Introduction: This phase 3 study assessed the efficacy, safety, and pharmacokinetics of the 6-month prolonged release (PR) formulation in Chinese children with central precocious puberty (CPP).
Methods: In this open-label study (NCT05029622), Chinese children (girls < 9 years, boys < 10 years) received two doses of triptorelin pamoate 22.5 mg (day 1 and month 6). Primary endpoint was the proportion at month 6 with luteinizing hormone (LH) suppression (stimulated peak LH ≤ 5 IU/L after gonadotropin-releasing hormone stimulation). Secondary endpoints included safety assessments, hormone level changes, and clinical parameters from baseline.
Results: Overall, 66 children completed the study (93.9% girls; median age 8.0 [range 5-9] years). At month 6, all patients had LH suppression; this was maintained at month 12 in 98.5% of patients. Mean basal and peak LH and follicle-stimulating hormone levels were suppressed throughout follow-up. All patients at months 3 to 12 had sex hormone suppression to prepubertal levels. Stable or reduced breast development was seen for 98.4% and 93.5% of girls at month 6 and 12, respectively; all boys had regression or stable genital development until month 12. Compared with baseline (9.82 cm/year), mean growth velocity was 5.88 cm/year at month 6 and 5.17 cm/year at month 12. Mean bone age/chronological age ratio decreased from 1.27 at baseline to 1.23 and 1.21 at month 6 and 12, respectively. In girls, 64.5% showed decreased uterine length at month 6 and 12 versus baseline, while 75.0% of boys showed stable testicular volume versus baseline. Thirteen patients (19.7%) had 22 drug-related treatment emergent adverse events (TEAEs); no grade ≥ 3 TEAEs were reported.
Conclusion: The efficacy and safety profile of triptorelin 6-month PR in Chinese children with CPP was consistent with data previously reported in non-Chinese children with CPP, supporting this as a viable treatment option for Chinese children with CPP.
Trial registration: Trial registration: ClinicalTrials.gov identifier, NCT05029622.
Keywords: Central precocious puberty; Chinese children; Triptorelin.
WHAT IS CENTRAL PRECOCIOUS PUBERTY (CPP)?: CPP is a condition where reproductive organs and sexual characteristics develop too early, before the age of 8 years in girls or 9 years in boys. CPP can negatively affect the mental health of patients and their caregivers. It can also lead to long-term problems like obesity and diabetes. CPP is caused by high levels of a hormone called luteinizing hormone. HOW IS CPP TREATED?: Triptorelin is an injectable treatment that can lower luteinizing hormone levels. Triptorelin injections are available for use once every month, once every 3 months, or once every 6 months. The injection for use once every 6 months (the 6-monthly injection) is not currently approved for CPP treatment in China. WHAT DID THIS STUDY LOOK AT?: This study assessed how well the 6-monthly triptorelin injections worked in 66 Chinese children with CPP. One injection was given at the start of the study and one after 6 months. WHAT WERE THE RESULTS?: Six months after their first injection, all children had luteinizing hormone levels that were below those seen with CPP. The development of sexual characteristics had slowed, such as pubic hair growth, breast and uterine length for girls, and testicular volume for boys. In addition, the rate at which children were increasing in height had also slowed down. These treatment effects were also seen at 12 months (6 months after the second injection). No children stopped treatment because of side effects. The researchers concluded that 6-monthly triptorelin may be a good treatment option for Chinese children with CPP.
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