Trial Outcomes & Findings for Histrelin Subcutaneous Implant in Children With Central Precocious Puberty (NCT NCT00779103)

NCT ID: NCT00779103

Last Updated: 2021-01-08

Results Overview

The suppression of gonadotropins (luteinizing hormone and follicle stimulating hormone) and gonadal sex steroids (estrogen in girls and testosterone in boys, respectively) on treatment.(LH suppression is defined as a peak LH \< 4 mIU/mL following stimulation with the GnRH analog).

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

36 participants

Primary outcome timeframe

Baseline - 6 Months Post Last Implant

Results posted on

2021-01-08

Participant Flow

Participant milestones

Participant milestones
Measure
Overall - Histrelin Subcutaneous Implant (50 mg)
Subcutaneous implant designed to deliver histrelin continously for 12 months. Histrelin Subcutaneous Implant: histrelin subcutaneous 50 mg implant
Overall Study
STARTED
36
Overall Study
Second & Third Implant
31
Overall Study
Fourth Implant
13
Overall Study
No Treatment
9
Overall Study
COMPLETED
36
Overall Study
NOT COMPLETED
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Histrelin Subcutaneous Implant in Children With Central Precocious Puberty

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Histrelin Subcutaneous Implant (50 mg)
n=31 Participants
Subcutaneous implant designed to deliver histrelin continously for 12 months. Histrelin Subcutaneous Implant: histrelin subcutaneous 50 mg implant Extension Safety Population (Second \& Third Implant)
Age, Continuous
7.7 years
STANDARD_DEVIATION 1.54 • n=5 Participants
Sex: Female, Male
Female
29 Participants
n=5 Participants
Sex: Female, Male
Male
2 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
5 Participants
n=5 Participants
Race (NIH/OMB)
White
12 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
1 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
13 Participants
n=5 Participants
Height
134.18 cm
STANDARD_DEVIATION 12.947 • n=5 Participants
Weight
38.12 kg
STANDARD_DEVIATION 11.835 • n=5 Participants
Body Mass Index (BMI)
20.66 kg/m^2
STANDARD_DEVIATION 3.541 • n=5 Participants
Pretreatment with Prior GnRH Therapy
Pretreated
13 Participants
n=5 Participants
Pretreatment with Prior GnRH Therapy
Naïve
18 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Baseline - 6 Months Post Last Implant

Population: Extension Safety Population

The suppression of gonadotropins (luteinizing hormone and follicle stimulating hormone) and gonadal sex steroids (estrogen in girls and testosterone in boys, respectively) on treatment.(LH suppression is defined as a peak LH \< 4 mIU/mL following stimulation with the GnRH analog).

Outcome measures

Outcome measures
Measure
Observed Value
n=31 Participants
Change From Baseline
n=31 Participants
Luteinizing Hormone (LH)
Month 66, Visit 18
0.18 MIU/ML
Standard Deviation 0.020
0.07 MIU/ML
Standard Deviation 0.100
Luteinizing Hormone (LH)
Month 72, Visit 19
0.36 MIU/ML
Standard Deviation 0.357
0.26 MIU/ML
Standard Deviation 0.237
Luteinizing Hormone (LH)
Baseline
0.88 MIU/ML
Standard Deviation 1.244
Luteinizing Hormone (LH)
Day 1, Visit 1
0.53 MIU/ML
0.07 MIU/ML
Luteinizing Hormone (LH)
Month 1, Visit 2
0.50 MIU/ML
Standard Deviation 0.302
-0.37 MIU/ML
Standard Deviation 1.111
Luteinizing Hormone (LH)
Month 3, Visit 3
0.39 MIU/ML
Standard Deviation 0.247
-0.50 MIU/ML
Standard Deviation 1.173
Luteinizing Hormone (LH)
Month 6, Visit 4
0.37 MIU/ML
Standard Deviation 0.225
-0.53 MIU/ML
Standard Deviation 1.227
Luteinizing Hormone (LH)
Month 9, Visit 5
0.38 MIU/ML
Standard Deviation 0.266
-0.51 MIU/ML
Standard Deviation 1.170
Luteinizing Hormone (LH)
Month 12, Visit 6
0.38 MIU/ML
Standard Deviation 0.247
-0.50 MIU/ML
Standard Deviation 1.108
Luteinizing Hormone (LH)
Month 13, Visit 7
0.35 MIU/ML
Standard Deviation 0.216
-0.58 MIU/ML
Standard Deviation 1.217
Luteinizing Hormone (LH)
Month 18, Visit 9
0.24 MIU/ML
Standard Deviation 0.118
-0.68 MIU/ML
Standard Deviation 1.233
Luteinizing Hormone (LH)
Month 24, Visit 11
0.22 MIU/ML
Standard Deviation 0.124
-0.66 MIU/ML
Standard Deviation 1.228
Luteinizing Hormone (LH)
Month 36, Visit 13
0.19 MIU/ML
Standard Deviation 0.126
-0.42 MIU/ML
Standard Deviation 0.734
Luteinizing Hormone (LH)
Month 42, Visit 14
0.14 MIU/ML
Standard Deviation 0.119
-0.53 MIU/ML
Standard Deviation 0.842
Luteinizing Hormone (LH)
Month 48, Visit 15
0.25 MIU/ML
Standard Deviation 0.232
-0.36 MIU/ML
Standard Deviation 0.871
Luteinizing Hormone (LH)
Month 54, Visit 16
0.24 MIU/ML
Standard Deviation 0.272
-0.47 MIU/ML
Standard Deviation 1.402
Luteinizing Hormone (LH)
Month 60, Visit 17
0.27 MIU/ML
Standard Deviation 0.336
-0.24 MIU/ML
Standard Deviation 0.937
Luteinizing Hormone (LH)
1 Month Post Last Implant
0.81 MIU/ML
Standard Deviation 0.952
0.53 MIU/ML
Standard Deviation 0.958
Luteinizing Hormone (LH)
6 Month Post Last Implant
3.66 MIU/ML
Standard Deviation 2.463
3.38 MIU/ML
Standard Deviation 2.410

SECONDARY outcome

Timeframe: Baseline - 6 Month Post Last Implant

Population: Extension Safety Population

The suppression of gonadotropins (luteinizing hormone and follicle stimulating hormone) and gonadal sex steroids (estrogen in girls and testosterone in boys, respectively) on treatment.(LH suppression is defined as a peak LH \< 4 mIU/mL following stimulation with the GnRH analog).

Outcome measures

Outcome measures
Measure
Observed Value
n=31 Participants
Change From Baseline
n=31 Participants
Follicle Stimulating Hormone (FSH)
Month 72, Visit 19
1.24 MIU/ML
Standard Deviation 0.369
-0.41 MIU/ML
Standard Deviation 1.257
Follicle Stimulating Hormone (FSH)
6 Month Post Last Implant
4.96 MIU/ML
Standard Deviation 1.411
3.46 MIU/ML
Standard Deviation 1.040
Follicle Stimulating Hormone (FSH)
Baseline
2.26 MIU/ML
Standard Deviation 1.656
Follicle Stimulating Hormone (FSH)
Day 1, Visit 1
1.60 MIU/ML
-0.20 MIU/ML
Follicle Stimulating Hormone (FSH)
Month 1, Visit 2
1.08 MIU/ML
Standard Deviation 0.611
-1.18 MIU/ML
Standard Deviation 1.566
Follicle Stimulating Hormone (FSH)
Month 3, Visit 3
1.36 MIU/ML
Standard Deviation 0.814
-0.90 MIU/ML
Standard Deviation 1.464
Follicle Stimulating Hormone (FSH)
Month 6, Visit 4
1.43 MIU/ML
Standard Deviation 0.787
-0.86 MIU/ML
Standard Deviation 1.674
Follicle Stimulating Hormone (FSH)
Month 9, Visit 5
1.77 MIU/ML
Standard Deviation 0.939
-0.52 MIU/ML
Standard Deviation 1.776
Follicle Stimulating Hormone (FSH)
Month 12, Visit 6
2.16 MIU/ML
Standard Deviation 1.712
-0.10 MIU/ML
Standard Deviation 1.868
Follicle Stimulating Hormone (FSH)
Month 13, Visit 7
1.68 MIU/ML
Standard Deviation 1.048
-0.65 MIU/ML
Standard Deviation 1.394
Follicle Stimulating Hormone (FSH)
Month 18, Visit 9
1.81 MIU/ML
Standard Deviation 1.142
-0.50 MIU/ML
Standard Deviation 1.668
Follicle Stimulating Hormone (FSH)
Month 24, Visit 11
1.89 MIU/ML
Standard Deviation 0.855
-0.37 MIU/ML
Standard Deviation 1.486
Follicle Stimulating Hormone (FSH)
Month 36, Visit 13
1.91 MIU/ML
Standard Deviation 1.146
-0.01 MIU/ML
Standard Deviation 1.027
Follicle Stimulating Hormone (FSH)
Month 42, Visit 14
1.63 MIU/ML
Standard Deviation 1.119
-0.62 MIU/ML
Standard Deviation 1.457
Follicle Stimulating Hormone (FSH)
Month 48, Visit 15
1.55 MIU/ML
Standard Deviation 1.199
-0.48 MIU/ML
Standard Deviation 1.619
Follicle Stimulating Hormone (FSH)
Month 54, Visit 16
1.43 MIU/ML
Standard Deviation 0.752
-0.73 MIU/ML
Standard Deviation 2.288
Follicle Stimulating Hormone (FSH)
Month 60, Visit 17
1.50 MIU/ML
Standard Deviation 0.741
-0.57 MIU/ML
Standard Deviation 1.573
Follicle Stimulating Hormone (FSH)
Month 66, Visit 18
0.76 MIU/ML
Standard Deviation 0.049
-0.89 MIU/ML
Standard Deviation 1.578
Follicle Stimulating Hormone (FSH)
1 Month Post Last Implant
3.04 MIU/ML
Standard Deviation 2.125
1.80 MIU/ML
Standard Deviation 1.792

SECONDARY outcome

Timeframe: Baseline - 12 Months Post Last Implant

Population: Extension Safety Population

Long-term treatment with histrelin acetate suppresses the LH response to GnRH causing LH levels to decrease to prepubertal levels within 1 month of treatment. As a result, serum concentrations of sex steroids (estrogen or testosterone) also decrease. Testosterone suppression is defined as serum testosterone \< 30.0 ng/dL (0.8 nmol/L) in boys following the induction of suppression. One black female participant age 8.9 years old had a testosterone value of 11ng/dL at visit 4 (month 6).

Outcome measures

Outcome measures
Measure
Observed Value
n=3 Participants
Change From Baseline
n=2 Participants
Testosterone
Baseline
10.95 NG/DL
Standard Deviation 1.485
Testosterone
Month 1, Visit 2
6.50 NG/DL
Standard Deviation 2.687
-4.45 NG/DL
Standard Deviation 1.202
Testosterone
Month 3, Visit 3
8.25 NG/DL
Standard Deviation 2.475
-2.70 NG/DL
Standard Deviation 0.990
Testosterone
Month 6, Visit 4
12.67 NG/DL
Standard Deviation 2.082
2.55 NG/DL
Standard Deviation 3.606
Testosterone
Month 9, Visit 5
8.15 NG/DL
Standard Deviation 2.616
-2.80 NG/DL
Standard Deviation 1.131
Testosterone
Month 12, Visit 6
8.00 NG/DL
Standard Deviation 4.243
-2.95 NG/DL
Standard Deviation 2.758
Testosterone
Month 13, Visit 7
14.00 NG/DL
2.00 NG/DL
Testosterone
Month 18, Visit 9
9.80 NG/DL
Standard Deviation 0.000
-1.15 NG/DL
Standard Deviation 1.485
Testosterone
Month 24, Visit 11
9.90 NG/DL
Standard Deviation 4.384
-1.05 NG/DL
Standard Deviation 2.899
Testosterone
Month 36, Visit 13
6.90 NG/DL
-3.00 NG/DL
Testosterone
Month 42, Visit 14
8.10 NG/DL
-1.80 NG/DL
Testosterone
Month 48, Visit 15
7.30 NG/DL
-2.60 NG/DL
Testosterone
Month 54, Visit 16
4.10 NG/DL
-5.80 NG/DL
Testosterone
Month 60, Visit 17
7.00 NG/DL
-2.90 NG/DL
Testosterone
6 Months Post Last Implant
17.00 NG/DL
7.10 NG/DL
Testosterone
12 Months Post Last Implant
130.00 NG/DL
120.10 NG/DL

SECONDARY outcome

Timeframe: Baseline - 36 Months Post Last Implant

Population: Extension Safety Population

DHEA=Dehydroepiandrosterone

Outcome measures

Outcome measures
Measure
Observed Value
n=31 Participants
Change From Baseline
n=31 Participants
DHEA Sulfate
12 Months Post Last Implant
131.88 UG/DL
Standard Deviation 69.907
71.00 UG/DL
Standard Deviation 53.492
DHEA Sulfate
Month 18, Visit 9
83.25 UG/DL
Standard Deviation 47.973
27.79 UG/DL
Standard Deviation 20.381
DHEA Sulfate
Month 24, Visit 11
87.31 UG/DL
Standard Deviation 47.283
32.08 UG/DL
Standard Deviation 34.599
DHEA Sulfate
Month 36, Visit 13
78.50 UG/DL
Standard Deviation 72.809
37.45 UG/DL
Standard Deviation 50.794
DHEA Sulfate
Month 42, Visit 14
49.00 UG/DL
Standard Deviation 39.443
14.00 UG/DL
Standard Deviation 28.537
DHEA Sulfate
Month 48, Visit 15
80.00 UG/DL
Standard Deviation 50.292
36.56 UG/DL
Standard Deviation 39.313
DHEA Sulfate
Month 54, Visit 16
60.60 UG/DL
Standard Deviation 43.952
31.67 UG/DL
Standard Deviation 22.723
DHEA Sulfate
Month 60, Visit 17
89.44 UG/DL
Standard Deviation 34.667
53.14 UG/DL
Standard Deviation 25.635
DHEA Sulfate
Month 66, Visit 18
57.50 UG/DL
Standard Deviation 3.536
40.00 UG/DL
DHEA Sulfate
Month 72, Visit 19
41.00 UG/DL
Standard Deviation 4.243
23.00 UG/DL
DHEA Sulfate
6 Months Post Last Implant
114.25 UG/DL
Standard Deviation 50.692
61.43 UG/DL
Standard Deviation 28.148
DHEA Sulfate
24 Months Post Last Implant
195.00 UG/DL
Standard Deviation 98.995
140.50 UG/DL
Standard Deviation 84.146
DHEA Sulfate
36 Months Post Last Implant
184.00 UG/DL
119.00 UG/DL
DHEA Sulfate
Baseline
61.69 UG/DL
Standard Deviation 36.526
DHEA Sulfate
Month 3, Visit 3
70.88 UG/DL
Standard Deviation 46.802
11.67 UG/DL
Standard Deviation 15.281
DHEA Sulfate
Month 6, Visit 4
66.92 UG/DL
Standard Deviation 36.739
6.08 UG/DL
Standard Deviation 14.961
DHEA Sulfate
Month 9, Visit 5
71.22 UG/DL
Standard Deviation 45.057
12.16 UG/DL
Standard Deviation 15.085
DHEA Sulfate
Month 12, Visit 6
80.34 UG/DL
Standard Deviation 48.207
25.77 UG/DL
Standard Deviation 28.256
DHEA Sulfate
Month 13, Visit 7
81.00 UG/DL
Standard Deviation 43.624
23.42 UG/DL
Standard Deviation 23.178

SECONDARY outcome

Timeframe: Month 36 - 36 Months Post Last Implant

Population: Extension Safety Population

Long-term treatment with histrelin acetate suppresses the LH response to GnRH causing LH levels to decrease to prepubertal levels within 1 month of treatment. As a result, serum concentrations of sex steroids (estrogen or testosterone) also decrease. Estradiol suppression is defined as serum estradiol in the assay specific range \< 20 pg/mL (73 pmol/L) in girls following the induction of suppression.

Outcome measures

Outcome measures
Measure
Observed Value
n=12 Participants
Change From Baseline
Estradiol (MS)
Month 36, Visit 13
0.46 NG/DL
Standard Deviation 0.277
Estradiol (MS)
Month 42, Visit 14
0.38 NG/DL
Standard Deviation 0.307
Estradiol (MS)
Month 48, Visit 15
0.52 NG/DL
Standard Deviation 0.319
Estradiol (MS)
Month 54, Visit 16
0.47 NG/DL
Standard Deviation 0.289
Estradiol (MS)
Month 60, Visit 17
0.50 NG/DL
Standard Deviation 0.201
Estradiol (MS)
Month 66, Visit 18
0.21 NG/DL
Standard Deviation 0.106
Estradiol (MS)
Month 72, Visit 19
0.34 NG/DL
Standard Deviation 0.205
Estradiol (MS)
6 Months Post Last Implant
2.38 NG/DL
Standard Deviation 0.909
Estradiol (MS)
12 Months Post Last Implant
4.00 NG/DL
Standard Deviation 2.810
Estradiol (MS)
24 Months Post Last Implant
2.70 NG/DL
Standard Deviation 0.424
Estradiol (MS)
36 Months Post Last Implant
3.10 NG/DL

SECONDARY outcome

Timeframe: Baseline - Month 24

Population: Extension Safety Population

Long-term treatment with histrelin acetate suppresses the LH response to GnRH causing LH levels to decrease to prepubertal levels within 1 month of treatment. As a result, serum concentrations of sex steroids (estrogen or testosterone) also decrease. Estradiol suppression is defined as serum estradiol in the assay specific range \< 20 pg/mL (73 pmol/L) in girls following the induction of suppression.

Outcome measures

Outcome measures
Measure
Observed Value
n=29 Participants
Change From Baseline
n=29 Participants
Estradiol (RIA)
Month 24, Visit 11
0.61 NG/DL
Standard Deviation 0.136
-0.48 NG/DL
Standard Deviation 1.119
Estradiol (RIA)
Baseline
1.58 NG/DL
Standard Deviation 1.754
Estradiol (RIA)
Day 1, Visit 1
0.50 NG/DL
0.00 NG/DL
Estradiol (RIA)
Month 1, Visit 2
0.58 NG/DL
Standard Deviation 0.199
-1.00 NG/DL
Standard Deviation 1.775
Estradiol (RIA)
Month 3, Visit 3
0.55 NG/DL
Standard Deviation 0.160
-1.03 NG/DL
Standard Deviation 1.765
Estradiol (RIA)
Month 6, Visit 4
0.52 NG/DL
Standard Deviation 0.061
-1.10 NG/DL
Standard Deviation 1.742
Estradiol (RIA)
Month 9, Visit 5
0.55 NG/DL
Standard Deviation 0.114
-1.06 NG/DL
Standard Deviation 1.794
Estradiol (RIA)
Month 12, Visit 6
0.72 NG/DL
Standard Deviation 0.526
-0.62 NG/DL
Standard Deviation 1.599
Estradiol (RIA)
Month 13, Visit 7
0.57 NG/DL
Standard Deviation 0.184
-1.05 NG/DL
Standard Deviation 1.806
Estradiol (RIA)
Month 18, Visit 9
0.61 NG/DL
Standard Deviation 0.154
-0.69 NG/DL
Standard Deviation 1.670

SECONDARY outcome

Timeframe: 12 months

Population: Extension Safety Population

There were 2 implants received that were not removed during the study and were excluded from this analysis due to unknown duration of treatment.

Outcome measures

Outcome measures
Measure
Observed Value
n=31 Participants
Change From Baseline
Average Number of Implants Received
3.5 Implants
Standard Deviation 1.36

SECONDARY outcome

Timeframe: 12 Months

Population: Extension Safety Population

There were 2 implants received that were not removed during the study and were excluded from this analysis due to unknown duration of treatment.

Outcome measures

Outcome measures
Measure
Observed Value
n=31 Participants
Change From Baseline
Average Mean Implant Duration by Subject
12.62 Months
Standard Deviation 0.469

SECONDARY outcome

Timeframe: Day 1 - Month 60

Population: Extension Safety Population

Once the female participants reached 11 years of age and the male participants reached 12 years of age or the investigator determined that subjects no longer required hormone suppression, participants underwent final explantation and were eligible to continue into an optional Long Term Follow Up Phase (Post Implant Treatment Phase) for up to 5 years. The purpose of the optional Long Term Follow Up Phase was to collect additional medical and developmental information, such as onset of menses and final adult height after hormone suppression was discontinued.

Outcome measures

Outcome measures
Measure
Observed Value
n=31 Participants
Change From Baseline
n=31 Participants
Summary of EN3326 Implantation and Explantations
First Implant (Day 1, Visit 1)
31 Participants
31 Participants
Summary of EN3326 Implantation and Explantations
Second Implant (Month 12, Visit 6)
31 Participants
31 Participants
Summary of EN3326 Implantation and Explantations
Third Implant (Month 24, Visit 11)
22 Participants
22 Participants
Summary of EN3326 Implantation and Explantations
Fourth Implant (Month 36, Visit 13)
13 Participants
13 Participants
Summary of EN3326 Implantation and Explantations
Fifth Implant (Month 48, Visit 15)
11 Participants
9 Participants
Summary of EN3326 Implantation and Explantations
Sixth Implant (Month 60, Visit 17)
2 Participants
2 Participants

Adverse Events

Overall - Histrelin Subcutaneous Implant (50 mg)

Serious events: 3 serious events
Other events: 31 other events
Deaths: 1 deaths

Serious adverse events

Serious adverse events
Measure
Overall - Histrelin Subcutaneous Implant (50 mg)
n=31 participants at risk
Subcutaneous implant designed to deliver histrelin continously for 12 months. Histrelin Subcutaneous Implant: histrelin subcutaneous 50 mg implant
Psychiatric disorders
Aggression
6.5%
2/31 • From start of 2nd implant period through end of 6th implant period up to 48 months.
Psychiatric disorders
Depression
3.2%
1/31 • From start of 2nd implant period through end of 6th implant period up to 48 months.
Infections and infestations
Bronchopneumonia
3.2%
1/31 • From start of 2nd implant period through end of 6th implant period up to 48 months.
Respiratory, thoracic and mediastinal disorders
Apnoea
3.2%
1/31 • From start of 2nd implant period through end of 6th implant period up to 48 months.

Other adverse events

Other adverse events
Measure
Overall - Histrelin Subcutaneous Implant (50 mg)
n=31 participants at risk
Subcutaneous implant designed to deliver histrelin continously for 12 months. Histrelin Subcutaneous Implant: histrelin subcutaneous 50 mg implant
General disorders
Implant Site Reaction
64.5%
20/31 • From start of 2nd implant period through end of 6th implant period up to 48 months.
Infections and infestations
Upper Respiratory Tract Infection
25.8%
8/31 • From start of 2nd implant period through end of 6th implant period up to 48 months.
Infections and infestations
Nasopharyngitis
19.4%
6/31 • From start of 2nd implant period through end of 6th implant period up to 48 months.
Infections and infestations
Pharyngitis Streptococcal
16.1%
5/31 • From start of 2nd implant period through end of 6th implant period up to 48 months.
Infections and infestations
Sinusitis
12.9%
4/31 • From start of 2nd implant period through end of 6th implant period up to 48 months.
Respiratory, thoracic and mediastinal disorders
Cough
12.9%
4/31 • From start of 2nd implant period through end of 6th implant period up to 48 months.
Nervous system disorders
Headache
19.4%
6/31 • From start of 2nd implant period through end of 6th implant period up to 48 months.
Investigations
Weight Increased
12.9%
4/31 • From start of 2nd implant period through end of 6th implant period up to 48 months.
Psychiatric disorders
Agression
9.7%
3/31 • From start of 2nd implant period through end of 6th implant period up to 48 months.
Psychiatric disorders
Depression
6.5%
2/31 • From start of 2nd implant period through end of 6th implant period up to 48 months.

Additional Information

Saji Vijayan, MBBS

Endo Pharmaceuticals

Phone: 800-462-3636

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place