E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Adult growth hormone deficiency (AGHD) |
|
E.1.1.1 | Medical condition in easily understood language |
lack of growth hormone in the body |
|
E.1.1.2 | Therapeutic area | Diseases [C] - Hormonal diseases [C19] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 18.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10056438 |
E.1.2 | Term | Growth hormone deficiency |
E.1.2 | System Organ Class | 10014698 - Endocrine disorders |
|
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
1.To assess the safety, tolerability and Pharmacokinetic/ Pharmacodynamic (PK/PD) profile of three doses of HM10560A on an every week (EW) regime and one dose on every other week(EOW) regime administered for a period of 24 weeks initial study
2.To select the optimal dose and dosing regimen of HM10560A for the subsequent phase III study on the basis of the safety and PK/PD profile after 24 weeks of treatment
3.To assess the long term safety of HM10560A when administered in optimal dose range and dose frequency for additional 48 weeks (followed with 2 weeks safety follow up) |
|
E.2.2 | Secondary objectives of the trial |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1.
GHDA subjects, males and females, of age between 23 and 65 years with
childhood or adult onset, as defined in the Consensus guidelines for the diagnosis and treatment of adults with GH deficiency II (2007) as well as American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for Growth Hormone use in Growth Hormone‐Deficient Adults and Transition Patients (2009).
2.
rhGH drug naive or any registered or investigational rhGH replacement therapy was not given for more than 6 months before the screening.
3.
Patients on stable hormonal replacement therapies for deficiencies of other hypothalamo‐pituitary axes must be on an optimized and stable treatment regimen (hormone levels within normal ranges on screening) for at least three months prior to screening. Temporary adjustment of glucocorticoid replacement therapy, as appropriate,is acceptable.
4.
Screening IGF‐I level of at least 1 SD (IGF‐I SDS<‐ 1) below the mean IGF‐I level standardized for age and sex according to the central laboratory reference values.
5.
Body Mass Index (BMI, kg/m2) of both male and female patients must be between 22.0 to 35.0 kg/m2.
6.
Fertile females must agree to use appropriate contraceptive methods during the study and 20 days after the last dose of study medication.
7.
Female patients must have a negative serum pregnancy test at inclusion.
8.
Confirmed to be negative for anti rhGH antibodies at the time of screening.
9.
Willing and able to provide written informed consent prior to performing any study procedures. |
|
E.4 | Principal exclusion criteria |
1.
Evidence of growth of pituitary adenoma or other intracranial tumor
within the last 12 months which has to be confirmed by computer
tomography (CT) or magnetic resonance imaging (MRI) scan (with
contrast) within 3 months prior to screening. (Patients with inactive
remnant intracranial tumors are eligible).
2.
History of malignancy other than i) cranial tumor or leukemia causing
GHD or ii) fully treated basal cell carcinoma or evidence of active
malignancy.
3.
Current antitumor therapy.
4.
Subjects presenting with any clinically significant ECG abnormality.
5.
Evidence of intracranial hypertension.
6.
Significant hepatic dysfunction (persistent elevation of alanine
transaminase [ALT] or aspartate transaminase [AST] >1.5 x upper limit
of normal).
7.
Significant renal impairment as indicated by serum creatinine levels
above the normalized range for age.
8.
Any other major medical conditions, including e.g., clinically manifest
diabetes mellitus, hypertension, tuberculosis, major surgery within the
last three months before screening, or significantly abnormal laboratory
tests (e.g., disturbed calcium homeostasis); or any other conditions
(e.g., acute infections) that may influence drug absorption, metabolism
or excretion or that may interfere with any study variables in the
judgment of the investigator.
9.
Systemic corticosteroids other than in replacement doses within the 3
months before screening. (Temporary adjustment of glucocorticoids, as
appropriate, is acceptable).
10.
Pregnancy and breastfeeding
11.
Anabolic steroids other than gonadal steroid replacement therapy within 2 months before screening. Per‐oral estrogen replacement and
hormonal
contraceptives are not allowed. For replacement purposes, transdermal
estrogens are permitted in female patients.
12.
History of non‐compliance with medications, un‐cooperativeness or
alcohol/drug abuse.
13.
Positive results from serology examination for HBV, HCV or HIV.
14.
Known or suspected hypersensitivity to the study treatment.
15.
Blood donation or any major blood loss >500 mL within the past 90 days
prior to screening.
16.
History of any medical or psychiatric condition that in the opinion of the
investigator would pose a risk for participation in this study or interfere
with the compliance needed for this study.
17.
Received an investigational drug or product, or participated in a drug
study within 30 days before Screening. |
|
E.5 End points |
E.5.1 | Primary end point(s) |
Primary efficacy endpoints: Change of IGF‐I levels in function of time, and dose strengths |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
on week 2,4,8,12,16,20,24,28,32,36,40,44,48,56,64,72,74 |
|
E.5.2 | Secondary end point(s) |
Secondary efficacy endpoints:
Biochemical endpoints (IGF‐I andIGFBP3 will also serve as pharmacodynamic endpoints):
Main biochemical endpoints
1)IGF‐I SDS; changes to baseline in IGF‐I SDS;
2)IGFBP3, IGFBP3 SDS (actual values and SDS changes to baseline)
Exploratory biochemical endpoints
1)Lipid parameters (Total Cholesterol, LDL, HDL, Lp(a) Lipoprotein, triglycerides; actual values and changes to baseline)
Clinical endpoints:
Main Clinical endpoints
1)Change in lean body mass (LBM) expressed in kg‐s; from the baseline to the end of study (as measured with DXA)
2)Change in body fat mass (FM) expressed in kg‐s from the baseline to the end of study as measured with DXA
3)Relative change in body fat,
4)Change in trunk fat (kg‐s)
5)Relative change in trunk fat
6)Change in bone mineral density
Exploratory clinical endpoints
1)Change in waist circumference
2)Change in hip circumference
3)Change in waist‐to‐hip ratio
4)Change in sum of skinfolds thickness
5)Change in BMI
6)Change in QoL (SF‐36) scores |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
Main biochemical endpoints on week 2,4,8,12,16,20,24,28,32,36,40,44,48,56,64,72,74
Exploratory biochemical endpoints on week 4,12,24,36,48,74
Main clinical endpoints on week 12,24,48,74
Exploratory clinical endpoints on week 12,24,48,74 |
|
E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
|
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 5 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 2 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 10 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Bulgaria |
Hungary |
India |
Korea, Republic of |
Poland |
Romania |
Russian Federation |
Serbia |
Ukraine |
|
E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
|
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 6 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |