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| Name | Class |
|---|---|
| Merck Serono S.A., Geneva | INDUSTRY |
Study of safety of Saizen® in children born with serious intra-uterine growth retardation (IUGR) treated to final height. An open, phase III study involving 17 centers in France.
The study enrolled children who have completed 3 or 2 years of treatment and at least one year of post treatment observation in the Sponsor Studies GF 4001 (Safety and Efficacy of Saizen in the Treatment of Young Children Born with Severe IUGR) or GF 6283 (Effect of Intermittent versus Continuous Saizen Therapy in Young Children Born with Severe IUGR), respectively.
Detailed description: Serious IUGR is a syndrome characterized by low birth length and weight for gestational age (less than 10 percentile). The secretion of growth hormone in response to provocative stimuli (e.g. arginine, insulin) is normal in these children. Apart from low birth weight, children born with IUGR may have minor or major malformations.
A catch-up period with a supraphysiological growth velocity generally occurs during the first 6 to 24 months of life in 80 to 90 percent (%) of these children. This generally allows them to reach normal height. That means that conversely, approximately 10 to 20% of children do maintain a statural handicap. Puberty occurs at a normal age and the retardation in bone maturation present during the first years of life disappears very quickly. This leads to short adult stature in subjects who have not shown spontaneous catch-up during the first years of life. A safe and effective means of promoting growth without accelerating the timing or tempo of puberty would therefore be desirable.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Saizen® (Continuous or intermittent treatment) | Experimental |
| |
| Saizen® (Observed and then continuous or no treatment) | Experimental |
| |
| Observation only | Other |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Saizen® A | Drug | Continuous or intermittent treatment with recombinant human Growth Hormone (r-hGH) 0.067 milligram/kilogram/day (mg/kg/day) subcutaneously (sc). |
|
| Measure | Description | Time Frame |
|---|---|---|
| Final Height | Final height was defined as the height reached 1 year after height velocity (HV) was less than 2 centimeter/year (cm/year). Height velocity was the change in height since the previous year's measurement. Height was measured with a wall-mounted stadiometer (or in supine position if the participant's age was less than 3 years) and the measurement was repeated thrice by the same observer. The mean of the values obtained in the repeated measurements was taken for the analysis. | One year after final height was attained up to 10.6 years |
| Height Standard Deviation Score (HSDS) | HSDS was calculated as height minus reference mean height divided by SD of the reference mean height, both given by the reference growth table (Sempe) for the corresponding chronological age at the height measurement. Greater HSDS indicate greater height. (Sempe M et al., 1979) | One year after final height was attained up to 10.6 years |
| Measure | Description | Time Frame |
|---|---|---|
| Parental Adjusted Height Standard Deviation Score (PAHSDS) | PAHSDS is the distance between the participant's current and target heights, expressed in units of SD of the height distribution of the reference population. Target height is a measure of the height which the participant could hypothetically reach based only on his parents' heights. Target height standard deviation score (THSDS) was calculated as target height minus mean adult height of the reference population divided by SD of the mean adult height of the reference population. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Medical Director | Merck Serono S.A., Geneva | Study Director |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Background | Sempé M, Pédron G, Roy-Pernot M-P. Auxologie, méthode et séquences. Paris: Theraplix, 1979. | ||
| 16772718 | Result | Simon D, Leger J, Fjellestad-Paulsen A, Crabbe R, Czernichow P; SGA Study Group. Intermittent recombinant growth hormone treatment in short children born small for gestational age: four-year results of a randomized trial of two different treatment regimens. Horm Res. 2006;66(3):118-23. doi: 10.1159/000093832. Epub 2006 Jun 12. | |
| 9641731 |
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Participants who completed 3 or 2 years treatment and at least 1 year post treatment observation in Sponsor Studies GF 4001 (Safety and Efficacy of Saizen in the Treatment of Young Children Born with Severe IUGR) or GF 6283 (Effect of Intermittent versus Continuous Saizen Therapy in Young Children Born with Severe IUGR), respectively were enrolled.
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| ID | Title | Description |
|---|---|---|
| FG000 | Saizen® Continuous (A1) | Participants with bone age less than or equal to (<=) 12 years for girls or 14 years for boys and height <=-2 standard deviation (SD) received continuous treatment with recombinant human Growth Hormone (r-hGH) 0.067 milligram/kilogram/day (mg/kg/day) subcutaneously (sc) until they reached final height for a maximum duration of 10.6 years. |
| FG001 | Saizen® Intermittent (A2) | Participants with bone age <=12 years for girls or 14 years for boys and height <=-2 SD received intermittent treatment with r-hGH 0.067 mg/kg/day sc until they reached final height for a maximum duration of 10.6 years. Intermittent treatment was given on an individual basis depending on the height achieved during the study. |
| FG002 | Observed, Not Randomized (B0) | Participants with bone age <=12 years for girls or 14 years for boys and height greater than (>) -2 SD were observed until first signs of puberty but not randomized. |
| FG003 | Observed Then Randomized to Saizen® (B1) | Participants with bone age <=12 years for girls or 14 years for boys and height >-2 SD were observed until first signs of puberty and if remained at a height >-2 SD, were randomized to receive continuous treatment with r-hGH 0.067 mg/kg/day sc until they reached final height for a maximum duration of 10.6 years. Participants whose height fell to <=-2 SD before the first sign of puberty, were randomized to either Saizen® Continuous (A1) or Saizen® Intermittent (A2) treatment group. |
| FG004 | Observed Then Randomized to Observation (B2) | Participants with bone age <=12 years for girls or 14 years for boys and height >-2 SD were observed until first signs of puberty and if remained at a height >-2 SD, were randomized to observation group with no treatment until they reached final height for a maximum duration of 10.6 years. Participants whose height fell to <=-2 SD before the first sign of puberty, were randomized to either Saizen® Continuous (A1) or Saizen® Intermittent (A2) treatment group. |
| FG005 | Observation (C) | Participants with bone age >12 years for girls or 14 years for boys or refused to be treated in any of the above groups were followed without treatment until they reached final height for a maximum duration of 10.6 years. |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Non-Final Height: Not Treated | Includes all participants who did not achieve the final height during the study period and did not receive r-hGH 0.067 mg/kg/day sc either continuously or intermittently. |
| BG001 | Non-Final Height: Treated |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Final Height | Final height was defined as the height reached 1 year after height velocity (HV) was less than 2 centimeter/year (cm/year). Height velocity was the change in height since the previous year's measurement. Height was measured with a wall-mounted stadiometer (or in supine position if the participant's age was less than 3 years) and the measurement was repeated thrice by the same observer. The mean of the values obtained in the repeated measurements was taken for the analysis. | Intention-to-treat (ITT) population included all participants enrolled in this study. Safety population was identical in this study. | Posted | Mean | Standard Deviation | cm | One year after final height was attained up to 10.6 years |
|
Baseline up to Day 30 after end of study
An adverse event (AE) was defined as any untoward medical occurrence in the form of signs, symptoms, abnormal laboratory findings, or diseases that emerges or worsens relative to baseline during a clinical study with an Investigational Medicinal Product (IMP), regardless of causal relationship and even if no IMP has been administered.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Not Treated | Included all participants who did not receive r-hGH 0.067 mg/kg/day sc either continuously or intermittently. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Epiphysiolysis | Musculoskeletal and connective tissue disorders | MedDRA 10.0 | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Pharyngitis | Infections and infestations | MedDRA 10.0 | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Merck KGaA Communication Center | Merck Serono, a division of Merck KGaA | +49-6151-72-5200 | service@merck.de |
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| ID | Term |
|---|---|
| D019382 | Human Growth Hormone |
| ID | Term |
|---|---|
| D013006 | Growth Hormone |
| D010908 | Pituitary Hormones, Anterior |
| D010907 | Pituitary Hormones |
| D036361 | Peptide Hormones |
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|
| Saizen® B | Drug | Observed until the first signs of puberty and then continuous treatment with r-hGH 0.067 mg/kg/day sc or observed without treatment. |
|
|
| Observation only | Other | Subjects were only observed. |
|
| One year after final height was attained up to 10.6 years |
| Result |
| Fjellestad-Paulsen A, Czernichow P, Brauner R, Bost M, Colle M, Lebouc JY, Lecornu M, Leheup B, Limal JM, Raux MC, Toublanc JE, Rappaport R. Three-year data from a comparative study with recombinant human growth hormone in the treatment of short stature in young children with intrauterine growth retardation. Acta Paediatr. 1998 May;87(5):511-7. doi: 10.1080/08035259850158209. |
| Withdrawal by Subject |
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| Protocol Violation |
|
| Non-compliance |
|
| Adverse Event |
|
| Other |
|
Includes all participants who did not achieve the final height during the study period and received r-hGH 0.067 mg/kg/day sc either continuously or intermittently. |
| BG002 | Final Height: Not Treated | Includes all participants who achieved the final height during the study period and did not receive r-hGH 0.067 mg/kg/day sc either continuously or intermittently. |
| BG003 | Final Height: Treated | Includes all participants who achieved the final height during the study period and received r-hGH 0.067 mg/kg/day sc either continuously or intermittently. |
| BG004 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race/Ethnicity, Customized | Number | participants |
|
| Original Study | Number | participants |
|
| Birth Height | Mean | Standard Deviation | cm |
|
| Birth Weight | Mean | Standard Deviation | g |
|
| Length of Gestation | Mean | Standard Deviation | weeks |
|
| OG001 | Non-Final Height: Treated | Includes all participants who did not achieve the final height during the study period and received r-hGH 0.067 mg/kg/day sc either continuously or intermittently. |
| OG002 | Final Height: Not Treated | Includes all participants who achieved the final height during the study period and did not receive r-hGH 0.067 mg/kg/day sc either continuously or intermittently. |
| OG003 | Final Height: Treated | Includes all participants who achieved the final height during the study period and received r-hGH 0.067 mg/kg/day sc either continuously or intermittently. |
|
|
| Primary | Height Standard Deviation Score (HSDS) | HSDS was calculated as height minus reference mean height divided by SD of the reference mean height, both given by the reference growth table (Sempe) for the corresponding chronological age at the height measurement. Greater HSDS indicate greater height. (Sempe M et al., 1979) | ITT population included all participants enrolled in this study. Safety population was identical in this study. | Posted | Mean | Standard Deviation | standard deviation score | One year after final height was attained up to 10.6 years |
|
|
|
| Secondary | Parental Adjusted Height Standard Deviation Score (PAHSDS) | PAHSDS is the distance between the participant's current and target heights, expressed in units of SD of the height distribution of the reference population. Target height is a measure of the height which the participant could hypothetically reach based only on his parents' heights. Target height standard deviation score (THSDS) was calculated as target height minus mean adult height of the reference population divided by SD of the mean adult height of the reference population. | ITT population included all participants enrolled in this study. Safety population was identical in this study. | Posted | Mean | Standard Deviation | standard deviation score | One year after final height was attained up to 10.6 years |
|
|
|
| Post-Hoc | Duration of Treatment | ITT population included all participants enrolled in this study. Safety population was identical in this study. Here, 'N' (number of participants analyzed) signifies those participants who were treated and hence, were evaluated for this measure. | Posted | Mean | Standard Deviation | years | Up to 10.6 years |
|
|
|
| Post-Hoc | Duration of Participation in the Study | ITT population included all participants enrolled in this study. Safety population was identical in this study. Here, 'N' (number of participants analyzed) signifies those participants who were evaluated for this measure. | Posted | Mean | Standard Deviation | years | Up to 10.6 years |
|
|
|
| 1 |
| 32 |
| 16 |
| 32 |
| EG001 | Treated | Included all participants who received r-hGH 0.067 mg/kg/day sc either continuously or intermittently. | 13 | 59 | 52 | 59 |
| Knee deformity | Musculoskeletal and connective tissue disorders | MedDRA 10.0 | Systematic Assessment |
|
| Limb asymmetry | Musculoskeletal and connective tissue disorders | MedDRA 10.0 | Systematic Assessment |
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| Femur fracture | Injury, poisoning and procedural complications | MedDRA 10.0 | Systematic Assessment |
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| Foot fracture | Injury, poisoning and procedural complications | MedDRA 10.0 | Systematic Assessment |
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| Head injury | Injury, poisoning and procedural complications | MedDRA 10.0 | Systematic Assessment |
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| Congenital jaw malformation | Congenital, familial and genetic disorders | MedDRA 10.0 | Systematic Assessment |
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| Hereditary haemorrhagic telangiectasia | Congenital, familial and genetic disorders | MedDRA 10.0 | Systematic Assessment |
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| Appendicitis | Infections and infestations | MedDRA 10.0 | Systematic Assessment |
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| Otitis media chronic | Infections and infestations | MedDRA 10.0 | Systematic Assessment |
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| Ear tube removal | Surgical and medical procedures | MedDRA 10.0 | Systematic Assessment |
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| Tonsillectomy | Surgical and medical procedures | MedDRA 10.0 | Systematic Assessment |
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| Keratoconus | Eye disorders | MedDRA 10.0 | Systematic Assessment |
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| Inguinal hernia, obstructive | Gastrointestinal disorders | MedDRA 10.0 | Systematic Assessment |
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| Febrile convulsion | Nervous system disorders | MedDRA 10.0 | Systematic Assessment |
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| Bronchitis | Infections and infestations | MedDRA 10.0 | Systematic Assessment |
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| Gastroenteritis | Infections and infestations | MedDRA 10.0 | Systematic Assessment |
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| Nasopharyngitis | Infections and infestations | MedDRA 10.0 | Systematic Assessment |
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| Influenza | Infections and infestations | MedDRA 10.0 | Systematic Assessment |
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| Ear infection | Infections and infestations | MedDRA 10.0 | Systematic Assessment |
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| Rhinitis | Infections and infestations | MedDRA 10.0 | Systematic Assessment |
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| Arthralgia | Musculoskeletal and connective tissue disorders | MedDRA 10.0 | Systematic Assessment |
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| Acne | Skin and subcutaneous tissue disorders | MedDRA 10.0 | Systematic Assessment |
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| Eczema | Skin and subcutaneous tissue disorders | MedDRA 10.0 | Systematic Assessment |
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| Headache | Nervous system disorders | MedDRA 10.0 | Systematic Assessment |
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| D006728 |
| Hormones |
| D006730 | Hormones, Hormone Substitutes, and Hormone Antagonists |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |