Ipsen: Encouraging Preliminary New Data Available For The Treatment Of Short Stature Children With Low IGF-1 Levels

Main Category: Diabetes
Also Included In: Clinical Trials / Drug Trials;  Pediatrics / Children's Health
Article Date: 17 Sep 2009 - 1:00 PDT

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Ipsen (Paris:IPN), announced preliminary results from a Phase II open-label clinical trial (MS316 study) that evaluates the co-administration of recombinant human growth hormone (rhGH) and recombinant human insulin-like growth factor-1 (rhIGF-1) in two separate daily injections as a potential treatment for children with otherwise unexplained short stature associated with low IGF-1 levels. Ipsen also announced results from a long-term study of rhIGF-1 (study 1419) in patients with severe primary insulin-like growth factor deficiency (sPIGFD) that demonstrated that long-term twice-daily therapy with rhIGF-1 improved the adult and near adult heights of extremely short patients with sPIGFD. The data from these two studies were presented along with posters on rhIGF-1 (Increlex®, mecasermin [rDNA origin] injection) at the 8th Joint Meeting of the Lawson Wilkins Pediatric Endocrine Society / European Society for Pediatric Endocrinology (LWPES/ESPE) in New York, NY.

These studies were performed under INDs (investigational new drug application protocols) and the co-administration of rhGH and rhIGF-1 is not an approved administration regimen for Increlex®. At this point in time, Increlex® is marketed in the U.S. and other countries throughout the world for the treatment of growth failure in children with severe Primary IGFD using twice-daily injections.

"The structuring of its US platform in 2008 enabled Ipsen to build a fully fledged commercial presence in the US but also to gain access to a promising pipeline. The Group intends to capitalize on its unique growth disorders and endocrinology franchise. The interim data presented at the LWPES/ ESPE meeting validate ongoing investigations and we look forward to continuing our research progress with our partners on this effort," said Jean-Luc Bélingard, Chairman and Chief Executive Officer, Ipsen. "Ipsen Group remains fully committed to furthering its endocrinology research and product development in support to its fastest growing franchise in this highly-specialized therapeutic area."

The MS316 study is an ongoing Phase II, randomized, open-label, active-treatment controlled trial evaluating the efficacy and safety of the co-administration of rhGH and rhIGF-1 therapy versus rhGH alone in 106 children with short stature associated with low levels of IGF-1. All participants received morning injections of either rhGH alone (45 μg/kg once-daily) or co-administered with rhIGF-1 (45 μg/kg rhGH and 50, 100 or 150 μg/kg rhIGF-1 also once daily as two injections). Subjects had a baseline mean height standard deviation score (SDS) of - 2.5. Thirty-six of the children enrolled in the study have completed one year of treatment. First-year height velocities were 9.2 cm for the patients receiving rhGH alone and 10.4, 10.7, and 12.1cm for the three rhGH/rhIGF-1 groups. At the end of one year, changes in mean height SDS were 0.72 for the patients receiving rhGH alone and 0.88, 0.91, and 1.11 for the three rhGH/rhIGF-1 groups. Among all patients, the most common adverse events (> 15%) were headache, upper respiratory infection, injection site reactions and fever. Other noteworthy but less frequent adverse events included vomiting, hypoglycemia and gynecomastia. In addition, 2 transient cases of papilledema (probable intracranial hypertension) occurred with co-administration. In both cases, treatment was discontinued and restarted without recurrence.

"The preliminary results for the MS316 study of a co-administration treatment of recombinant IGF-1 and recombinant growth hormone in children with short stature associated with low IGF-1 are encouraging," said L. Kurt Midyett, MD, Medical Director, Children's Mercy Hospital and Clinics, Kansas City, Missouri. "While there is a compelling scientific rationale for co-administration therapy, this remains a research endeavor at this point and I look forward to seeing the completed data compiled and analyzed for this potential co-administration treatment option."

Ipsen also announced data on 16 patients with severe Primary IGFD treated with Increlex® until adult or near-adult height. These patients were part of the original registration trial for Increlex® (study 1419), which continues to collect long-term follow-up data on treatment until they reached adult height. The analysis was done with 9 male and 7 female patients. Patients received a mean dose of 112 μg/kg Increlex® twice-daily for a mean of 9.9 years. Five patients also received GnRH-analog. The mean estimated gain in height up to the time of near-adult height in patients taking Increlex® was 13.2 cm (range -0.4 to 23.4) and the mean estimated gain in adult height was conservatively estimated as 10.5 cm (range -2.9 to 22.3). While long-term Increlex® therapy improved adult height for extremely short patients with severe Primary IGFD, most patients did not experience enough catch-up growth to bring their heights into the normal adult range. The most common side effects associated with Increlex® include dizziness, headache, nausea and vomiting.

"The data supporting the efficacy and safety of recombinant human IGF-I (rhIGF-I) (Increlex®) continue to grow, and these results demonstrate that children with severe Primary IGF-I deficiency can improve their adult/near- adult height with long-term IGF-I therapy," said Philippe F. Backeljauw, MD, Professor of Pediatrics, Cincinnati Children's Hospital Medical Center. "These results provide increased confidence to treat patients with severe Primary IGFD with rhIGF-I (Increlex®)."

Other Ipsen poster presentations included safety and efficacy data of Increlex® based on the IGFD Registry database, which now has over 700 patients enrolled since May 2006, and data on an 86-week, open-label trial of pharmacokinetic (PK)-based once-daily (QD) dosing of rhIGF-1 in 45 treatment-naïve prepubertal children with short stature associated with low IGF-1 levels.

About Increlex® (mecasermin (rDNA origin) injection)

The active ingredient of Increlex® is recombinant human insulin-like growth factor-1 (IGF-1). IGF-1 is the direct mediator of many of growth hormone's (GH) effects on statural growth, and must be present for normal growth of bones and cartilage in children. Without adequate IGF-1, children may not achieve normal height.

Increlex® has been marketed in the United States since early 2006 and in Europe since late 2007 for the treatment of growth failure in children with severe Primary IGFD. Severe Primary IGFD is defined by height at least three standard deviations below the mean and IGF-1 levels at least three standard deviations below the mean for age and sex, and presence of normal or elevated GH level in the US, and IGF-1 levels below the 2.5% percentile for age and sex, and GH sufficiency throughout Europe. In children with this disorder, low IGF-1 levels may be due to growth-hormone resistance or insensitivity associated with mutations in GH receptors, post-GH receptor signaling pathways, or to defects in the IGF-1 gene.

Source
Ipsen

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