OPKO Health, Inc, a multinational biopharmaceutical and diagnostics company, hosted a webcast presenting outstanding interim six-month results from a Phase 2 study of its long-acting human growth hormone product Lagova to treat paediatric growth hormone deficiency disorder (GHD).
During the webcast, Dr. Ron Rosenfeld, chairman of OPKO Biologic's Scientific Advisory Board and professor emeritus of Pediatrics at both Stanford University and Oregon Health and Science University, highlighted the superior interim results from the study. In particular, Dr. Rosenfeld, a pioneer in the recombinant human growth hormone field, noted that the mean height velocity achieved with each of the three different doses of Lagova administered in the study was "actually quite dramatic, ranging from 12.25 centimeters to almost 15.5 centimeters. Every child enrolled in the study experienced a significant improvement in height velocity from weekly administration of Lagova," he noted.
"OPKO believes there is a significant market opportunity with Lagova, as compliance with daily injections is problematic. Non-compliance leads to a significant decrease in growth response in both adults and children, which is well evidenced by current clinical literature," said OPKO's chief executive officer, Phillip Frost, M.D. "The outstanding interim Phase II results allow for dose selection for a Phase III study which is anticipated to start in 2015."
Unlike other pediatric long-acting growth hormone deficiency clinical trials, the Lagova Phase II trials also included a direct comparator arm at the same population with similar baseline values. Children were given daily administration of growth hormone at a dosage of 0.24 mg/kg per week, but administered daily in a traditional manner. There was no statistically significant difference among any of the three dosage strengths of Lagova used in the study versus the comparator arm.
As any Phase III trial for a long-acting recombinant human growth hormone will likely require proof of non-inferiority against a comparator arm of daily administered growth hormone, this is an important distinction that gives OPKO great confidence in designing its non-inferiority pivotal Phase III study for Lagova. had OPKO utilised historical database comparisons as utilised in other pediatric GHD clinical trials versus an actual comparator arm, annualised height velocity for Lagova at all three dosage strengths would have been notably superior, exceeding comparable age-matched historical controls, as published by Bakker (2008) and Ranke (2010) for the same GHD patient population by approximately 30 per cent .
Lagova uses OPKO Biologics' novel CTP technology which attaches a short naturally occurring peptide to the natural human growth hormone. Approximately 75 per cent of the injected protein in Lagova is the actual native growth hormone, altogether resulting in a highly water soluble compound that can be delivered in high concentrations using a very thin 31 gauge needle to patients of a wide range of body weights and ages by a single, weekly injection. As expected, the safety profile from the six-month data was excellent. No serious adverse events were reported. There were no episodes of either lipoatrophy or lipodystrophy and there were no injection site tolerability issues. More importantly, long term safety is supported by the pharmacokinetic and pharmacodynamics profiles; there was no accumulation and no over-exposure of IGF-1.
In June 2013, OPKO initiated a multi-centre worldwide pivotal Phase 3 clinical trial in adults for its proprietary long-acting version of hGH-CTP (Lagova). Lagova has been awarded orphan drug designation in the US. and Europe for both adults and children with growth hormone deficiency.