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A Study of Leuprolide 11.25 mg and 30 mg Administered Every 3 Months to Treat Central Precocious Puberty

Primary Purpose

Puberty, Precocious

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Leuprolide acetate 11.25 mg
Leuprolide acetate 30 mg
Sponsored by
Abbott
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Puberty, Precocious focused on measuring CPP, central precocious puberty, pediatrics, suppression of luteinizing hormone, Lupron, leuprolide acetate, depot formulation, GnRHa, GnRH agonist, GnRH analog, luteinizing hormone

Eligibility Criteria

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

Inclusion Criteria:

  • Subject has a clinical diagnosis of CPP.
  • Eligible to receive at least 6 mo of therapy to treat CPP after study entry.
  • Bone age advanced at least 1 year beyond the chronological age at time of diagnosis or first treatment.
  • In general good health with no uncontrolled, clinically significant disease which would interfere with bone maturation or mask the objectives of this protocol as assessed by the investigator.

Additional criteria for subjects who have not had previous treatment:

  • Girls 2-8 years inclusive or Boys 2-9 years inclusive at Day 1.
  • Has pretreatment pubertal response to leuprolide acetate stimulation (luteinizing hormone ≥8 mIU/mL) at Screening.
  • Breast pubertal staging of at least 2 in girls; testicular volume of at least 4 cc or testicular length greater than 2.5 cm in boys at Screening.

Additional criteria for subjects previously treated:

  • Girls 2-10 years inclusive or boys 2-11 years inclusive at Day 1.
  • Must have been on standard gonadotropin releasing hormone analog therapy for at least the 6 mo prior to Day 1.
  • Has documented maintenance of luteinizing hormone suppression as evidenced by peak stimulated level <4 mIU/mL at Screening.

Exclusion Criteria:

  • Incomplete precocious puberty (premature thelarche, premature adrenarche).
  • Peripheral precocious puberty: gonadal or adrenal tumors, congenital adrenal hyperplasia, testotoxicosis in boys, human chorionic gonadotropin secreting tumor or McCune-Albright syndrome in girls.
  • Evidence of any abnormal pituitary, hypothalamic, adrenal, thyroid and gonadal function other than premature secretion of gonadotropins not adequately controlled.
  • Unstable intracranial tumors (unresponsive to treatment/expanding) except hamartoma.
  • Previous treatment with GnRHa therapy requiring leuprolide acetate for depot suspension >15 mg monthly.
  • Bone age >13 years for girls and >14 years for boys.
  • Any other condition interfering with growth, ie, skeletal dysplasia, cerebral palsy.
  • Chronic illness requiring treatment that may interfere with growth, ie, chronic steroid use, renal failure, moderate to severe scoliosis.
  • Diagnosis of short stature, ie more than 2.25 standard deviations below the mean height for age (growth chart measurement).
  • Prior or current therapy with medroxyprogesterone acetate or growth hormone.
  • Has an abnormal laboratory value suggesting a clinically significant underlying disease .
  • Creatinine >1.5 mg/dL, alanine aminotransferase and/or aspartate aminotransferase >2.0 x upper limit of normal, or total bilirubin >2.0 mg/dL with aspartate aminotransferase/alanine aminotransferase elevated above normal limits.
  • Positive pregnancy test.
  • Known hypersensitivity to study medication or its excipients.
  • Participation in another drug research within 3 mo of enrollment into this study.
  • Prior or current therapy with insulin-like growth factor-1.
  • Use of an estrogen preparation within 2 mo prior to Day 1.

Sites / Locations

  • Site Reference ID/Investigator# 8765
  • Site Reference ID/Investigator# 11522
  • Site Reference ID/Investigator# 8756
  • Site Reference ID/Investigator# 8755
  • Site Reference ID/Investigator# 8761
  • Site Reference ID/Investigator# 8772
  • Site Reference ID/Investigator# 8749
  • Site Reference ID/Investigator# 8771
  • Site Reference ID/Investigator# 8764
  • Site Reference ID/Investigator# 17621
  • Site Reference ID/Investigator# 8752
  • Site Reference ID/Investigator# 8766
  • Site Reference ID/Investigator# 8768
  • Site Reference ID/Investigator# 17341
  • Site Reference ID/Investigator# 8759
  • Site Reference ID/Investigator# 8750
  • Site Reference ID/Investigator# 8760
  • Site Reference ID/Investigator# 8763
  • Site Reference ID/Investigator# 8754
  • Site Reference ID/Investigator# 8762
  • Site Reference ID/Investigator# 8753
  • Site Reference ID/Investigator# 17922
  • Site Reference ID/Investigator# 17923
  • Site Reference ID/Investigator# 18242
  • Site Reference ID/Investigator# 19661

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Leuprolide acetate 11.25 mg

Leuprolide acetate 30 mg

Arm Description

There are 2 arms that received leuprolide acetate 11.25 mg. Subjects who are treatment naive to leuprolide acetate are designated to be in Arm A and subjects who have previously been treated with leuprolide acetate are designated to be in Arm B.

There are 2 arms that received leuprolide acetate 30 mg. Subjects who are treatment naive to leuprolide acetate are designated to be in Arm C and subjects who have previously been treated with leuprolide acetate are designated to be in Arm D.

Outcomes

Primary Outcome Measures

Percentage of Participants With Suppression of Peak Stimulated Luteinizing Hormone (<4 mIU/mL) From Month 2 Through Month 6
Percentage of participants with suppression of peak stimulated luteinizing hormone that was measured after a gonadotropin-releasing hormone agonist (GnRHa) stimulation test at Month (Mo) 2, 3, and 6. The analysis was performed according to a life table method. Subjects who withdrew without peak-stimulated luteinizing hormone >= 4 mIU/mL were censored at their last measurement of peak-stimulated luteinizing hormone.

Secondary Outcome Measures

Percentage of Participants With Suppression of Basal Estradiol <20 pg/mL by Visit
Percentage of participants with suppression of estradiol, out of the number of girls with at least 1 estradiol measurement at each visit (n/N%). Only girls are analyzed in this outcome measure. Observed data were used with no imputation for missing data.
Percentage of Participants With Suppression of Testosterone in <30 ng/dL by Visit
Percentage of participants with suppression of testosterone, out of the number of boys with at least 1 testosterone measurement at each visit (n/N%). Only boys are analyzed in this outcome measure. Observed data were used with no imputation for missing data.
Peak-stimulated Luteinizing Hormone Concentration by Visit
Observed data were used with no imputation for missing data.
Percentage of Participants With Suppression of the Physical Signs of Puberty (Breast Development) at Month 6
Percentage of participants with suppression of breast development, out of the number of girls with pubertal staging of breast development (n/N%). Only girls are analyzed in this outcome measure. Breast development was rated from Stage 1 (early development) through Stage 5 (full development) according to a Tanner Staging pictogram. Girls entering the study with fully developed breasts (Stage 5) were excluded from this analysis. Observed data were used with no imputation for missing data.
Percentage of Participants With Suppression of the Physical Signs of Puberty (Testicular Volume and Genital Development) at Month 6
Percentage of participants with suppression of genital development and testicular volume, out of the number of boys with pubertal staging of genital development or testicular volume (n/N%). Only boys are analyzed in this outcome measure. External genital development (testes and penis) was rated from Stage 1 (early development) through Stage 5 (full development) according to a Tanner Staging pictogram. Boys entering the study with fully developed genitals (Stage 5) were excluded from this analysis. Observed data were used with no imputation for missing data.
Change From Baseline in Incremental Growth Rate (cm/Year) at Month 6
The growth rate at baseline was the growth rate during the last year before the start of treatment and was calculated with the measurement closest to Day -336 (before Day -30) and the measurement up to Day 1. Growth rate at Month 6 was defined as the ratio of the change in height from Day 1 to the change in chronological age, with an approximate 6-month interval between the 2 height measurements. Observed data were used with no imputation for missing data.
Ratio of Change From Baseline in Bone Age/Change From Baseline in Chronological Age at Month 6
The ratio at Month 6 was calculated as (bone age at Month 6 - bone age at baseline)/(chronological age at Month 6 - chronological age at baseline). Observed data were used with no imputation for missing data. Baseline bone-age radiograph was performed at or within 3 months of the Screening Visit.

Full Information

First Posted
March 7, 2008
Last Updated
October 25, 2011
Sponsor
Abbott
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1. Study Identification

Unique Protocol Identification Number
NCT00635817
Brief Title
A Study of Leuprolide 11.25 mg and 30 mg Administered Every 3 Months to Treat Central Precocious Puberty
Official Title
A Phase 3, Randomized, Multi-Center, Open-Label Study to Evaluate the Efficacy and Safety of Leuprolide Acetate 11.25 and 30 mg Formulations in Children With Central Precocious Puberty
Study Type
Interventional

2. Study Status

Record Verification Date
October 2011
Overall Recruitment Status
Completed
Study Start Date
June 2008 (undefined)
Primary Completion Date
January 2010 (Actual)
Study Completion Date
June 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Abbott

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine if 11.25 and 30 mg formulations of leuprolide are effective in treating children with Central Precocious Puberty (CPP).
Detailed Description
Study Design: A total of 80 children with confirmed CPP were planned to be enrolled and randomized in a 1:1 ratio to receive 2 injections of either leuprolide acetate 11.25 mg or 30 mg depot formulation, each injection administered 3 mo apart (6 mo of treatment): This study includes a 4-week Screening Period, two 3-mo treatment cycles, and a posttreatment follow-up period (12 weeks following the Mo 6 visit). Study visits will occur at Screening, Day 1, Week 2 (only for subjects participating in the pharmacokinetic subset), Mo 1, 2, 3, Mo 6/Early Termination, and 12 weeks later, for the Posttreatment Follow-up Visit. This study was conducted at 18 sites in the United States and 4 sites in Puerto Rico.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Puberty, Precocious
Keywords
CPP, central precocious puberty, pediatrics, suppression of luteinizing hormone, Lupron, leuprolide acetate, depot formulation, GnRHa, GnRH agonist, GnRH analog, luteinizing hormone

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
84 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Leuprolide acetate 11.25 mg
Arm Type
Experimental
Arm Description
There are 2 arms that received leuprolide acetate 11.25 mg. Subjects who are treatment naive to leuprolide acetate are designated to be in Arm A and subjects who have previously been treated with leuprolide acetate are designated to be in Arm B.
Arm Title
Leuprolide acetate 30 mg
Arm Type
Experimental
Arm Description
There are 2 arms that received leuprolide acetate 30 mg. Subjects who are treatment naive to leuprolide acetate are designated to be in Arm C and subjects who have previously been treated with leuprolide acetate are designated to be in Arm D.
Intervention Type
Drug
Intervention Name(s)
Leuprolide acetate 11.25 mg
Other Intervention Name(s)
ABT-818, leuprolide acetate, Lupron
Intervention Description
Two intramuscular injections of leuprolide acetate for depot suspension 11.25 mg administered 3 mo apart.
Intervention Type
Drug
Intervention Name(s)
Leuprolide acetate 30 mg
Other Intervention Name(s)
ABT-818, leuprolide acetate, Lupron
Intervention Description
Two intramuscular injections of leuprolide acetate for depot suspension 30 mg administered 3 mo apart.
Primary Outcome Measure Information:
Title
Percentage of Participants With Suppression of Peak Stimulated Luteinizing Hormone (<4 mIU/mL) From Month 2 Through Month 6
Description
Percentage of participants with suppression of peak stimulated luteinizing hormone that was measured after a gonadotropin-releasing hormone agonist (GnRHa) stimulation test at Month (Mo) 2, 3, and 6. The analysis was performed according to a life table method. Subjects who withdrew without peak-stimulated luteinizing hormone >= 4 mIU/mL were censored at their last measurement of peak-stimulated luteinizing hormone.
Time Frame
Month 2 through 6
Secondary Outcome Measure Information:
Title
Percentage of Participants With Suppression of Basal Estradiol <20 pg/mL by Visit
Description
Percentage of participants with suppression of estradiol, out of the number of girls with at least 1 estradiol measurement at each visit (n/N%). Only girls are analyzed in this outcome measure. Observed data were used with no imputation for missing data.
Time Frame
Month 1, 2, 3 and 6
Title
Percentage of Participants With Suppression of Testosterone in <30 ng/dL by Visit
Description
Percentage of participants with suppression of testosterone, out of the number of boys with at least 1 testosterone measurement at each visit (n/N%). Only boys are analyzed in this outcome measure. Observed data were used with no imputation for missing data.
Time Frame
Month 1, 2, 3 and 6
Title
Peak-stimulated Luteinizing Hormone Concentration by Visit
Description
Observed data were used with no imputation for missing data.
Time Frame
Baseline, Month 1, 2, 3 and 6
Title
Percentage of Participants With Suppression of the Physical Signs of Puberty (Breast Development) at Month 6
Description
Percentage of participants with suppression of breast development, out of the number of girls with pubertal staging of breast development (n/N%). Only girls are analyzed in this outcome measure. Breast development was rated from Stage 1 (early development) through Stage 5 (full development) according to a Tanner Staging pictogram. Girls entering the study with fully developed breasts (Stage 5) were excluded from this analysis. Observed data were used with no imputation for missing data.
Time Frame
Month 6
Title
Percentage of Participants With Suppression of the Physical Signs of Puberty (Testicular Volume and Genital Development) at Month 6
Description
Percentage of participants with suppression of genital development and testicular volume, out of the number of boys with pubertal staging of genital development or testicular volume (n/N%). Only boys are analyzed in this outcome measure. External genital development (testes and penis) was rated from Stage 1 (early development) through Stage 5 (full development) according to a Tanner Staging pictogram. Boys entering the study with fully developed genitals (Stage 5) were excluded from this analysis. Observed data were used with no imputation for missing data.
Time Frame
Month 6
Title
Change From Baseline in Incremental Growth Rate (cm/Year) at Month 6
Description
The growth rate at baseline was the growth rate during the last year before the start of treatment and was calculated with the measurement closest to Day -336 (before Day -30) and the measurement up to Day 1. Growth rate at Month 6 was defined as the ratio of the change in height from Day 1 to the change in chronological age, with an approximate 6-month interval between the 2 height measurements. Observed data were used with no imputation for missing data.
Time Frame
Baseline and Month 6
Title
Ratio of Change From Baseline in Bone Age/Change From Baseline in Chronological Age at Month 6
Description
The ratio at Month 6 was calculated as (bone age at Month 6 - bone age at baseline)/(chronological age at Month 6 - chronological age at baseline). Observed data were used with no imputation for missing data. Baseline bone-age radiograph was performed at or within 3 months of the Screening Visit.
Time Frame
Baseline to Month 6

10. Eligibility

Sex
All
Minimum Age & Unit of Time
2 Years
Maximum Age & Unit of Time
11 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject has a clinical diagnosis of CPP. Eligible to receive at least 6 mo of therapy to treat CPP after study entry. Bone age advanced at least 1 year beyond the chronological age at time of diagnosis or first treatment. In general good health with no uncontrolled, clinically significant disease which would interfere with bone maturation or mask the objectives of this protocol as assessed by the investigator. Additional criteria for subjects who have not had previous treatment: Girls 2-8 years inclusive or Boys 2-9 years inclusive at Day 1. Has pretreatment pubertal response to leuprolide acetate stimulation (luteinizing hormone ≥8 mIU/mL) at Screening. Breast pubertal staging of at least 2 in girls; testicular volume of at least 4 cc or testicular length greater than 2.5 cm in boys at Screening. Additional criteria for subjects previously treated: Girls 2-10 years inclusive or boys 2-11 years inclusive at Day 1. Must have been on standard gonadotropin releasing hormone analog therapy for at least the 6 mo prior to Day 1. Has documented maintenance of luteinizing hormone suppression as evidenced by peak stimulated level <4 mIU/mL at Screening. Exclusion Criteria: Incomplete precocious puberty (premature thelarche, premature adrenarche). Peripheral precocious puberty: gonadal or adrenal tumors, congenital adrenal hyperplasia, testotoxicosis in boys, human chorionic gonadotropin secreting tumor or McCune-Albright syndrome in girls. Evidence of any abnormal pituitary, hypothalamic, adrenal, thyroid and gonadal function other than premature secretion of gonadotropins not adequately controlled. Unstable intracranial tumors (unresponsive to treatment/expanding) except hamartoma. Previous treatment with GnRHa therapy requiring leuprolide acetate for depot suspension >15 mg monthly. Bone age >13 years for girls and >14 years for boys. Any other condition interfering with growth, ie, skeletal dysplasia, cerebral palsy. Chronic illness requiring treatment that may interfere with growth, ie, chronic steroid use, renal failure, moderate to severe scoliosis. Diagnosis of short stature, ie more than 2.25 standard deviations below the mean height for age (growth chart measurement). Prior or current therapy with medroxyprogesterone acetate or growth hormone. Has an abnormal laboratory value suggesting a clinically significant underlying disease . Creatinine >1.5 mg/dL, alanine aminotransferase and/or aspartate aminotransferase >2.0 x upper limit of normal, or total bilirubin >2.0 mg/dL with aspartate aminotransferase/alanine aminotransferase elevated above normal limits. Positive pregnancy test. Known hypersensitivity to study medication or its excipients. Participation in another drug research within 3 mo of enrollment into this study. Prior or current therapy with insulin-like growth factor-1. Use of an estrogen preparation within 2 mo prior to Day 1.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Peter Bacher, MD,
Organizational Affiliation
Abbott
Official's Role
Study Director
Facility Information:
Facility Name
Site Reference ID/Investigator# 8765
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35233
Country
United States
Facility Name
Site Reference ID/Investigator# 11522
City
Long Beach
State/Province
California
ZIP/Postal Code
90806
Country
United States
Facility Name
Site Reference ID/Investigator# 8756
City
Los Angeles
State/Province
California
ZIP/Postal Code
90027
Country
United States
Facility Name
Site Reference ID/Investigator# 8755
City
San Diego
State/Province
California
ZIP/Postal Code
92123
Country
United States
Facility Name
Site Reference ID/Investigator# 8761
City
San Diego
State/Province
California
ZIP/Postal Code
92123
Country
United States
Facility Name
Site Reference ID/Investigator# 8772
City
Stanford
State/Province
California
ZIP/Postal Code
94305-5208
Country
United States
Facility Name
Site Reference ID/Investigator# 8749
City
Greenwood Village
State/Province
Colorado
ZIP/Postal Code
80111
Country
United States
Facility Name
Site Reference ID/Investigator# 8771
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32608
Country
United States
Facility Name
Site Reference ID/Investigator# 8764
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32207
Country
United States
Facility Name
Site Reference ID/Investigator# 17621
City
Pensacola
State/Province
Florida
ZIP/Postal Code
32504
Country
United States
Facility Name
Site Reference ID/Investigator# 8752
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Facility Name
Site Reference ID/Investigator# 8766
City
Shreveport
State/Province
Louisiana
ZIP/Postal Code
71103
Country
United States
Facility Name
Site Reference ID/Investigator# 8768
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55455
Country
United States
Facility Name
Site Reference ID/Investigator# 17341
City
St. Paul
State/Province
Minnesota
ZIP/Postal Code
55102
Country
United States
Facility Name
Site Reference ID/Investigator# 8759
City
Kansas City
State/Province
Missouri
ZIP/Postal Code
64108
Country
United States
Facility Name
Site Reference ID/Investigator# 8750
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73104
Country
United States
Facility Name
Site Reference ID/Investigator# 8760
City
Tulsa
State/Province
Oklahoma
ZIP/Postal Code
74135
Country
United States
Facility Name
Site Reference ID/Investigator# 8763
City
Hershey
State/Province
Pennsylvania
ZIP/Postal Code
17033
Country
United States
Facility Name
Site Reference ID/Investigator# 8754
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84108
Country
United States
Facility Name
Site Reference ID/Investigator# 8762
City
Seattle
State/Province
Washington
ZIP/Postal Code
98104
Country
United States
Facility Name
Site Reference ID/Investigator# 8753
City
Seattle
State/Province
Washington
ZIP/Postal Code
98105
Country
United States
Facility Name
Site Reference ID/Investigator# 17922
City
Bayamon
ZIP/Postal Code
00960
Country
Puerto Rico
Facility Name
Site Reference ID/Investigator# 17923
City
Ponce
ZIP/Postal Code
00717-2116
Country
Puerto Rico
Facility Name
Site Reference ID/Investigator# 18242
City
San Juan
ZIP/Postal Code
00936-5067
Country
Puerto Rico
Facility Name
Site Reference ID/Investigator# 19661
City
San Juan
ZIP/Postal Code
00936-8344
Country
Puerto Rico

12. IPD Sharing Statement

Citations:
PubMed Identifier
22344198
Citation
Lee PA, Klein K, Mauras N, Neely EK, Bloch CA, Larsen L, Mattia-Goldberg C, Chwalisz K. Efficacy and safety of leuprolide acetate 3-month depot 11.25 milligrams or 30 milligrams for the treatment of central precocious puberty. J Clin Endocrinol Metab. 2012 May;97(5):1572-80. doi: 10.1210/jc.2011-2704. Epub 2012 Feb 16.
Results Reference
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A Study of Leuprolide 11.25 mg and 30 mg Administered Every 3 Months to Treat Central Precocious Puberty

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