Long-term follow up of carbohydrate metabolism and adverse events after termination of Omnitrope® treatment in children born small for gestational age

Mieczyslaw Walczak; Mieczyslaw Szalecki; Gerd Horneff; Jan Lebl; Barbara Kalina-Faska; Tomasz Giemza; Florentina Moldovanu; Michaela Nanu; Hichem Zouater

doi:10.1177/20420188211013121

Long-term follow up of carbohydrate metabolism and adverse events after termination of Omnitrope® treatment in children born small for gestational age

Ther Adv Endocrinol Metab. 2021 May 5:12:20420188211013121. doi: 10.1177/20420188211013121. eCollection 2021.

Authors

Mieczyslaw Walczak¹, Mieczyslaw Szalecki², Gerd Horneff³, Jan Lebl⁴, Barbara Kalina-Faska⁵, Tomasz Giemza⁶, Florentina Moldovanu⁷, Michaela Nanu⁷, Hichem Zouater⁸

Affiliations

¹ Department of Pediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University, Szczecin, Zachodniopomorskie, Poland.
² Collegium Medicum UJK, Kielce, Children's Memorial Health Institute, Warsaw, Poland.
³ Department of Pediatrics, Center for Pediatric Rheumatology, Asklepios Clinic Sankt Augustin, Sankt Augustin, Germany.
⁴ Department of Pediatrics, Charles University and University Hospital Motol, Prague, Czech Republic.
⁵ Department of Pediatrics and Pediatric Endocrinology, Medical University of Silesia, Faculty of Medical Science, Katowice, Slaskie, Poland.
⁶ Sandoz Poland, Warsaw, Poland.
⁷ National Institute for Mother and Child Health, 'Alessandrescu Rusescu', Bucharest, Romania.
⁸ Sandoz Biopharmaceuticals, Hexal AG, Industriestr. 18/5, Holzkirchen D-83607, Germany.

Abstract

Background: Recombinant human growth hormone (rhGH) therapy can affect carbohydrate metabolism and lead to impaired glucose tolerance during treatment. In addition, short children born small for gestational age (SGA) are predisposed to metabolic abnormalities. This study assessed the long-term safety of rhGH (Omnitrope®) use in short children born SGA.

Methods: This was a follow-up observational study of patients from a phase IV study. The baseline visit was the final visit of the phase IV study. Further visits were planned after 6 months (F1), 1 year (F2), 5 years (F3), and 10 years (F4). The primary objective was to evaluate the long-term effect of rhGH treatment on the development of diabetes mellitus; secondary objectives included incidence/severity of adverse events (AEs).

Results: In total, 130 subjects were enrolled in the follow-up study; 99 completed F1, 88 completed F2, and 13 completed F3 (no subject reached F4). The full analysis set for evaluation comprised 118 patients (64 female). Mean (standard deviation) duration of follow up was 39.6 (24.4) months. No subject was newly diagnosed with diabetes. The results for carbohydrate metabolism parameters were consistent with this finding. A total of 144 AEs were reported in 54 subjects; these were mostly of mild-to-moderate intensity (96.5%) and not suspected to be related to previous rhGH treatment (94.4%). Serious AEs (n = 18) were reported in eight patients; three (in one patient) were suspected as possibly related to previous rhGH treatment (anemia, menorrhagia, oligomenorrhoea). One fatal event occurred (sepsis), which was judged as not related to previous rhGH treatment.

Conclusions: None of the participating subjects, who had all been previously treated with Omnitrope® in a phase IV study, developed diabetes during this follow-up study. In addition, no other unexpected or concerning safety signals were observed.

Keywords: growth hormone; paediatrics; recombinant human growth hormone; small for gestational age.