Switching to Weekly Lonapegsomatropin from Daily Somatropin in Children with Growth Hormone Deficiency: The fliGHt Trial

Horm Res Paediatr. 2022;95(3):233-243. doi: 10.1159/000524003. Epub 2022 Mar 9.

Abstract

Introduction: The phase 3 fliGHt Trial evaluated the safety and tolerability of once-weekly lonapegsomatropin, a long-acting prodrug, in children with growth hormone deficiency (GHD) who switched from daily somatropin therapy to lonapegsomatropin.

Methods: This multicenter, open-label, 26-week phase 3 trial took place at 28 sites across 4 countries (Australia, Canada, New Zealand, and the USA). The trial enrolled 146 children with GHD, 143 of which were previously treated with daily somatropin. All subjects received once-weekly lonapegsomatropin 0.24 mg human growth hormone/kg/week. The primary outcome measure was safety and tolerability of lonapegsomatropin over 26 weeks. Secondary outcome measures assessed annualized height velocity (AHV), height standard deviation score (SDS), and IGF-1 SDS at 26 weeks.

Results: Subjects had a mean prior daily somatropin dose of 0.29 mg/kg/week. Treatment-emergent adverse events (AEs) reported were similar to the published AE profile of daily somatropin therapies. After switching to lonapegsomatropin, the least-squares mean (LSM) AHV was 8.7 cm/year (95% CI: 8.2, 9.2) at Week 26 and LSM height SDS changed from baseline to Week 26 of +0.25 (95% CI: 0.21, 0.29). Among switch subjects, the LSM for average IGF-1 SDS was sustained at Weeks 13 and 26, representing an approximate 0.7 increase from baseline (prior to switching from daily somatropin therapy). Patient-reported outcomes indicated a preference for weekly lonapegsomatropin among both children and their parents.

Conclusions: Lonapegsomatropin treatment outcomes were as expected across a range of ages and treatment experiences. Switching to lonapegsomatropin resulted in a similar AE profile to daily somatropin therapy.

Keywords: Growth hormone; Growth hormone deficiency; Growth hormone replacement therapy; Lonapegsomatropin; Long-acting growth hormone; TransCon human growth hormone.

Publication types

  • Clinical Trial, Phase III
  • Multicenter Study

MeSH terms

  • Body Height
  • Child
  • Drug Substitution*
  • Dwarfism, Pituitary* / drug therapy
  • Growth Disorders / drug therapy
  • Growth Hormone* / therapeutic use
  • Human Growth Hormone* / therapeutic use
  • Humans
  • Insulin-Like Growth Factor I / therapeutic use

Substances

  • lonapegsomatropin
  • Human Growth Hormone
  • Insulin-Like Growth Factor I
  • Growth Hormone