Efficacy and Safety of Lonapegsomatropin in Children With Turner Syndrome: 52-Week Results From the New InsiGHTS Trial.
Davis Shanlee M SM, Abuzzahab M Jennifer MJ, Tryggestad Jeanie B JB, Fechner Patricia Y PY et al.
Treatment with growth hormone is effective in improving height outcomes in children with Turner syndrome. However, poor adherence-often influenced by daily injection burden-may compromise treatment outcomes. Lonapegsomatropin is a prodrug, administered once weekly, that provides sustained release of somatropin. To evaluate the efficacy and safety of lonapegsomatropin in children with Turner syndrome. New InsiGHTS is a phase 2 dose-ranging trial (ClinicalTrials.gov: NCT05690386). This trial was conducted across 19 centers in the United States. This trial enrolled and dosed 49 prepubertal children with Turner syndrome. Randomization was 1:1:1:1 to receive once-weekly lonapegsomatropin (0.24, 0.30, or 0.36 mg hGH/kg/week) or daily somatropin (0.35 mg/kg/week). The primary efficacy endpoint was annualized height velocity (AHV) at week 26. Secondary efficacy endpoints included AHV at week 52 and change from baseline in height standard deviation score (SDS) at weeks 26 and 52. At week 26, AHV was comparable between lonapegsomatropin starting dose cohorts (range: 9.23 to 10.36 cm/year) and the somatropin cohort (10.86 cm/year). At week 52, AHV was comparable between pooled lonapegsomatropin cohorts (9.05 cm/year) and the somatropin cohort (9.04 cm/year), with mean gains in height SDS of 0.60 and 0.67, respectively. Lonapegsomatropin was well tolerated with a safety profile similar to somatropin. Across evaluated doses, lonapegsomatropin treatment demonstrated comparable efficacy, safety, and tolerability to somatropin after 1 year, supporting development of lonapegsomatropin as a once-weekly treatment option for short stature in children with Turner syndrome.