Somatrogon, a long-acting recombinant human growth hormone (GH) is approved in several countries as a once-weekly treatment for children with GH deficiency (GHD). In this phase 3 study, children with GHD received somatrogon or Genotropin. We evaluated the impact of testing positive for anti-drug antibodies to somatrogon (ADA+) on the efficacy and safety of somatrogon.
In the 12-month main study, subjects were randomized to once-weekly somatrogon (0.66 mg/kg/week) or once-daily Genotropin (0.24 mg/kg/week). After the main study, subjects could enroll in an open label extension (OLE), where all subjects received somatrogon (0.66 mg/kg/week). Samples to assess ADAs were collected quarterly during the main study and every 6 months during the OLE. Samples were initially assessed for anti-somatrogon ADAs; ADA+ samples were further assessed for anti-hGH and anti-CTP ADAs. Neutralizing ADAs (NAb) to somatrogon and hGH were also identified. Subjects with ≥1 ADA+ result were compared with subjects with no ADA+ samples (ADA−).
By Month 12, 84/109 (77.1%) somatrogon-treated subjects had ≥1 ADA+ result; most were anti-hGH+. Two of the 84 subjects tested NAb+ for somatrogon. At OLE Month 12, of the 212 subjects (108 subjects had received Genotropin in the main study), 114 (53.8%) had ≥1 ADA+ result; most ADA+ samples were anti-hGH. No additional subjects tested NAb+ for somatrogon while 3 subjects tested NAb+ for hGH. ADA status had no effect on growth parameters (Table). Being ADA+ was associated with numerically higher mean IGF-1 SDS values and greater changes from baseline but there was considerable overlap between ADA+ and ADA− subjects (Table). The presence of ADAs to somatrogon did not affect the incidence of treatment-emergent adverse events (AEs), serious AEs, or AEs of special interest; there was no association between the incidence of AEs and ADA titer.
ADA+ did not affect the efficacy or safety of somatrogon.
Clinicaltrials.gov:NCT02968004