Abstract
Somatrogon (NGENLA®), a modified long-acting form of recombinant human growth hormone (rhGH), is a valuable new option for the treatment of paediatric patients aged ≥ 3 years with growth disturbance due to insufficient GH secretion in the EU, and offers the convenience of once-weekly administration. In a phase 3 randomized trial, once-weekly somatrogon was non-inferior to once-daily somatropin (rhGH; standard therapy) in increasing height velocity in paediatric patients with GH deficiency (GHD). Once-weekly somatrogon was associated with a lower treatment burden than once-daily somatropin in another phase 3 randomized trial. Somatrogon is generally well tolerated, with injection site pain being the most frequent treatment-emergent adverse event. Somatrogon is available as a multi-dose prefilled pen for subcutaneous injection.
Plain Language Summary
Growth hormone deficiency (GHD) is a rare cause of growth failure in children. Affected children are usually much shorter than their peers and over time will tend to drop farther below the normal range. When GHD is recognised, children ordinarily begin treatment with recombinant human growth hormone (rhGH; somatropin) administered once daily, which while effective, has been associated with non-adherence and thus impaired therapeutic response. Somatrogon (NGENLA®) is a novel long-acting rhGH that allows once-weekly administration. Administered as a once-weekly subcutaneous injection in a clinical trial in pre-pubertal children diagnosed with GHD who had not received prior rhGH therapy, somatrogon was no less effective than once-daily somatropin in terms of annualised height velocity following 12 months of treatment, with catch-up growth continuing over the longer term. In another clinical trial, once-weekly somatrogon reduced treatment burden relative to once-daily somatropin in treatment-experienced paediatric patients with GHD. When used to treat paediatric GHD, somatrogon was generally well tolerated, with a tolerability profile consistent with that of somatropin; most adverse events were mild or moderate in severity. Somatrogon is a valuable new treatment option for children and adolescents aged ≥ 3 years with growth disturbance due to insufficient GH secretion, and offers the convenience of once-weekly administration.
Similar content being viewed by others
References
Pediatric Endocrine Society and American Academy of Pediatrics. Growth hormone deficiency: a guide for families. 2018. https://pedsendo.org/patient-resource/growth-hormone-deficiency/. Accessed 8 Sep 2022.
National Organization for Rare Disorders. Growth hormone deficiency. 2016. https://rarediseases.org/rare-diseases/growth-hormone-deficiency/. Accessed 8 Sep 2022.
Caicedo A, Rosenfeld R. Challenges and future for the delivery of growth hormone therapy. Growth Horm IGF Res. 2018;38:39–43.
Christiansen JS, Backeljauw PF, Bidlingmaier M, et al. Growth Hormone Research Society perspective on the development of long-acting growth hormone preparations. Eur J Endocrinol. 2016;174(6):C1-8.
Lamb YN. Somatrogon: first approval. Drugs. 2022;82(2):227–34.
Pfizer Europe MA EEIG. Ngenla (somatrogon) solution for injection in pre-filled pen: EU summary of product characteristics. 2022. https://www.ema.europa.eu/en/medicines/human/EPAR/ngenla. Accessed 8 Sep 2022.
Zelinska N, Iotova V, Skorodok J, et al. Long-acting C-terminal peptide-modified hGH (MOD-4023): results of a safety and dose-finding study in GHD children. J Clin Endocrinol Metab. 2017;102(5):1578–87.
Deal C, Steelman J, Vlachopapadopoulou E, et al. Efficacy and safety of weekly somatrogon vs daily somatropin in children with growth hormone deficiency: a phase 3 study. J Clin Endocrinol Metab. 2022;107(7):e2717–28.
Horikawa R, Tanaka T, Hasegawa Y, et al. Efficacy and safety of once-weekly somatrogon compared with once-daily somatropin (Genotropin®) in Japanese children with pediatric growth hormone deficiency: results from a randomized phase 3 study. Horm Res Paediatr. 2022. https://doi.org/10.1159/000524600.
Loftus J, Quitmann J, Valluri S, et al. Comparison of quality of life responses from caregiver and children aged ≥7 years using the quality of life in short stature youth (QoLISSY) questionnaire, following 12 months of growth hormone treatment with either a weekly somatrogon or a daily genotropin injection schedule [abstract]. J Endocr Soc. 2021;5(Suppl. 1):A674.
Wajnrajch M, Miller BS, Steelman J, et al. Switch data from the open-label extension of the pivotal phase 3 study of once weekly somatrogon compared to daily somatropin in pediatric patients with growth hormone deficiency (pGHD) [abstract]. J Endocr Soc. 2021;5(Suppl. 1):A686–7.
Pastrak A, Choe J, Wajnrajch M, et al. Long-term safety and efficacy of a once-weekly somatrogon (hGH-CTP): a 5-year phase 2 extension study in children with growth hormone deficiency [abstract no. 98]. Horm Res Paediatr. 2020;93(Suppl. 1):68.
Maniatis AK, Carakushansky M, Galcheva S, et al. Treatment burden of weekly somatrogon vs daily somatropin in children with growth hormone deficiency: a randomized study. J Endocr Soc. 2022;6(10):bvac117.
Zelinska N, Skorodok Y, Malievsky O, et al. Long-term safety of a once-weekly somatrogon (hGH-CTP): 4-year results: of a phase 2 extension study in children with growth hormone deficiency [abstract no. P1–361]. Horm Res Paediatr. 2019;91(Suppl. 1):309.
Bouhours-Nouet N, Teinturier C. Long-acting recombinant human growth hormone in the treatment of pediatric growth hormone deficiency, how far have we got? Arch Pediatr. 2022;28(8 Suppl. 1):28/8S14-20.
Ascendis Pharma Endocrinology Division A/S. Skytrofa (lonapegsomatropin) powder and solvent for solution for injection in cartridge: EU summary of product characteristics. 2022. https://www.ema.europa.eu/en/documents/product-information/skytrofa-previously-lonapegsomatropin-ascendis-pharma-epar-product-information_en.pdf. Accessed 8 Sept 2022.
Lamb YN. Lonapegsomatropin: pediatric first approval. Paediatr Drugs. 2022;24(1):83–90.
Deal CL, Pastrak A, Silverman LA, et al. Somatrogon growth hormone in the treatment of pediatric growth hormone deficiency: results of the pivotal pediatric phase 3 clinical trial [abstract no. OR10-06]. J Endocr Soc. 2020;4(Suppl. 1):A648-9.
Acknowledgements
The manuscript was reviewed by: J. Jose, School of Pharmacy, University of Nizwa, Nizwa, Oman; R. Shah, Department of Pharmacology, All India Institute of Medical Sciences, Rajkot, Gujarat, India. During the peer review process, Pfizer Europe MA EEIG, the marketing authorization holder of somatrogon, was also offered an opportunity to provide a scientific accuracy review of their data. Changes resulting from comments received were made on the basis of scientific and editorial merit.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Funding
The preparation of this review was not supported by any external funding.
Authorship and conflict of interest
E.S. Kim is a contracted employee of Adis International Ltd/Springer Nature and declares no conflicts of interest. Z.T. Al-Salama, a salaried employee of Adis International Ltd/Springer Nature and an editor of Drugs & Therapy Perspectives, was not involved in any publishing decisions for the manuscript and declares no relevant conflicts of interest. All authors contributed to the review and are responsible for the article content.
Ethics approval, Consent to participate, Consent to publish, Availability of data and material, Code availability
Not applicable.
Supplementary Information
Below is the link to the electronic supplementary material.
Rights and permissions
Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Kim, E.S., Al-Salama, Z.T. Somatrogon in paediatric growth hormone deficiency: a profile of its use in the EU. Drugs Ther Perspect 38, 501–507 (2022). https://doi.org/10.1007/s40267-022-00955-1
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40267-022-00955-1