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A Trial of YPEG-rhGH in Children With Short Stature

Primary Purpose

Idiopathic Short Stature, Small for Gestational Age, Turner Syndrome

Status
Active
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
YPEG-rhGH
YPEG-rhGH
rhGH
rhGH
Sponsored by
Xiamen Amoytop Biotech Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Idiopathic Short Stature focused on measuring Growth hormone, Somatotropin, Short stature, Idiopathic short stature, Small for gestational age, Turner syndrome

Eligibility Criteria

4 Years - 11 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Prepubertal (Tanner I), aged older than 4 years and younger than10 years for girls and 11 years for boys. Body weight: 12kg ≤ body weight ≤ 50kg. For children with idiopathic short stature: a) Birth length and weight were at the 10th percentile and above of normal reference values for infants of the same gestational age and sex; b) Height at screening was 2.0 standard deviations (SD) below the mean height for chronological age and sex c) Exclude other causes such as systemic diseases, other endocrine diseases, nutritional diseases, chromosomal abnormalities, skeletal dysplasia, psycho-emotional disorders, etc. were excluded d) GH peak ≥10.0ng/ml confirmed by two different drug GH provocation tests; e) Bone age (BA)-chronological age (CA) ≤1 year. For children with small for gestational age: a) Birth length and weight were at the 10th percentile and below the normal reference values for infants if the same gestational age and sex; b) Gestational age at birth ≥ 24 weeks; c) Height at screening was below -2 SD of the mean for the same age and sex, and please refer to the protocol annex 1 for height. For children with Turner syndrome: a) Chromosome karyotype: 45, X; 45, X/46, XXqi; 45, X/46, XXr; 45, X/46, XX; 46, XXqi; 46, XXpi; 45, X/47, XXX; 46, XXp-; 45, X/46, XXp-; 46, XXq-; 45, x/46, XXq-; 45, X/46, XX/47, XXX, etc.; b) Having at least one specific physical characteristic: Including but not limited to low posterior hairline, facial skin nevus, neck flips, short neck, low ear position, small jaw, high palatal arch, shield chest, wide breast spacing, elbow ectropion, knee ectropion, short 4th and 5th metacarpal, nail dysplasia, scoliosis, ptosis, strabismus, cardiovascular system abnormalities such as aortic stenosis, bicuspid aortic valve, hypertension, and reproductive system abnormalities such as primary gonadal insufficiency, renal malformation, hypothyroidism and middle ear disease; c) The height at screening was below the mean -2SD of the same age and gender, and please refer to the protocol annex 1 for height. Understands and signs the informed consent form voluntarily by the subject's parent(s) and/or legal guardian(s). And written assent of the subject is required if the subject is 8 years of age or older). Exclusion Criteria: For children with small for gestational: confirmed or suspected Bloom syndrome. For children with Turner syndrome: containing a Y chromosome or a fragment derived from a Y chromosome. Children with closed epiphysis. Children who diagnosed or highly suspected growth hormone deficiency (GHD), or other types of growth abnormalities: e.g., Noonan syndrome, Prader-Willi syndrome, Russell-Silver syndrome, etc. Children who have previously received systemic growth-promoting therapy, including but not limited to rhGH, aromatase inhibitors, sex hormones, etc., for at least 1 month or longer. Children who are now receiving or plan to receive the therapy of glucocorticoids, methylphenidate, and any other drugs that may have an effect on growth. Children with abnormal values of liver and kidney function (ALT > 1.5 ULN, Cr > 1 ULN). Concomitant with chronic hepatitis B, AIDS, tuberculosis, and any other chronic infectious disease. Patients with severe allergic constitutions or allergic to growth hormone or its excipients such as mannitol, lysine, sodium chloride and other ingredients. Patients with a previous history of malignancy or are currently suffering from active malignancy, including intracranial tumors. Patients with abnormal glucose regulation (including abnormal fasting glucose and/or abnormal glucose tolerance) or diabetes. Patients who are mentally ill or have a family history of mental illness. Patients who are suffering from chronic systemic diseases, such as malnutrition, immunocompromised individuals, asthma, etc. Patients with congenital intracranial hypertension. Patients with slipped capital femoral epiphysis (SCFE). Patients with scoliosis exceeding 15°; Patients who have participated in any drug clinical study (as a subject) within 3 months prior to screening and have received a drug intervention Patients who the investigators considered unfit for the study.

Sites / Locations

  • The Fourth Affiliated Hospital of Anhui Medical University
  • The Second Hospital of Anhui Medical University
  • The First Affiliated Hospital of Xiamen University
  • Sun Yat-sen Memorial Hospital, Sun Yat-sen University
  • The Third Affiliated Hospital, Sun Yat-sen University
  • Sanya Central Hospital (Hainan Third People's Hospital)
  • Henan Children's Hospital Zhengzhou Children's Hospital
  • Tongji Hospital, Tongji Medical College of HUST
  • Wuhan Children's Hospital
  • Hunan Children's Hospital
  • Children's Hospital of Nanjing Medical University
  • Children's Hospital of Soochow University
  • Affiliated Hospital of Jiangnan University
  • Jiangxi Provincial Children's Hospital
  • Chengdu Women's and Children's Central Hospital
  • West China Second University Hospital, Sichuan University
  • Zhejiang Provincial People's Hospital
  • Children's Hospital, Capital Institute of Pediatrics
  • Children's Hospital of Shanghai

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Active Comparator

Active Comparator

Arm Label

YPEG-GH low dose group

YPEG-GH high dose group

rhGH low dose group

rhGH high dose group

Arm Description

Outcomes

Primary Outcome Measures

Pharmacokinetic-area under plasma concentration versus time curve
Pharmacokinetic-maximum serum concentration
Pharmacokinetic-time to reach the maximum plasma concentration
Pharmacokinetic-terminal disposition phase half-life
Pharmacokinetic-terminal elimination rate constant
Pharmacokinetic-apparent clearance after extravascular administration
Pharmacokinetic-apparent volume of distribution

Secondary Outcome Measures

Pharmacodynamics-the properties of Insulin-like growth facto1 and Insulin-like growth factor binding receptor 3.
Height velocity (HV, cm/year)
Change of height velocity compared to baseline (ΔHV, cm/year)
Height standard deviation according to chronological age (Ht SDS CA)
Change in bone age
Adverse events (including injection site reactions), changes from baseline in vital signs and laboratory tests

Full Information

First Posted
March 21, 2023
Last Updated
April 27, 2023
Sponsor
Xiamen Amoytop Biotech Co., Ltd.
Collaborators
Tongji Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT05838885
Brief Title
A Trial of YPEG-rhGH in Children With Short Stature
Official Title
A Multicenter, Randomized, Open-label, Positive-controlled Phase 2 Study to Explore the Optimal Dose of Y- Shaped Pegylated Recombinant Growth Hormone (YPEG-rhGH) in Children With Short Stature (ISS, SGA, TS)
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
February 15, 2022 (Actual)
Primary Completion Date
December 2023 (Anticipated)
Study Completion Date
March 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Xiamen Amoytop Biotech Co., Ltd.
Collaborators
Tongji Hospital

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
To explore the dose-response relationship between pharmacokinetics and pharmacodynamics of Y- Shaped Pegylated growth hormone injection (YPEG-GH) in children with short stature (idiopathic short stature (ISS), small for gestational age (SGA), Turner syndrome (TS)). To evaluate its tolerability, safety and efficacy and to provide evidence for dose selection and titration for future clinical development and clinical application in these population.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Idiopathic Short Stature, Small for Gestational Age, Turner Syndrome
Keywords
Growth hormone, Somatotropin, Short stature, Idiopathic short stature, Small for gestational age, Turner syndrome

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
YPEG-GH low dose group
Arm Type
Experimental
Arm Title
YPEG-GH high dose group
Arm Type
Experimental
Arm Title
rhGH low dose group
Arm Type
Active Comparator
Arm Title
rhGH high dose group
Arm Type
Active Comparator
Intervention Type
Drug
Intervention Name(s)
YPEG-rhGH
Intervention Description
YPEG-rhGH, 140μg/kg, s.c., once a week, for 52 weeks
Intervention Type
Drug
Intervention Name(s)
YPEG-rhGH
Intervention Description
YPEG-rhGH, 280μg/kg, s.c., once a week, for 52 weeks
Intervention Type
Drug
Intervention Name(s)
rhGH
Intervention Description
rhGH, 245μg/kg/week, divided into 7 subcutaneous injections, once daily, for 52 weeks
Intervention Type
Drug
Intervention Name(s)
rhGH
Intervention Description
rhGH, 470μg/kg/week, divided into 7 subcutaneous injections, once daily, for 52 weeks
Primary Outcome Measure Information:
Title
Pharmacokinetic-area under plasma concentration versus time curve
Time Frame
up to 52 weeks
Title
Pharmacokinetic-maximum serum concentration
Time Frame
up to 52weeks
Title
Pharmacokinetic-time to reach the maximum plasma concentration
Time Frame
up to 52 weeks
Title
Pharmacokinetic-terminal disposition phase half-life
Time Frame
up to 52 weeks
Title
Pharmacokinetic-terminal elimination rate constant
Time Frame
up to 52 weeks
Title
Pharmacokinetic-apparent clearance after extravascular administration
Time Frame
up to 52 weeks
Title
Pharmacokinetic-apparent volume of distribution
Time Frame
up to 52 weeks
Secondary Outcome Measure Information:
Title
Pharmacodynamics-the properties of Insulin-like growth facto1 and Insulin-like growth factor binding receptor 3.
Time Frame
up to 57 weeks
Title
Height velocity (HV, cm/year)
Time Frame
At 52 weeks of treatment
Title
Change of height velocity compared to baseline (ΔHV, cm/year)
Time Frame
At 52 weeks of treatment
Title
Height standard deviation according to chronological age (Ht SDS CA)
Time Frame
At 52 weeks of treatment
Title
Change in bone age
Time Frame
At 52 weeks of treatment
Title
Adverse events (including injection site reactions), changes from baseline in vital signs and laboratory tests
Time Frame
up to 57 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
4 Years
Maximum Age & Unit of Time
11 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Prepubertal (Tanner I), aged older than 4 years and younger than10 years for girls and 11 years for boys. Body weight: 12kg ≤ body weight ≤ 50kg. For children with idiopathic short stature: a) Birth length and weight were at the 10th percentile and above of normal reference values for infants of the same gestational age and sex; b) Height at screening was 2.0 standard deviations (SD) below the mean height for chronological age and sex c) Exclude other causes such as systemic diseases, other endocrine diseases, nutritional diseases, chromosomal abnormalities, skeletal dysplasia, psycho-emotional disorders, etc. were excluded d) GH peak ≥10.0ng/ml confirmed by two different drug GH provocation tests; e) Bone age (BA)-chronological age (CA) ≤1 year. For children with small for gestational age: a) Birth length and weight were at the 10th percentile and below the normal reference values for infants if the same gestational age and sex; b) Gestational age at birth ≥ 24 weeks; c) Height at screening was below -2 SD of the mean for the same age and sex, and please refer to the protocol annex 1 for height. For children with Turner syndrome: a) Chromosome karyotype: 45, X; 45, X/46, XXqi; 45, X/46, XXr; 45, X/46, XX; 46, XXqi; 46, XXpi; 45, X/47, XXX; 46, XXp-; 45, X/46, XXp-; 46, XXq-; 45, x/46, XXq-; 45, X/46, XX/47, XXX, etc.; b) Having at least one specific physical characteristic: Including but not limited to low posterior hairline, facial skin nevus, neck flips, short neck, low ear position, small jaw, high palatal arch, shield chest, wide breast spacing, elbow ectropion, knee ectropion, short 4th and 5th metacarpal, nail dysplasia, scoliosis, ptosis, strabismus, cardiovascular system abnormalities such as aortic stenosis, bicuspid aortic valve, hypertension, and reproductive system abnormalities such as primary gonadal insufficiency, renal malformation, hypothyroidism and middle ear disease; c) The height at screening was below the mean -2SD of the same age and gender, and please refer to the protocol annex 1 for height. Understands and signs the informed consent form voluntarily by the subject's parent(s) and/or legal guardian(s). And written assent of the subject is required if the subject is 8 years of age or older). Exclusion Criteria: For children with small for gestational: confirmed or suspected Bloom syndrome. For children with Turner syndrome: containing a Y chromosome or a fragment derived from a Y chromosome. Children with closed epiphysis. Children who diagnosed or highly suspected growth hormone deficiency (GHD), or other types of growth abnormalities: e.g., Noonan syndrome, Prader-Willi syndrome, Russell-Silver syndrome, etc. Children who have previously received systemic growth-promoting therapy, including but not limited to rhGH, aromatase inhibitors, sex hormones, etc., for at least 1 month or longer. Children who are now receiving or plan to receive the therapy of glucocorticoids, methylphenidate, and any other drugs that may have an effect on growth. Children with abnormal values of liver and kidney function (ALT > 1.5 ULN, Cr > 1 ULN). Concomitant with chronic hepatitis B, AIDS, tuberculosis, and any other chronic infectious disease. Patients with severe allergic constitutions or allergic to growth hormone or its excipients such as mannitol, lysine, sodium chloride and other ingredients. Patients with a previous history of malignancy or are currently suffering from active malignancy, including intracranial tumors. Patients with abnormal glucose regulation (including abnormal fasting glucose and/or abnormal glucose tolerance) or diabetes. Patients who are mentally ill or have a family history of mental illness. Patients who are suffering from chronic systemic diseases, such as malnutrition, immunocompromised individuals, asthma, etc. Patients with congenital intracranial hypertension. Patients with slipped capital femoral epiphysis (SCFE). Patients with scoliosis exceeding 15°; Patients who have participated in any drug clinical study (as a subject) within 3 months prior to screening and have received a drug intervention Patients who the investigators considered unfit for the study.
Facility Information:
Facility Name
The Fourth Affiliated Hospital of Anhui Medical University
City
Hefei
State/Province
Anhui
Country
China
Facility Name
The Second Hospital of Anhui Medical University
City
Hefei
State/Province
Anhui
Country
China
Facility Name
The First Affiliated Hospital of Xiamen University
City
Xiamen
State/Province
Fujian
Country
China
Facility Name
Sun Yat-sen Memorial Hospital, Sun Yat-sen University
City
Guangzhou
State/Province
Guangdong
Country
China
Facility Name
The Third Affiliated Hospital, Sun Yat-sen University
City
Guangzhou
State/Province
Guangdong
Country
China
Facility Name
Sanya Central Hospital (Hainan Third People's Hospital)
City
Sanya
State/Province
Hainan
Country
China
Facility Name
Henan Children's Hospital Zhengzhou Children's Hospital
City
Zhengzhou
State/Province
Henan
Country
China
Facility Name
Tongji Hospital, Tongji Medical College of HUST
City
Wuhan
State/Province
Hubei
Country
China
Facility Name
Wuhan Children's Hospital
City
Wuhan
State/Province
Hubei
Country
China
Facility Name
Hunan Children's Hospital
City
Changsha
State/Province
Hunan
Country
China
Facility Name
Children's Hospital of Nanjing Medical University
City
Nanjing
State/Province
Jiangsu
Country
China
Facility Name
Children's Hospital of Soochow University
City
Suzhou
State/Province
Jiangsu
Country
China
Facility Name
Affiliated Hospital of Jiangnan University
City
Wuxi
State/Province
Jiangsu
Country
China
Facility Name
Jiangxi Provincial Children's Hospital
City
Nanchang
State/Province
Jiangxi
Country
China
Facility Name
Chengdu Women's and Children's Central Hospital
City
Chengdu
State/Province
Sichuan
Country
China
Facility Name
West China Second University Hospital, Sichuan University
City
Chengdu
State/Province
Sichuan
Country
China
Facility Name
Zhejiang Provincial People's Hospital
City
Hangzhou
State/Province
Zhejiang
Country
China
Facility Name
Children's Hospital, Capital Institute of Pediatrics
City
Beijing
Country
China
Facility Name
Children's Hospital of Shanghai
City
Shanghai
Country
China

12. IPD Sharing Statement

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A Trial of YPEG-rhGH in Children With Short Stature

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