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A Clinical Study in AGHD to Assess Safety, Tolerability and Efficacy of GX-H9

Primary Purpose

Adult Growth Hormone Deficiency

Status
Completed
Phase
Phase 2
Locations
Korea, Republic of
Study Type
Interventional
Intervention
GX-H9
Genotropin
Sponsored by
Genexine, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Adult Growth Hormone Deficiency

Eligibility Criteria

20 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

Each subject must meet all of the following criteria to be enrolled in this study:

  1. Is a male or female aged ≥20 and 65 years with AGHD, either adult onset GHD due to hypothalamic pituitary disease or childhood onset GHD that is either idiopathic or due to hypothalamic pituitary disease or due to genetic causes.
  2. Has documented confirmation (medical history) of GH deficiency during adulthood by 1 or more growth hormone (GH) stimulation tests, as follows:

    • Insulin tolerance test (peak hGH≤3.0 ng/mL)
    • Arginine + growth-hormone-releasing hormone (peak hGH≤4.0 ng/mL)
  3. Has been treated with stable hormonal replacement therapies for deficiencies of other hypothalamo pituitary axes and must have been on an optimized and stable treatment regimen for at least 3 months before screening (free thyroxine [T4] level within normal range at screening). Temporary adjustment of glucocorticoid replacement therapy, as appropriate, is acceptable.
  4. Has a screening IGF-1 level of at least 1 standard deviation (SD) score (IGF-1 SD score <1) below the mean IGF-1 level standardized for age and gender according to the central laboratory reference values.
  5. Has a BMI of ≥18.0 and 35.0 kg/m2 (both male and female subjects).
  6. Has a confirmed negative test result for anti-recombinant human growth hormone (anti-rhGH) antibodies at screening.
  7. Must agree to use appropriate contraceptive methods (ie, condoms, cervical cap in conjunction with spermicide, sterilization, and intra uterine device) during the study and for 6 months after the last dose of study drug.
  8. Female subjects must have a negative serum pregnancy test result at screening.
  9. Must be willing and able to provide written informed consent before performing any study procedures.

Exclusion Criteria:

A subject meeting any of the following criteria will be excluded from the study:

  1. Has evidence of growth of pituitary adenoma or other intracranial tumor within the last 12 months which has to be confirmed by computed tomography or magnetic resonance imaging scan (with contrast) within 3 months before screening. (Subjects with inactive remnant intracranial tumors are eligible).
  2. Is currently receiving antitumor therapy and has a 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. Has any clinically significant electrocardiogram (ECG) abnormality at screening.
  4. Has evidence of intracranial hypertension at screening.
  5. Has uncontrolled diabetes mellitus with diet and exercise, as determined based on glycated hemoglobin (HbA1c) levels ≥7.0% at screening.
  6. Has impaired liver function defined as elevation of alanine aminotransferase (ALT) or aspartate aminotransferase (AST) greater than 2.0 × upper limit of normal (ULN).
  7. Has impaired kidney function defined as increased serum creatinine levels greater than 1.5 × ULN.
  8. Has had active acromegaly within 18 months before screening.
  9. Has active carpal tunnel syndrome.
  10. Has Prader-Willi syndrome.
  11. Has had active Cushing syndrome within 12 months before screening.
  12. Has any other major medical conditions, including eg, clinically manifested hypertension, tuberculosis, major surgery within the 3 months before screening, or significantly abnormal laboratory test results (eg, disturbed calcium homeostasis); or any other conditions (eg, acute infections) that may influence drug absorption, metabolism, or excretion, or that may interfere with any study variables in the judgment of the investigator.
  13. Has been treated with systemic corticosteroids other than replacement therapy within 3 months before screening.
  14. Is a female subject of childbearing potential who is pregnant, breastfeeding, or intends to become pregnant.
  15. Has been treated with anabolic steroids other than gonadal steroid replacement therapy within 2 months before screening. Oral estrogen replacement and hormonal contraceptives are not allowed in female subjects. For replacement purposes, transdermal estrogens are permitted in female subjects.
  16. Has a history of noncompliance with medications, uncooperativeness, or alcohol/drug abuse.
  17. Has a positive result from serology examination for hepatitis B virus (HBV), hepatitis C virus (HCV), or human immunodeficiency virus (HIV).
  18. Has a known or suspected hypersensitivity to rhGH.
  19. Has donated blood or had any major blood loss greater than 500 mL within 90 days before screening.
  20. Has a 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.
  21. Has received an investigational drug or product or has participated in a drug study within 60 days before screening.

Sites / Locations

  • Severance Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Group 1: GX-H9 + Genotropin

Group 2: GX-H9 + Genotropin

Group 3: GX-H9 + Genotropin

Arm Description

GX-H9 (weekly dose), Genotropin (daily)

GX-H9 (weekly dose), Genotropin (daily)

GX-H9 (weekly dose), Genotropin (daily)

Outcomes

Primary Outcome Measures

The change in insulin-like growth factor-1 (IGF-1) levels in relation to time and dose strength

Secondary Outcome Measures

Pharmacokinetic (PK) profile of GX-H9 in the treatment of AGHD: Area under the curve, AUC0-t
PK profile of GX-H9 in the treatment of AGHD: Area under the curve, AUC0-inf
PK profile of GX-H9 in the treatment of AGHD: Area under the curve, AUC0-tau
PK profile of GX-H9 in the treatment of AGHD: Maximum serum concentration, Cmax
PK profile of GX-H9 in the treatment of AGHD: The time taken to reach the maximum concentration, Tmax
PK profile of GX-H9 in the treatment of AGHD: Half-life, t1/2
Pharmacodynamic (PD) profile of GX-H9 in the treatment of AGHD: Maximum serum concentration of IGF-1, Cmax
PD profile of GX-H9 in the treatment of AGHD: Area under curve of IGF-1, AUC0-t
PD profile of GX-H9 in the treatment of AGHD: Maximum serum concentration of IGFBP-3, Cmax
PD profile of GX-H9 in the treatment of AGHD: Area under curve of IGFBP-3, AUC0-t
Data in Physical examination, Vital signs, Electrocardiography, Clinical Laboratory Test Results Related to Investigational Product
Immunogenicity Test After subcutaneous injection of GX-H9
The changes of glucose metabolism indices
Data in hormonal status of thyroid, estradiol(female), testosterone(male), and cortisol levels
The lipid parameters as actual values and percent change from baseline (CFB)at week 12: total cholesterol
The lipid parameters as actual values and percent change from baseline (CFB) at week 12: High-density lipoprotein cholesterol
The lipid parameters as actual values and percent change from baseline (CFB) at week 12: low-density lipoprotein cholesterol
The lipid parameters as actual values and percent change from baseline (CFB) at week 12: Triglycerides
The lipid parameters as actual values and percent change from baseline (CFB) at week 12: lipoprotein[a]
The waist circumference as actual values and CFB at week 12
The hip circumference as actual values and CFB at week 12
The waist-to-hip ratio as actual values and CFB at week 12
The BMI as actual values and CFB at week 12

Full Information

First Posted
August 28, 2015
Last Updated
September 4, 2017
Sponsor
Genexine, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02946606
Brief Title
A Clinical Study in AGHD to Assess Safety, Tolerability and Efficacy of GX-H9
Official Title
A Randomized, Active-controlled, Multiple-dose, Open-label Study to Evaluate the Safety, Tolerability, and Efficacy of the Long-acting Antibody-fused Recombinant Human Growth Hormone (GX-H9) in Adult Growth Hormone Deficiency (AGHD)
Study Type
Interventional

2. Study Status

Record Verification Date
September 2017
Overall Recruitment Status
Completed
Study Start Date
January 2015 (undefined)
Primary Completion Date
December 30, 2016 (Actual)
Study Completion Date
December 30, 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Genexine, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a randomized, active-controlled, open-label, sequential dose group, Phase 1b/2 study designed to assess the safety, tolerability, efficacy, pharmacokinetics, and pharmacodynamics of weekly and every other week doses of GX-H9 in the treatment of AGHD.
Detailed Description
The subjects who are adequately eligible to attend this clinical trial via screening will be sequentially assigned starting with Group 1. Each group will be comprised of subjects who will receive both GX-H9 and Genotropin, and subjects will be randomly assigned to either GX-H9 and Genotropin in the ratio of 4:1. The treatment will proceed as the proposed group order (Group 1, Group 2, Group 3), and safety and insulin-like growth factor (IGF-1) will be reviewed six weeks after each treatment by the safety monitoring committees before proceeding to the next group.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Adult Growth Hormone Deficiency

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Masking Description
Open Label
Allocation
Randomized
Enrollment
45 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Group 1: GX-H9 + Genotropin
Arm Type
Experimental
Arm Description
GX-H9 (weekly dose), Genotropin (daily)
Arm Title
Group 2: GX-H9 + Genotropin
Arm Type
Experimental
Arm Description
GX-H9 (weekly dose), Genotropin (daily)
Arm Title
Group 3: GX-H9 + Genotropin
Arm Type
Experimental
Arm Description
GX-H9 (weekly dose), Genotropin (daily)
Intervention Type
Drug
Intervention Name(s)
GX-H9
Intervention Description
Human growth hormone
Intervention Type
Drug
Intervention Name(s)
Genotropin
Intervention Description
Human growth hormone
Primary Outcome Measure Information:
Title
The change in insulin-like growth factor-1 (IGF-1) levels in relation to time and dose strength
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Pharmacokinetic (PK) profile of GX-H9 in the treatment of AGHD: Area under the curve, AUC0-t
Time Frame
12 weeks
Title
PK profile of GX-H9 in the treatment of AGHD: Area under the curve, AUC0-inf
Time Frame
12 weeks
Title
PK profile of GX-H9 in the treatment of AGHD: Area under the curve, AUC0-tau
Time Frame
12 weeks
Title
PK profile of GX-H9 in the treatment of AGHD: Maximum serum concentration, Cmax
Time Frame
12 weeks
Title
PK profile of GX-H9 in the treatment of AGHD: The time taken to reach the maximum concentration, Tmax
Time Frame
12 weeks
Title
PK profile of GX-H9 in the treatment of AGHD: Half-life, t1/2
Time Frame
12 weeks
Title
Pharmacodynamic (PD) profile of GX-H9 in the treatment of AGHD: Maximum serum concentration of IGF-1, Cmax
Time Frame
12 weeks
Title
PD profile of GX-H9 in the treatment of AGHD: Area under curve of IGF-1, AUC0-t
Time Frame
12 weeks
Title
PD profile of GX-H9 in the treatment of AGHD: Maximum serum concentration of IGFBP-3, Cmax
Time Frame
12 weeks
Title
PD profile of GX-H9 in the treatment of AGHD: Area under curve of IGFBP-3, AUC0-t
Time Frame
12 weeks
Title
Data in Physical examination, Vital signs, Electrocardiography, Clinical Laboratory Test Results Related to Investigational Product
Time Frame
12 weeks
Title
Immunogenicity Test After subcutaneous injection of GX-H9
Time Frame
12 weeks
Title
The changes of glucose metabolism indices
Time Frame
12 weeks
Title
Data in hormonal status of thyroid, estradiol(female), testosterone(male), and cortisol levels
Time Frame
12 weeks
Title
The lipid parameters as actual values and percent change from baseline (CFB)at week 12: total cholesterol
Time Frame
change from baseline at 12weeks
Title
The lipid parameters as actual values and percent change from baseline (CFB) at week 12: High-density lipoprotein cholesterol
Time Frame
change from baseline at 12weeks
Title
The lipid parameters as actual values and percent change from baseline (CFB) at week 12: low-density lipoprotein cholesterol
Time Frame
change from baseline at 12weeks
Title
The lipid parameters as actual values and percent change from baseline (CFB) at week 12: Triglycerides
Time Frame
change from baseline at 12weeks
Title
The lipid parameters as actual values and percent change from baseline (CFB) at week 12: lipoprotein[a]
Time Frame
change from baseline at 12weeks
Title
The waist circumference as actual values and CFB at week 12
Time Frame
change from baseline at 12weeks
Title
The hip circumference as actual values and CFB at week 12
Time Frame
change from baseline at 12weeks
Title
The waist-to-hip ratio as actual values and CFB at week 12
Time Frame
change from baseline at 12weeks
Title
The BMI as actual values and CFB at week 12
Time Frame
change from baseline at 12weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Each subject must meet all of the following criteria to be enrolled in this study: Is a male or female aged ≥20 and 65 years with AGHD, either adult onset GHD due to hypothalamic pituitary disease or childhood onset GHD that is either idiopathic or due to hypothalamic pituitary disease or due to genetic causes. Has documented confirmation (medical history) of GH deficiency during adulthood by 1 or more growth hormone (GH) stimulation tests, as follows: Insulin tolerance test (peak hGH≤3.0 ng/mL) Arginine + growth-hormone-releasing hormone (peak hGH≤4.0 ng/mL) Has been treated with stable hormonal replacement therapies for deficiencies of other hypothalamo pituitary axes and must have been on an optimized and stable treatment regimen for at least 3 months before screening (free thyroxine [T4] level within normal range at screening). Temporary adjustment of glucocorticoid replacement therapy, as appropriate, is acceptable. Has a screening IGF-1 level of at least 1 standard deviation (SD) score (IGF-1 SD score <1) below the mean IGF-1 level standardized for age and gender according to the central laboratory reference values. Has a BMI of ≥18.0 and 35.0 kg/m2 (both male and female subjects). Has a confirmed negative test result for anti-recombinant human growth hormone (anti-rhGH) antibodies at screening. Must agree to use appropriate contraceptive methods (ie, condoms, cervical cap in conjunction with spermicide, sterilization, and intra uterine device) during the study and for 6 months after the last dose of study drug. Female subjects must have a negative serum pregnancy test result at screening. Must be willing and able to provide written informed consent before performing any study procedures. Exclusion Criteria: A subject meeting any of the following criteria will be excluded from the study: Has evidence of growth of pituitary adenoma or other intracranial tumor within the last 12 months which has to be confirmed by computed tomography or magnetic resonance imaging scan (with contrast) within 3 months before screening. (Subjects with inactive remnant intracranial tumors are eligible). Is currently receiving antitumor therapy and has a history of malignancy other than i) cranial tumor or leukemia causing GHD, or ii) fully treated basal cell carcinoma or evidence of active malignancy. Has any clinically significant electrocardiogram (ECG) abnormality at screening. Has evidence of intracranial hypertension at screening. Has uncontrolled diabetes mellitus with diet and exercise, as determined based on glycated hemoglobin (HbA1c) levels ≥7.0% at screening. Has impaired liver function defined as elevation of alanine aminotransferase (ALT) or aspartate aminotransferase (AST) greater than 2.0 × upper limit of normal (ULN). Has impaired kidney function defined as increased serum creatinine levels greater than 1.5 × ULN. Has had active acromegaly within 18 months before screening. Has active carpal tunnel syndrome. Has Prader-Willi syndrome. Has had active Cushing syndrome within 12 months before screening. Has any other major medical conditions, including eg, clinically manifested hypertension, tuberculosis, major surgery within the 3 months before screening, or significantly abnormal laboratory test results (eg, disturbed calcium homeostasis); or any other conditions (eg, acute infections) that may influence drug absorption, metabolism, or excretion, or that may interfere with any study variables in the judgment of the investigator. Has been treated with systemic corticosteroids other than replacement therapy within 3 months before screening. Is a female subject of childbearing potential who is pregnant, breastfeeding, or intends to become pregnant. Has been treated with anabolic steroids other than gonadal steroid replacement therapy within 2 months before screening. Oral estrogen replacement and hormonal contraceptives are not allowed in female subjects. For replacement purposes, transdermal estrogens are permitted in female subjects. Has a history of noncompliance with medications, uncooperativeness, or alcohol/drug abuse. Has a positive result from serology examination for hepatitis B virus (HBV), hepatitis C virus (HCV), or human immunodeficiency virus (HIV). Has a known or suspected hypersensitivity to rhGH. Has donated blood or had any major blood loss greater than 500 mL within 90 days before screening. Has a 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. Has received an investigational drug or product or has participated in a drug study within 60 days before screening.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Eun Jig Lee, MD, PhD
Organizational Affiliation
Yonsei University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Severance Hospital
City
Seoul
Country
Korea, Republic of

12. IPD Sharing Statement

Plan to Share IPD
No

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A Clinical Study in AGHD to Assess Safety, Tolerability and Efficacy of GX-H9

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