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Completed

NCT Number: NCT00448747

Investigation of a New, Oral Growth Hormone Secretagogue, AEZS-130 as a Growth Hormone Stimulation Test.

The diagnosis of growth hormone deficiency (GHD) in adults is established by laboratory testing in patients with an appropriate clinical history of hypothalamic pituitary disease. Two tests that are considered to be gold standard tests for the diagnosis of GHD are the insulin tolerance test (ITT) and growth hormone releasing hormone (GHRH) combined with L-arginine (L-ARG). However, these tests are either bothersome (given intravenously) to the patient or are linked with side effects. Therefore, an orally available compound like AEZS-130 (formerly ARD-07), if demonstrated to be safe and providing adequate sensitivity and specificity could be a welcome alternative and/or complement to the current available tests.

The intent was to recruit 40 adult GHD (AGHD) patients and 40 healthy control subjects into this trial, but the original sponsor (Ardana Biosciences Ltd.) discontinued the study for financial reasons before this was completed. At the time of withdrawal of GHRH from the market in 2008, 42 AGHD patients and 10 normal controls had completed the study at 9 US sites. This study reactivated to complete the remaining 30 matched control subjects.

Additionally upon agreement with the FDA in a Special Protocol Assessment (SPA), 10 additional adult growth hormone deficient and their matched control were planned to be enrolled into this trial for a total treated population of approximatively 100 subjects.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

Celerion, Tempe, Arizona, United States

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About this study

Thirty control subjects (i.e., without AGHD) were matched to the 30 AGHD patients who were not previously matched. Matching was based upon gender, age, BMI, and estrogen status for females. They received one oral dose of AEZS-130 followed by serial blood draws for growth hormone (GH), insulin-like growth factor 1 (IGF-1) and pharmacokinetic (PK) determinations. There was no cross over due to the unavailability of GHRH (Geref) in the United States. Under Amendment #4 to this protocol, 10 additional AGHD subjects were to be enrolled and matched as described above.

Furthermore, the objective of the study was changed to delete comparison with L-ARG + GHRH.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion for Matched Control Subjects:

  • Undergone normal growth and development
  • Normal serum prolactin (PRL) concentrations
  • Females should have a history of regular, age-appropriate menses
  • Males should have normal serum testosterone concentrations
  • Matched GHD subject already enrolled in study; matched in terms of sex, age, BMI and Estrogen status (women only)

Exclusion criteria

for Matched Control Subjects:

  • Inability or unwillingness to comply with study medication
  • Pregnancy or lactation
  • Clinically relevant ECG abnormalities (including QT/QTc interval > 450 ms) at any time prior to dosing at Visit 2
  • Treatment with any drugs that might prolong QT/QTc

Inclusion criteria

dor Adult GHD Subjects:

  • Confirmed GH deficiency with a low IGF-1
  • 3 months of stable treatment for those requiring hormone replacement therapy for hormones deficiencies other than GHD
  • subjects with hypogonadism must be treated with sex steroid therapy, excluding women over 50 yr of age
  • women on estrogen therapy, for whatever reason, must be on stable treatment for ar least 3 months prior to study

Exclusion criteria

for Adult GHD Subjects:

  • Untreated hypothyroidism
  • Known hypersensitivity to any excipient in study medication
  • Inability or unwillingness to comply with study procedures
  • Intracranial lesions stable for less than 12 months
  • GH therapy within one month of study entry
  • Clinically significant cardiovascular, or cerebrovascular disease
  • Current active malignancy other than non-melanoma skin cancer
  • Renal or hepatic dysfunction (> 3 x ULN liver function enzymes (LFEs) - aspartate amino transferase (ASAT); alanine amino transferase (ALAT); gamma-glutamyltransferase (GGT) or creatinine > 2x ULN)
  • Pregnancy or lactation
  • Active Cushing's disease
  • Clinically relevant ECG abnormalities (including QT/heart rate corrected QT interval (QTc) interval > 450 ms) at any time prior to dosing at Visit 2
  • Treatment with any drugs that might prolong QT/QTc

Treatment and study plan

AEZS-130 (formerly ARD-07)

Drug

A single oral administration of AEZS-130 as Growth Hormone Stimulation Test

Other names: Test 1, Macimorelin

L-ARG+GHRH

Drug

A single administration of L-ARG+GHRH (iv bolus) followed by a 30min infusion of L-ARG as Growth Hormone Stimulation Test

Other names: Test Control

Primary outcomes

  1. Receiver Operating Characteristic (ROC) Analysis on Peak GH (Growth Hormon) Concentrations

    Time frame: GH sampling: pre-dose and 30, 45, 60, 75, 90, 120, 150 min post-dose

    The primary endpoint for each individual is the peak GH concentration following AEZS-130 (macimorelin) administration.

Secondary outcomes

  1. Peak Insulin-Like Growth Factor (IGF)-1 Concentration Following Treatment

    Time frame: 15 min. before macimorelin administration and at 150 min after macimorelin administration

    Descriptive summaries for IGF-1 and correlation with GH concentrations based on macimorelin treatment. Mean IGF-1 values taken pre- and post- macimorelin administration.

  2. Classification and Regression Tree (CART) Analysis of Peak Growth Hormone (GH) Following Macimorelin Administration

    Time frame: GH sampling: pre-dose and 30, 45, 60, 75, 90, 120, 150 min post-dose

    The CART Analysis for macimorelin estimated: a) a macimorelin cut-point that minimized the misclassification of AGHD patients and healthy control subjects; b) an optimal decision tree for macimorelin that incorporated age, sex and BMI.

    Sensitivity (correct identification of AGHD cases) and specificity (correct identification of control subjects) for macimorelin was summarized for age, gender, BMI and estrogen status subgroups containing n > 10.

    At least 8 of the 10 newly enrolled AGHD patients should have been correctly classified for a protocol pre-specified threshold of Peak GH concentration which was 8.5 (ng/ml).

    Software CART Version 6.0 was used.

  3. Number of Participants With Drug Related Adverse Events (AEs)

    Time frame: 14 days

    Total number of participants with drug related AEs, following macimorelin administration of L-Arginine (ARG) - Growth Hormone Releasing Hormone (GHRH) administration.

Sponsors and collaborators

Lead sponsor

AEterna Zentaris

Industry

Registry information

Official study title

A Multi-center, Study Investigating a New, Oral Growth Hormone Secretagogue (GHS)(AEZS 130, Formerly Ardana (ARD)-07) as a Growth Hormone (GH) Stimulation Test in Terms of Safety and Efficacy

Important dates

Study start
2007
Primary completion
2011
Study completion
2011
First posted
Mar 19, 2007
Registry last updated
Jul 23, 2019

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.