32
views
0
recommends
+1 Recommend
1 collections
    0
    shares

          The flagship journal of the Society for Endocrinology. Learn more

      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Safety, pharmacokinetic and pharmacodynamic properties of TV-1106, a long-acting GH treatment for GH deficiency

      research-article

      Read this article at

      ScienceOpenPublisherPMC
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          TV-1106 (Teva Pharmaceuticals) is a genetically fused recombinant protein of human GH (hGH) and human serum albumin, in development for treatment of GH deficiency (GHD). TV-1106 is expected to have an extended duration of action compared to daily GH treatment and may enable a reduction in the frequency of injections and improve compliance and quality of life for adults and children requiring GHD therapy.

          Objective

          To assess the safety, local tolerability, pharmacokinetics and pharmacodynamics of TV-1106 following single s.c. injections in healthy male volunteers.

          Methods

          Subjects ( n=56) were assigned to one of seven ascending dose groups (3–100 mg) and received either a single dose of TV-1106 ( n=6) or placebo ( n=2) by s.c. injection.

          Results

          Eighteen subjects reported 43 adverse effects (AEs), which were mild to moderate; no serious AEs (SAEs) occurred. In 50, 70 and 100 mg groups there were mild to moderate increases in heart rate and systolic blood pressure that significantly correlated with higher levels of IGF1. TV-1106 showed pharmacokinetic characteristics of a long-acting hGH as demonstrated by a terminal elimination half-life of 23–35 h, delayed time of peak concentration, and systemic levels seen up to 7 days after dosing. IGF1 levels increased in a dose-dependent manner, before reaching a plateau, with levels above baseline extending beyond 7 days post dose.

          Conclusion

          Single administration of TV-1106 up to 100 mg was safe in healthy volunteers. Pharmacokinetics and pharmacodynamics support once-weekly administration in patients with GHD.

          Related collections

          Most cited references18

          • Record: found
          • Abstract: found
          • Article: not found

          Effects of growth hormone on glucose, lipid, and protein metabolism in human subjects.

          In evolutionary terms, GH and intracellular STAT 5 signaling is a very old regulatory system. Whereas insulin dominates periprandially, GH may be viewed as the primary anabolic hormone during stress and fasting. GH exerts anabolic effects directly and through stimulation of IGF-I, insulin, and free fatty acids (FFA). When subjects are well nourished, the GH-induced stimulation of IGF-I and insulin is important for anabolic storage and growth of lean body mass (LBM), adipose tissue, and glycogen reserves. During fasting and other catabolic states, GH predominantly stimulates the release and oxidation of FFA, which leads to decreased glucose and protein oxidation and preservation of LBM and glycogen stores. The most prominent metabolic effect of GH is a marked increase in lipolysis and FFA levels. In the basal state, the effects of GH on protein metabolism are modest and include increased protein synthesis and decreased breakdown at the whole body level and in muscle together with decreased amino acid degradation/oxidation and decreased hepatic urea formation. During fasting and stress, the effects of GH on protein metabolism become more pronounced; lack of GH during fasting increases protein loss and urea production rates by approximately 50%, with a similar increase in muscle protein breakdown. GH is a counterregulatory hormone that antagonizes the hepatic and peripheral effects of insulin on glucose metabolism via mechanisms involving the concomitant increase in FFA flux and uptake. This ability of GH to induce insulin resistance is significant for the defense against hypoglycemia, for the development of "stress" diabetes during fasting and inflammatory illness, and perhaps for the "Dawn" phenomenon (the increase in insulin requirements in the early morning hours). Adult patients with GH deficiency are insulin resistant-probably related to increased adiposity, reduced LBM, and impaired physical performance-which temporarily worsens when GH treatment is initiated. Conversely, despite increased LBM and decreased fat mass, patients with acromegaly are consistently insulin resistant and become more sensitive after appropriate treatment.
            • Record: found
            • Abstract: found
            • Article: not found

            Consensus guidelines for the diagnosis and treatment of adults with GH deficiency II: a statement of the GH Research Society in association with the European Society for Pediatric Endocrinology, Lawson Wilkins Society, European Society of Endocrinology, Japan Endocrine Society, and Endocrine Society of Australia.

            Ken Ho (2007)
            The GH Research Society held a Consensus Workshop in Sydney, Australia, 2007 to incorporate the important advances in the management of GH deficiency (GHD) in adults, which have taken place since the inaugural 1997 Consensus Workshop. Two commissioned review papers, previously published Consensus Statements of the Society and key questions were circulated before the Workshop, which comprised a rigorous structure of review with breakout discussion groups. A writing group transcribed the summary group reports for drafting in a plenary forum on the last day. All participants were sent a polished draft for additional comments and gave signed approval to the final revision. Testing for GHD should be extended from hypothalamic-pituitary disease and cranial irradiation to include traumatic brain injury. Testing may indicate isolated GHD; however, idiopathic isolated GHD occurring de novo in the adult is not a recognized entity. The insulin tolerance test, combined administration of GHRH with arginine or growth hormone-releasing peptide, and glucagon are validated GH stimulation tests in the adult. A low IGF-I is a reliable diagnostic indicator of GHD in the presence of hypopituitarism, but a normal IGF-I does not rule out GHD. GH status should be reevaluated in the transition age for continued treatment to complete somatic development. Interaction of GH with other axes may influence thyroid, glucocorticoid, and sex hormone requirements. Response should be assessed clinically by monitoring biochemistry, body composition, and quality of life. There is no evidence that GH replacement increases the risk of tumor recurrence or de novo malignancy.
              • Record: found
              • Abstract: found
              • Article: not found

              Compliance and persistence in pediatric and adult patients receiving growth hormone therapy.

              To identify key factors that influence compliance and persistence in patients receiving growth hormone (GH) therapy and to promote the development of interventions to support continuous GH use. A 134-question survey was conducted involving 158 adult patients, 326 adolescents or teens, and 398 parents of children currently receiving or previously treated with GH. Questions explored perceptions about GH deficiency and treatment outcomes, quality of training received for administration of injections, and disruptions affecting compliance and persistence with therapy. Compliance was defined by a categorical assessment of frequency of missed GH doses for specific reasons. Persistence was defined as continuing GH therapy with no interruption. On the basis of their responses to questions about potential reasons for missing GH doses, patients were categorized by level of compliance into 3 segments--highly compliant, occasionally noncompliant, or noncompliant and skeptical. Noncompliance with GH therapy (that is, classification in one of the last 2 segments) ranged from 64% to 77% among the 3 age-groups evaluated, with teens having the highest rate of noncompliance. Misperceptions about the consequences of missed GH doses, discomfort with injections, dissatisfaction with treatment results, and inadequate contact with health-care providers (along with other factors) were strongly associated with noncompliance. Survey questions related to these factors were considered useful for identifying patients requiring additional support or intervention to improve compliance. Routine education should emphasize therapeutic end points and their relationship to compliance with GH therapy in an effort to convince and empower patients with GH deficiency to use self-care strategies to achieve their treatment goals.

                Author and article information

                Journal
                Eur J Endocrinol
                Eur. J. Endocrinol
                EJE
                European Journal of Endocrinology
                Bioscientifica Ltd (Bristol )
                0804-4643
                1479-683X
                November 2015
                18 August 2015
                : 173
                : 5
                : 541-551
                Affiliations
                [1]Teva Pharmaceuticals, Inc. , 12 Hatrufa Street, Netanya 42504, Israel
                [1 ]Teva Biopharmaceuticals, Inc. , Rockville, Maryland, USA
                [2 ]Teva Pharmaceuticals, Inc. , Frazer, Pennsylvania, USA
                [3 ]Cardiac Safety Consultants Ltd , London, UK
                Author notes
                Correspondence should be addressed to O Cohen-Barak orit.cohen-barak@ 123456teva.co.il
                Article
                EJE150554
                10.1530/EJE-15-0554
                4584421
                26286586
                dc13e3d1-aaf5-4a60-8f6f-234d5bf1cb2c
                © 2015 The authors

                This work is licensed under a Creative Commons Attribution 3.0 Unported License

                History
                : 4 June 2015
                : 18 August 2015
                Categories
                Clinical Study

                Endocrinology & Diabetes
                Endocrinology & Diabetes

                Comments

                Comment on this article

                Related Documents Log