Safety and Efficacy of Pegvisomant in Children With Growth Hormone Excess
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- STATUS
- Recruiting
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- End date
- Jan 1, 2024
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- participants needed
- 140
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- sponsor
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Summary
- Background
For children with gigantism, too much growth hormone (GH) in the body causes abnormal growth and many other problems. Current treatments often don t work; no medical treatment is approved by FDA. Researchers want to see if the drug pegvisomant can help.
- Objective
To test the role of pegvisomant in children and adolescents with gigantism.
- Eligibility
People ages 2-18 with GH excess for whom usual treatments have not worked or who are not eliginle for them
- Design
Participants will be screened with a medical history.
The study will last 60 weeks and include at least 3 visits: baseline, 6-month, and 12-month visits. For the baseline visit, participants will stay a few nights for testing. They may stay overnight for the other visits.
All visits will include:
Medical history
Physical exam
Questionnaires
Heart and liver tests
Participants may be photographed in their underwear if they agree.
Blood tests: Participants will get a catheter: A small plastic tube will be placed in an arm vein. For some tests, the blood may be drawn every 30 minutes over 3 hours. For other tests, blood will be drawn every 20 minutes over 12 hours. Only clinically necessary tests will be done in each patient.
At the baseline visit, participants will have the study drug injected under the skin. They will learn to take the injection at home. They will take the injection daily during the study.
The baseline and 12-month visits will include:
MRI: Participants will have a dye injected into a vein. They will lie in a machine that takes pictures of the body.
Hand X-ray
Participants must get their height and weight at their local doctor s office monthly.
Participants must have blood and urine tests at their local lab monthly for the first 6 months then every 3 months until the study ends.
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Description
Growth hormone excess is a rare and potentially lethal condition associated with hypersecretion of growth hormone (GH), usually by a pituitary tumor or hyperplasia. When it occurs prior to the complete fusion of growth plates, it leads to pathological tall stature, and it is called gigantism. After the fusion of the growth plates, it is called acromegaly. It may be associated with debilitating cardiovascular disease and/or diabetes. Children and adolescents with gigantism are currently treated with surgery, radiation therapy, and medications, such as octreotide, to reduce hypersecretion of GH; however, these treatments may lack efficacy and have significant side effects. Pegvisomant is a genetically engineered GH-receptor (GHR) antagonist that blocks the action of GH. In adults with acromegaly, pegvisomant has been shown to effectively reduce serum insulin-likegrowth factor type 1 (IGF-1) concentrations and lead to clinical improvement. However, experience in children and adolescents is limited to a small number of case series. We propose the initiation of a new protocol at the NICHD, NIH, to treat children and adolescents with GH excess that is refractory to surgical therapy and/or radiation therapy, or in children and adolescents where the above therapies are contraindicated.
Details
| Condition | Pituitary Disease |
|---|---|
| Treatment | pegvisomant |
| Clinical Study Identifier | NCT03882034 |
| Sponsor | Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) |
| Last Modified on | 11 May 2022 |
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Additional screening procedures may be conducted by the study team before you can be confirmed eligible to participate.
Learn moreIf you are confirmed eligible after full screening, you will be required to understand and sign the informed consent if you decide to enroll in the study. Once enrolled you may be asked to make scheduled visits over a period of time.
Learn moreComplete your scheduled study participation activities and then you are done. You may receive summary of study results if provided by the sponsor.
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