months prior to screening as determined by two different GH (growth hormone) stimulation tests, defined as a peak GH level of below or equal to 7.0 ng/ml. For children with three or more pituitary hormone deficiencies only one GH stimulation test is needed
  • No prior exposure to GH therapy and/or IGF-I (insulin-like growth factor I) treatment
  • Height of at least 2.0 standard deviations below the mean height for chronological age (CA) and gender according to the standards of Centers for Disease Control and Prevention 2-20 years: Girls/Boys stature-for-age and weight-for-age percentiles CDC at screening
  • Annualized height velocity (HV) below the 25th percentile for CA (chronological age) and gender or below -0.7 SD (standard deviation) score for CA and sex, according to the standards of Prader calculated over a time span of minimum 6 months and maximum 18 months
Exclusion Criteria
  • Any clinically significant abnormality likely to affect growth or the ability to evaluate
  • growth with standing measurements: Chromosomal aneuploidy and significant gene mutations causing medical "syndromes" with short stature, including but not limited to Turner syndrome, Laron syndrome, Noonan syndrome, or absence of GH receptors. Congenital abnormalities (causing skeletal abnormalities), including but not limited to Russell-Silver Syndrome, skeletal dysplasias. Significant spinal abnormalities including but not limited to scoliosis, kyphosis and spina bifida variants
  • Children born small for gestational age (SGA - birth weight and/or birth length below-2 SD for gestational age)
  • Concomitant administration of other treatments that may have an effect on growth, including but not limited to methylphenidate for treatment of attention deficit hyperactivity disorder (ADHD)
  • Prior history or presence of malignancy and/or intracranial tumour

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Blinded NNC0195-0092 (0.04 mg/kg/week)somapacitanParticipants receive NNC0195-0092 (somapacitan) (0.04 mg/kg/week) during the main trial and the extension period and thereafter NNC0195-0092 (somapacitan) (0.16 mg/kg/week) during the safety extension and the long-term safety extension periods.
Blinded NNC0195-0092 (0.04 mg/kg/week)NNC0195-0092Participants receive NNC0195-0092 (somapacitan) (0.04 mg/kg/week) during the main trial and the extension period and thereafter NNC0195-0092 (somapacitan) (0.16 mg/kg/week) during the safety extension and the long-term safety extension periods.
Blinded NNC0195-0092 (0.08 mg/kg/week)somapacitanParticipants receive NNC0195-0092 (somapacitan) (0.08 mg/kg/week) during the main trial and the extension period and thereafter NNC0195-0092 (somapacitan) (0.16 mg/kg/week) during the safety extension and the long-term safety extension periods.
Blinded NNC0195-0092 (0.08 mg/kg/week)NNC0195-0092Participants receive NNC0195-0092 (somapacitan) (0.08 mg/kg/week) during the main trial and the extension period and thereafter NNC0195-0092 (somapacitan) (0.16 mg/kg/week) during the safety extension and the long-term safety extension periods.
Blinded NNC0195-0092 (0.16 mg/kg/week)somapacitanParticipants receive the same dose (0.16 mg/kg/week) of NNC0195-0092 (somapacitan) during all 4 trial periods.
Blinded NNC0195-0092 (0.16 mg/kg/week)NNC0195-0092Participants receive the same dose (0.16 mg/kg/week) of NNC0195-0092 (somapacitan) during all 4 trial periods.
Open labelled daily Norditropin® (0.034 mg/kg/day)somapacitanParticipants receive Norditropin during the main trial, the extension period and the safety extension period and thereafter NNC0195-0092 (somapacitan) (0.16 mg/kg/week) during the long-term safety extension periods.
Open labelled daily Norditropin® (0.034 mg/kg/day)Norditropin® FlexPro® penParticipants receive Norditropin during the main trial, the extension period and the safety extension period and thereafter NNC0195-0092 (somapacitan) (0.16 mg/kg/week) during the long-term safety extension periods.
Primary Outcome Measures
NameTimeMethod
Cohort I: Height velocity (HV) during the first 26 weeks of treatment, measured as standing height with stadiometerWeek 0-26

cm/year

Height velocity (HV) (cm/year) during the first 26 weeks of treatment, measured as standing height with stadiometerWeek 0-26
Cohort II and III: Incidence of adverse events, including injection site reactions, in children with GHDDuring 208 weeks

Number of events

Secondary Outcome Measures
NameTimeMethod
Insulin-like growth factor binding protein 3 (IGFBP-3) SDSWeek 26-52

Typically -10 to +10

Serum NNC0195-0092 (somapacitan) concentrationsWeek 52

ng/mL

Changes in emotional well-being score, physical health score, social well-being score and total score in Treatment Related Impact Measure - Child Growth Hormone Deficiency- Observer (TRIM-CGHD-O)Week 0-52

The scores range from 0-100. A lower score indicates a better health state.

Change in height standard deviation score (SDS)Week 26-52

Typically -10 to +10

Change in HV (height velocity) SDSWeek 0-52

Baseline (week 0) HV SDS is derived from reported pre-trial standing height measured at minimum 6 months and maximum 18 months prior to screening visit to standing height at baseline (week 0)

Insulin-like growth factor 1 (IGF-I) SDSWeek 26-52

Typically -10 to +10

Height velocityWeek 52

cm/year, derived from standing height from baseline (week 0) to week 52

Bone ageWeek 52

X-Ray of left hand and wrist, central assessed according to Greulich \& Pyle atlas progression vs. chronological age

Incidence of adverse events, including injection site reactionsAt week 53
Occurrence of anti-hGH antibodiesWeek 364

Yes/no

Total score of The Treatment Burden Measure - Child Growth Hormone Deficiency - Observer (TB-CGHD-O)Week 52

The scores range from 0-100. A lower score indicates a better health state.

Total score of The Treatment Burden Measure - Child Growth Hormone Deficiency - Parent/Guardian (TB-CGHD-P)Week 52

The scores range from 0-100. A lower score indicates a better health state.

Occurrence of anti-NNC0195-0092 (somapacitan) antibodiesWeek 364

Yes/no

Occurrence of anti-NNC0195-0092 and anti-hGH antibodiesAt week 53

Trial Locations

Locations (38)

Novo Nordisk Clinical Trial Call Center

🇺🇸

Cincinnati, Ohio, United States

Nemours/AI duPont Hosp-Chld

🇺🇸

Wilmington, Delaware, United States

Goryeb Children's Hospital

🇺🇸

Morristown, New Jersey, United States

Rutgers-Rwjms

🇺🇸

New Brunswick, New Jersey, United States

NYU Langone Hospital-LI

🇺🇸

Mineola, New York, United States

CCHMC_Cinc

🇺🇸

Cincinnati, Ohio, United States

Kepler Universitätsklinikum GmbH - Med Campus IV (vorm.LFKK)

🇦🇹

Linz, Upper Austria, Austria

Landeskrankenhaus Villach

🇦🇹

Villach, Austria

CPQuali Pesquisa Clínica Ltda

🇧🇷

São Paulo, Sao Paulo, Brazil

Centre Hospitalier Régional Universitaire d' Angers

🇫🇷

ANGERS cedex 09, France

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Novo Nordisk Clinical Trial Call Center
🇺🇸Cincinnati, Ohio, United States

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