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Growth Hormone DeficiencyPhase 3DETECTNCT04786873

A Research Study of How Well Macimorelin Works to Find Out if Children Have a Lack of Growth Hormone and How Safe it is

A Phase 3 study testing Macimorelin, Arginine and Clonidine in people with Growth Hormone Deficiency, run by AEterna Zentaris at 45 sites in 11 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This research study will find out if a new growth hormone stimulation test is safe and works as well as other tests to diagnose growth hormone deficiency (GHD) in children. The stimulation test will use a new growth hormone stimulating substance called macimorelin. Read more about this study

Who is it for?
Ages 2 to 17 years
Conditions the study is for
Growth Hormone Deficiency
What is being tested?
Macimorelin, Arginine and Clonidine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
101 participants
Where
45 sitesin 11 countries
Study dates
16 Nov 2021to 13 Jun 2024
Phase
Phase 3
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 2 to 17 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Informed consent of subject, parent(s) or legally acceptable representative (LAR) of subject and child assent, if appropriate, must be obtained before any trial-related activities. Trial-related activities are any procedures that are carried out as part of the trial, including activities to determine suitability for the trial.
  • Male and female pediatric subjects from 2 to less than 18 years of age at the time of signing informed consent.
  • Indication for the performance of growth hormone stimulation test.
  • Presence of a height measurement minimum 6 and maximum 18 months prior to screening.

Who cannot join

  • Established diagnosis of a disease that is sufficient to explain growth deficiency or metabolic disorders that are also associated with short stature (e.g., Turner syndrome, skeletal dysplasia's, celiac disease, etc.).
  • Ongoing growth hormone therapy.
  • Presence of hypothyroidism and/or adrenal insufficiency without adequate and stable replacement therapy treatment for at least 30 days prior to first GHST.
  • Treatment with drugs directly affecting the pituitary secretion of somatotropin (e.g., somatostatin analogues, clonidine, levodopa and dopamine agonists) or provoking the release of somatostatin (antimuscarinic agents e.g., atropine).
  • Medical history of ongoing clinically symptomatic psychiatric disorders.
  • 2nd or 3rd degree atrioventricular-block, prolongation of the QRS complex over 120 milliseconds, prolongation of the QTc interval over 450 milliseconds, or any other clinically significant abnormal electrocardiogram results at the V2 pre-dose electrocardiogram (ECG) as judged by the investigator.
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  • Previous participation in this trial. Participation is defined as signed informed consent.
  • Participation in any clinical trial of an approved or non-approved investigational medicinal product within 30 days before screening.
  • Known or suspected hypersensitivity to trial product(s) or related products;
  • Any disorder, which in the investigator's opinion might jeopardize subject's safety or compliance with the protocol.
  • Concomitant treatment with any drugs that might prolong QT/QTc Note: A subject who receives such treatment will not be a candidate for this study, if his/her condition does not allow for a treatment-free period of at least 5 elimination half-lives of the drug that might prolong QT/QTc before the GHST;
  • Elevation of laboratory parameters indicating hepatic or renal dysfunction or damage (aspartate amino transferase (AST), alkaline phosphatase (ALT), gamma-glutamyl transferase (GGT) > 2.5 x upper limit of normal (ULN); creatinine or bilirubin > 1.5x ULN);
  • Current active malignancy other than non-melanoma skin cancer;
  • Female of child-bearing potential and not using an adequate contraceptive method (adequate contraceptive measures as required by local regulation or practice).
  • Male of reproductive age who or whose partner(s) is not using an adequate contraceptive method (adequate contraceptive measures as required by local regulation or practice).
  • Lack of ability or willingness to give informed consent by the subject and/or his/her legal representative;
  • Anticipated non-availability for trial visits/procedures.

Trial locations and contacts

45 sites in 11 countries.

45 sites in 11 countries

United States12 sites
  • Emory Healthcare-Children's Center

    Atlanta, Georgia, 30329

  • St. Luke's Children's Endocrinology

    Boise, Idaho, 83712

  • UNC Hospitals

    Chapel Hill, North Carolina, 27599

  • Pediatric Endocrine Associates, p.c.

    Greenwood Village, Colorado, 80111

  • The Children's Mercy Hospital - Broadway

    Kansas City, Missouri, 64108

  • University of Minnesota, Masonic Children's Hospital

    Minneapolis, Minnesota, 55454

  • Icahn School of Medicine at Mount Sinai

    New York, New York, 10129

  • Alchemi Research Center

    Rosharon, Texas, 77583

  • John Hopkins All Children's Hospital

    St. Petersburg, Florida, 33701

  • Multicare Health System

    Tacoma, Washington, 98405

  • Children's Hospital at Montefiore

    The Bronx, New York, 10709

  • Angel Wing Clinic For Children With Diabetes

    Tucson, Arizona, 85724

Other trials in United States

Romania8 sites
  • Cen Med de Diagn si Trat Amb NEOMED

    Brasov, 500283

  • Sana Monitoring

    Bucharest, 011025

  • Medicover Hospitals

    Bucharest, 013982

  • Institutul de Endocrinologie "C.I. Parhon"

    Bucharest, 10587

  • Spitalul Clinic Judetean de Urgenta "Sf. Apostol Andrei" Constanta

    Constanța, 900591

  • Spitalul Clinic Judetean de Urgenta "Sf. Spiridon" Iasi

    Iași, 700111

  • Spitalul Clinic Judetean Mures

    Târgu Mureş, 540072

  • Spitalul Cl. de Urgenta pentru Copii Louis Turcanu Timisoara

    Timișoara, 300011

Other trials in Romania

Italy5 sites
  • Ospedale Pediatrico G. Salesi

    Ancona, 60126

  • Azienda Ospedaliero-Universitaria Anna Meyer

    Florence, 50139

  • Osp. dei Bambini V. Buzzi, ASST Fatebenefratelli Sacco

    Milan, 20154

  • Azienda Ospedaliero-Universitaria di Parma Ospedale dei Bambini Pietro Barilla, Clinica Pediatrica

    Parma, 43100

  • IRCCS Ospedale Pediatrico Bambino Gesù

    Roma, 00165

Other trials in Italy

Poland4 sites
  • MED-POLONIA Sp.z o.o.

    Poznan, 60-693

  • Kliniczny Szpital Wojewodzki nr 2 im. Sw. Jadwigi Krolowej w Rzeszowie

    Rzeszów, 35-301

  • SPSK Nr 1 im. prof. Tadeusza Sokolowskiego PUM

    Szczecin, 71252

  • Uniwersytecki Szpital Kliniczny im. Jana Mikulicza Radeckiego we Wroclawiu

    Wroclaw, 50368

Other trials in Poland

Turkey (Türkiye)4 sites
  • Ankara University, Faculty of Medicine

    Ankara, 6100

  • Antalya Training and Research Hospital

    Antalya, 7050

  • Kocaeli University Faculty of Medicine

    Kocaeli, 41380

  • Karadeniz Technical University

    Ortahisar, 61080

Other trials in Turkey (Türkiye)

Georgia3 sites
  • JSC Maritime Hospital

    Batumi, 0179

  • National Institute of Endocrinology

    Tbilisi, 0159

  • TSMU Givi Jvania Pediatric Academic Clinik

    Tbilisi, 0159

Other trials in Georgia

Serbia3 sites
  • University children's clinic Belgrade - Department of Endocrinology

    Belgrade, 11000

  • Clinical Center Nis - Clinic for Children's Internal Medicine

    Niš, 18000

  • Institute for Child and Youth Health Care of Vojvodina - Endocrinology

    Novi Sad, 21000

Other trials in Serbia

Slovakia3 sites
  • National Institute of Children's Diseases

    Bratislava, 83340

  • Children's University Hospital Kosice

    Košice, 4011

  • National Institute of Endocrinology and Diabetology

    Ľubochňa, 03491

Other trials in Slovakia

Armenia1 site
  • Yerevan State Medical University after Mkhitar Heraci

    Yerevan, 0024

Other trials in Armenia

Germany1 site
  • Evangelisches Klinikum Bethel

    Bielefeld, 33617

Other trials in Germany

Slovenia1 site
  • Univerzitetni Klinicni Center Ljubljana - Pediatrics

    Ljubljana, 1000

Other trials in Slovenia

About this study

Official title: Multicenter, Open Label Trial to Investigate the Efficacy and Safety of a Single Oral Dose of 1.0 mg/kg Macimorelin Acetate as Growth Hormone Stimulation Test (GHST) in Pediatric Patients With Suspected Growth Hormone Deficiency (GHD)

This research study will find out if a new growth hormone stimulation test is safe and works as well as other tests to diagnose growth hormone deficiency (GHD) in children. The stimulation test will use a new growth hormone stimulating substance called macimorelin. By now, only adults in the USA can get this new stimulation test. The results of this study are expected to help children and teenagers with suspected GHD to get the macimorelin stimulation test.

The macimorelin test will be compared to a clonidine and an arginine test. Both are known standard stimulation tests. Altogether two macimorelin tests are planned to be performed in the study, to show how repeatable macimorelin tests results are (under a set of similar conditions).

Read the detailed description

Each study participant (patient) will have 5 to 6 visits in total with the study doctor.

The study will last for about 1 to 4 months, dependent on how close the visits are done. At the visits 2, 3, 4 and 5, the patient will get a stimulation test done and blood samples will be taken. At those 4 visits, the patient will have either to drink a macimorelin drink, take some clonidine tablets or get an arginine infusion. In total, the patient will get 2 macimorelin, 1 clonidine and 1 arginine test done. The level of growth hormone (GH) will be measured 4 times during the clonidine and during the arginine test and 5 times during the macimorelin test. After the test, questions on the test tolerability will be captured from patients and parents. After the arginine test, a urine dipstick test is to be done by the patient at home.

Being tested
Macimorelin, Arginine, Clonidine
Keywords
childhood-onset growth hormone deficiency, diagnosis of growth hormone deficiency, diagnosis of childhood-onset growth hormone deficiency, diagnostic test for growth hormone deficiency
Medical subject headings
Dwarfism, Pituitary

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • MacimorelinDrug

    Also called Macrilen, AEZS-130, Macimorelin GHST, Macimorelin test

    Dosage form: granules for oral solution, Dosage: 1.0 mg/kg body weight, Frequency and duration: single oral dose administration. Macimorelin will be supplied in single-use aluminum pouches (synonymous: sachets) each containing 63.6 mg macimorelin as acetate, which provide 0.5 mg/mL of macimorelin when dissolved in 120 mL of water. The excess amount of 3.6 mg represents an overfill, which is needed to obtain the target concentration.

  • ArginineDiagnostic test

    Also called R-Gene 10, arginine test, arginine GHST

    For the arginine GHST, R-Gene® 10 from Pfizer will be provided as labelled investigational medicinal product (IMP). After an overnight fast, soluble arginine hydrochloride (0.5 g/kg) will be given i.v. as an infusion with an infusion duration of 30 min.

  • ClonidineDiagnostic test

    Also called Catapressan 75, Clonidine test, Clonidine GHST

    For the clonidine GHST, CATAPRESAN® 75 tablets (Boehringer Ingelheim) will be provided as labelled IMP. Each tablet contains 75 ug clonidine hydrochloride. The tablets will be provided in boxes containing 10 tablets. The target dose is 0.15 mg/m2 body surface with a dose range of 0.08 - 0.15 mg/m2. Maximum dose will be 0.25 mg.

    After an overnight fast, clonidine (0.15 mg/m2 body surface) will be given orally.

Study groups in NCT04786873
Study groupRoleWhat they receive
standard GHST order randomized: arginine - clonidineActive comparatorAt visit 2 (V2), all subjects will perform the macimorelin GHST and will be randomized 1:1 to the order of the clonidine and arginine GHSTs at visit 3 (V3) and visit 4 (V4). In this arm, those subjects will be presented which will have been randomized to the arginine GHST at V3 and the clonidine GHST at V4. At visit 5 (V5) all subjects will perform the macimorelin GHST.
Receives: Drug: Macimorelin; Diagnostic Test: Arginine; Diagnostic Test: Clonidine
standard GHST order randomized: clonidine - arginineActive comparatorAt V2, all subjects will perform the macimorelin GHST and will be randomized 1:1 to the order of the clonidine and arginine GHSTs at V3 and V4. In this arm, those subjects will be presented which will have been randomized to the clonidine GHST at V3 and to the arginine GHST at V4. At V5 all subjects will perform the macimorelin GHST.
Receives: Drug: Macimorelin; Diagnostic Test: Arginine; Diagnostic Test: Clonidine

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Area under the Receiver Operator Characteristic curve (ROC AUC) based on GH concentration during GHST following macimorelin administration

    Assuming the outcome of GHD status adjudication final clinical diagnosis as the "true" GHD status, the diagnostic efficacy (estimated sensitivity, specificity, misclassification) of the macimorelin GHST will be based on the area under the receiver operating characteristic curve (ROC AUC).

    Measured: Derived from Cmax GH measurements collected in the time frame from 0 to 90 minutes after initial macimorelin GHST (visit 2 (day 0)) and GH adjudication status performed by the adjudication committee after visit 4 (between day 11 and day 58)).

Secondary outcomes (3)
  1. Sensitivity for the macimorelin GHST

    Sensitivity (confirmatory secondary endpoint) will be derived from the empirical ROC plot using this GH cut-off point.

    Measured: Derived from Cmax GH measurements collected in the time frame from 0 to 90 minutes after initial macimorelin GHST (visit 2 (day 0)) and GH adjudication status performed by the adjudication committee after visit 4 (between day 11 and day 58)).

  2. Specificity for the macimorelin GHST

    Specificity (confirmatory secondary endpoint) will be derived from the empirical ROC plot using this GH cut-off point.

    Measured: Derived from Cmax GH measurements collected in the time frame from 0 to 90 minutes after initial macimorelin GHST (visit 2 (day 0)) and GH adjudication status performed by the adjudication committee after visit 4 (between day 11 and day 58)).

  3. Overall agreement between the outcome of the macimorelin GHST and the combined outcome from the 2 standard GHSTs

    Agreement between the outcome of macimorelin and the combined outcome of the 2 standard GHSTs will be evaluated by 'percent overall agreement'.

    Measured: Visit 4 (between day 11 and day 58)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted8 Mar 2021
  2. Study start16 Nov 2021
  3. Primary completion13 Jun 2024
  4. Study completion13 Jun 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Diagnosis
Allocation
Randomised
Intervention model
Crossover
Model description
This is an open label, single-dose trial to determine the diagnostic efficacy and safety of macimorelin in pediatric subjects aged 2 to less than 18 years of age in whom, based on auxological and clinical criteria, growth hormone stimulation test (GHST) is indicated due to suspected growth hormone deficiency. Four GHSTs will be conducted during the trial: the macimorelin GHST will be performed twice, and arginine and clonidine standard GHSTs will be performed once each. The macimorelin GHST will be administered at the beginning of the trial and after serial performance of the two different standard GHSTs. The macimorelin GHSTs will be performed twice to show repeatability of the macimorelin GHST. All subjects will be randomized 1:1 to the order of the arginine and clonidine GHSTs, and in a crossover manner all subjects will receive both these GHSTs.
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
101 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04786873
Sponsor's protocol ID
AEZS-130-P02
Other IDs
2018-001989-42, U1111-1248-5075, 2018
Acronym
DETECT
Status last verified
Aug 2024
First submitted
3 Mar 2021
Last updated
12 Aug 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Macimorelin, Arginine and Clonidine in people with Growth Hormone Deficiency, run by AEterna Zentaris at 45 sites in 11 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 17 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 12 Aug 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 45 sites in United States, Romania, Italy, Poland, Turkey (Türkiye) and 6 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Area under the Receiver Operator Characteristic curve (ROC AUC) based on GH concentration during GHST following macimorelin administration (time frame: Derived from Cmax GH measurements collected in the time frame from 0 to 90 minutes after initial macimorelin GHST (visit 2 (day 0)) and GH adjudication status performed by the adjudication committee after visit 4 (between day 11 and day 58)).). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Aug 2024.

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