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Qian Y, Shao Q, Xu Q, Qiao H. Pharmacokinetics of Recombinant Human Growth Hormone (rhGH) in Beagles by ELISA. CURR PHARM ANAL 2020. [DOI: 10.2174/1573412915666190709094740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background::
Somatropin is recombinant human growth (GH) used for the treatment of
growth failure in children and GH deficiency in adults. At present, rhGH marketed in China is mostly
freeze-dried powder injection. As the lyophilization process is unstable, time-consuming and costly,
rhGH has been prepared into an aqueous solution for administering directly.
Introduction::
In this study, the pharmacokinetics of two dosage forms of rhGH in beagle dogs after
single subcutaneous administration was determined by enzyme-linked immunosorbent assay (ELISA).
Methods:
Twelve healthy beagles (male, 6:female, 6) were used for the pharmacokinetic study and
were equally divided into two groups. Subcutaneous injection of 0.2 IU/kg with rhGH in the two formulations.
The blood samples were taken from forearms, 0, 0.033, 0.083, 0.25, 0.5, 1, 2, 3, 4, 7, 10, 24 h
and collected the beagle plasma on time. The pharmacokinetic parameters of rhGH after subcutaneous
(s.c.) injection were determined experimentally on beagles. Primary PK endpoints were area under the
serum concentration-time curve (AUC0-t) and maximum serum concentration (Cmax). Serum rhGH level
was determined by enzyme-linked immunosorbent assay.
Results::
The calibration curves obtained were linear over the concentration range of 25 to 1600 ng/ml
for recombinant human growth. The results of the intra- and inter-day precision and accuracy studies
were well within the acceptable limits. The analysis samples were stable under different storage conditions
and temperature.
Conclusions::
The developed ELISA method has been successfully applied to the studies of pharmacokinetic
of recombinant human growth hormone in beagles.
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Affiliation(s)
- Yueyue Qian
- School of Pharmaceutical Sciences, Nanjing Tech University, Nanjing 211816, China
| | - Qing Shao
- Jiangsu Provincial Institute of Materia Medica, Nanjing 211816, China
| | - Quanyu Xu
- School of Pharmaceutical Sciences, Nanjing Tech University, Nanjing 211816, China
| | - Hongqun Qiao
- School of Pharmaceutical Sciences, Nanjing Tech University, Nanjing 211816, China
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Lundberg E, Andersson B, Kriström B, Rosberg S, Albertsson-Wikland K. Broad variability in pharmacokinetics of GH following rhGH injections in children. Growth Horm IGF Res 2018; 40:61-68. [PMID: 29422321 DOI: 10.1016/j.ghir.2018.01.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 01/26/2018] [Accepted: 01/27/2018] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Daily subcutaneous self-injection of GH is used worldwide to treat short stature in childhood; longitudinal data on the impact of this regimen on GH-uptake are lacking. DESIGN Children with/without GH-deficiency participating in clinical trials were followed prospectively (≤8 times). Blood was sampled pre-GH-injection (dose GH33/GH67 μg/kg) and either every 30 min thereafter for 24 h (Experimental-setting; 59 GH-curves/15 children); or every 2 h thereafter for 16 h (Clinical-setting; 429 GH-curves/117 children). Pharmacokinetics were estimated by time Tmax (h) of maximal GH-concentration (Cmax, mU/L) and area under the curve for 16 h (AUC, mU/L ∗ h). RESULTS In the Clinical-setting, median Cmax was 71 mU/L and AUC was 534 mU/L ∗ h, with coefficients of variation for intra-individual variation of 39% and 36%, respectively, and inter-individual variation of 44% and 42%, respectively. 43% of Cmax and AUC variability was explained by GH-dose and proxies for injection depth (baseline GH-level, GHpeakwidth, BMISDS). In the Experimental- versus Clinical-setting, 85% and 40% of GH-curves, respectively, reached zero-levels within 24 h. A longer duration was found following a more superficial GH-injection. Spontaneous GH-peaks were identified already 6 h after the GH-injection in about half of the curves of both GHD and non-GHD patients. CONCLUSION Very broad intra-individual and inter-individual variability was found. A high GH-peak will optimize growth effects; the highest Cmax was found after a deep injection of GH at the higher dose and concentration. In as many as 60% of the children, GH remained detectable in serum after 24 h; a constant GH-level will promote IGF-I and metabolic effects.
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Affiliation(s)
- Elena Lundberg
- Institute of Clinical Science/Pediatrics, Umeå University, SE-90185 Umeå, Sweden.
| | - Björn Andersson
- Institute of Clinical Science/Pediatrics, Umeå University, SE-90185 Umeå, Sweden.
| | - Berit Kriström
- Institute of Clinical Science/Pediatrics, Umeå University, SE-90185 Umeå, Sweden.
| | - Sten Rosberg
- Department of Physiology/Endocrinology, Institute of Neurosciences and Physiology, The Sahlgrenska Academy at University of Gothenburg, SE-40530 Gothenburg, Sweden.
| | - Kerstin Albertsson-Wikland
- Department of Physiology/Endocrinology, Institute of Neurosciences and Physiology, The Sahlgrenska Academy at University of Gothenburg, SE-40530 Gothenburg, Sweden.
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Salmaso S, Bersani S, Scomparin A, Balasso A, Brazzale C, Barattin M, Caliceti P. A novel soluble supramolecular system for sustained rh-GH delivery. J Control Release 2014; 194:168-77. [DOI: 10.1016/j.jconrel.2014.08.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 08/22/2014] [Accepted: 08/23/2014] [Indexed: 10/24/2022]
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Reed ML, Merriam GR, Kargi AY. Adult growth hormone deficiency - benefits, side effects, and risks of growth hormone replacement. Front Endocrinol (Lausanne) 2013; 4:64. [PMID: 23761782 PMCID: PMC3671347 DOI: 10.3389/fendo.2013.00064] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Accepted: 05/18/2013] [Indexed: 11/26/2022] Open
Abstract
Deficiency of growth hormone (GH) in adults results in a syndrome characterized by decreased muscle mass and exercise capacity, increased visceral fat, impaired quality of life, unfavorable alterations in lipid profile and markers of cardiovascular risk, decrease in bone mass and integrity, and increased mortality. When dosed appropriately, GH replacement therapy (GHRT) is well tolerated, with a low incidence of side effects, and improves most of the alterations observed in GH deficiency (GHD); beneficial effects on mortality, cardiovascular events, and fracture rates, however, remain to be conclusively demonstrated. The potential of GH to act as a mitogen has resulted in concern over the possibility of increased de novo tumors or recurrence of pre-existing malignancies in individuals treated with GH. Though studies of adults who received GHRT in childhood have produced conflicting reports in this regard, long-term surveillance of adult GHRT has not demonstrated increased cancer risk or mortality.
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Affiliation(s)
- Mary L. Reed
- Geriatrics and Extended Care, VA Puget Sound Health Care System, Madigan Health Care System, Tacoma, WA, USA
| | - George R. Merriam
- Division of Metabolism, Endocrinology, and Nutrition, VA Puget Sound Health Care System, University of Washington School of Medicine, Tacoma, WA, USA
| | - Atil Y. Kargi
- Division of Endocrinology, Diabetes, and Metabolism, University of Miami Miller School of Medicine, Miami, FL, USA
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Ebbers HC, Muenzberg M, Schellekens H. The safety of switching between therapeutic proteins. Expert Opin Biol Ther 2012; 12:1473-85. [PMID: 22849511 DOI: 10.1517/14712598.2012.711308] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The approval of several biosimilars in the past years has prompted discussion on potential safety risks associated with switching to and from these products. It has been suggested that switching may lead to safety concerns. However, data is limited on the clinical effects of switching. AREAS COVERED In this review we provide an overview of data related to switching between human recombinant growth hormones, erythropoietins and granulocyte colony stimulating agents. We reviewed data from clinical trials, pharmacovigilance databases and an overview of the literature on the frequency of switching between these products. The review covers both switching between innovator products within the same product class and switching to and from biosimilars. EXPERT OPINION Data on the frequency of switching in clinical practice is scarce, but it seems most frequent for erythropoietins. We have found no evidence from clinical trial data or post marketing surveillance data that switching to and from different biopharmaceuticals leads to safety concerns.
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Affiliation(s)
- Hans C Ebbers
- Utrecht University, Utrecht Institute for Pharmaceutical Sciences, Division of Pharmacoepidemiology and Clinical Pharmacology, PO Box 80082, 3508 TB Utrecht, The Netherlands
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Yuen KCJ, Amin R. Developments in administration of growth hormone treatment: focus on Norditropin® Flexpro®. Patient Prefer Adherence 2011; 5:117-24. [PMID: 21448295 PMCID: PMC3063658 DOI: 10.2147/ppa.s10985] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Indexed: 11/23/2022] Open
Abstract
Recombinant human growth hormone is used for the treatment of growth failure in children and metabolic dysfunction in adults with growth hormone deficiency. However, conventional growth hormone therapy requires daily subcutaneous injections that may affect treatment adherence, and subsequently efficacy outcomes. To enhance potential treatment adherence, improved ease of use of growth hormone delivery devices and long-acting growth hormone formulations are now being developed. Flexpro(®), approved by the US Food and Drug Administration in March 2010, is the most recent pen device developed by Novo Nordisk A/S to deliver Norditropin(®). It is a multidose, premixed, preloaded, disposable pen device that requires relatively less force to inject and does not require refrigeration after initial use. Dose adjustments can be optimized by small dose increments of the pen delivery device at 0.025 mg, 0.05 mg and 0.1 mg. In addition, for patients with needle anxiety, NovoFine(®) needles, some of the shortest and thinnest available, and Autocover(®), which hides the needle during injections, can be used with the Flexpro pen device. This article reviews the Norditropin Flexpro pen device in the context of other growth hormone delivery devices, sustained-release growth hormone formulations in development, and future prospects.
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Affiliation(s)
- Kevin C J Yuen
- Division of Endocrinology, Diabetes and Clinical Nutrition, Department of Medicine, Oregon Health and Science University, Portland, Oregon, USA.
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Laursen T, Hansen B, Fisker S. Pain Perception after Subcutaneous Injections of Media Containing Different Buffers. Basic Clin Pharmacol Toxicol 2006; 98:218-21. [PMID: 16445598 DOI: 10.1111/j.1742-7843.2006.pto_271.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Several hormones are administered by daily subcutaneous injections. Pain caused by subcutaneous injection is an unpleasant condition, which can limit patient compliance. The objective of the present study was to evaluate the perception of pain by subcutaneous injection of two different and commercially available solutions for dispensing recombinant human growth hormone. The solutions are characterised by pH, conservation, and buffer. Isotonic saline was used as reference solution. Fifty-four healthy volunteers (mean age (+/-S.E.M.): 35.5+/-1.1 years) were recruited to the double-blind, randomised study. All injections were performed pairwise (right and left thigh) in one day by the same experienced nurse. Perception of pain was evaluated by the volunteers immediately after injection and 2 min. after injection into the thigh of three formulations, which differed with respect to pH and buffers (histidine, citrate and saline, respectively). Significantly more participants (38/54) found than the citrate buffer caused more pain than the histidine buffer immediately after injection (P=0.002). Histidine buffer did not cause more pain than saline (P=0.996). After 2 min., there was no difference between the histidine and the citrate buffer (P=1.00), nor between the histidine buffer and saline (P=1.00). In summary, the solution-containing citrate as buffer caused more pain after subcutaneous injection than the solution with histidine as buffer. Considering patient compliance, it seems advisable to employ histidine-buffered solution rather than citrate-buffered solution for dispensing recombinant human growth hormone by daily subcutaneous injections.
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Affiliation(s)
- Torben Laursen
- Medical Department M (Diabetes and Endocrinology), Aarhus Sygehus, NBG, Aarhus University Hospital, Aarhus, Denmark
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Affiliation(s)
- Torben Laursen
- Department of Pharmacology, The Bartholin Building, University of Aarhus, and Medical Department M (Endocrinology & Diabetes), Aarhus University Hospital, Kommunehospitalet, Aarhus 8000, Denmark.
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Vahl N, Jensen SB, Rasmussen MH, Susgaard S, Jørgensen JO, Christiansen JS, Rasmussen UF, Hilsted J. Bioavailability of recombinant human growth hormone in different concentrations and formulations. PHARMACOLOGY & TOXICOLOGY 1996; 79:144-9. [PMID: 8884873 DOI: 10.1111/j.1600-0773.1996.tb00258.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Whether the bioavailability of growth hormone depends on the concentration or formulation of the preparation was evaluated in 18 growth hormone-deficient patients. The design was a single-blinded, randomized cross-over study, where the patients were given a single, fixed dose subcutaneous injection of growth homrone (3 IU/m2) of 3 different preparations: (1) 4 IU/ml in a bicarbonate buffer dissolved in 0.9% benzyl alcohol (approximately 1.37 mg/ml), (2) 5.9 IU/ml in a phosphate buffer dissolved in 1.5% benzyl alcohol (approximately 2 mg/ml) and (3) 11 7 IU/ml in a phosphate buffer dissolved in 1.5% benzyl alcohol (approximately 4 mg/ml). Conventional growth hormone-therapy was withdrawn 2 days before each study period. Blood samples were drawn over a 24-hr period and assessed for growth hormone, serum insulin-like growth factor I (IGF-I), insulin and glucose. The geometric mean values (+/- geometric S.D) of the relative absorption fractions were F5.9 IU/4 IU = AUC5.9 IU/AUC4 IU = (+/- 1.139) (P = 0.66), F11.7 IU/AUC4 IU = AUC11.7 IU/AUC4 IU (1.14 +/- 1.21) (P = 0.009) AND F11.7 IU/5.9 IU = AUC11.7 IU/AUC5.9 IU = 1.12 (+/- 1.17) (P = 0.005), respectively. The 90% confidence intervals were contained within the limits of 0.80-1.25 accepted for bioequivalence. Geometric mean values (+/- geometric S.D.) of the relative observed maximum concentration, Cmax was for Cmax 5.9 IU/Cmax 4 IU = 1.04 (+/- 1.19) (P = 0.32), Cmax 11.7 IU/Cmax 4 IU = 1.24 (+/- 1.21) (P = 0.0002) and Cmax 11.7 IU/Cmax 5.9 IU = 1.19 (+/- 1.29) (P = 0.012). The median and the range values for the observed time to reach Cmax was tmax 5.9 IU/tmax 4 IU = 0.63 (0.04-1.00), tmax 11.7 IU/tmax 4 IU = 0.59 (0.06-1.0) and tmax 11.7 IU/tmax 5.9 IU = 0.90 (0.51-18.00). There were no significant differences in IGF-I, glucose and insulin profiles. Based on the upper limits of the 90% confidence intervals for relative AUC's the conclusion is that the three different preparations were bioequivalent.
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Affiliation(s)
- N Vahl
- Medical Department M (Endocrinology and Diabetes), Aarhus Kommunehospital, Aarhus University, Denmark
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Laursen T, Susgaard S, Jensen FS, Jørgensen JO, Christiansen JS. Absorption kinetics of two highly concentrated preparations of growth hormone: 12 IU/ml compared to 56 IU/ml. PHARMACOLOGY & TOXICOLOGY 1994; 74:54-7. [PMID: 8159637 DOI: 10.1111/j.1600-0773.1994.tb01074.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The purpose of this study was to compare the relative bioavailability of two highly concentrated (12 IU/ml versus 56 IU/ml) formulations of biosynthetic human growth hormone administered subcutaneously. After pretreatment with growth hormone for at least four weeks, nine growth hormone deficient patients with a mean age of 26.2 years (range 17-43) were studied two times in a randomized design, the two studies being separated by at least one week. At the start of each study period (7 p.m.), growth hormone was injected subcutaneously in a dosage of 3 IU/m2. The 12 IU/ml preparation of growth hormone was administered on one occasion, and the 56 IU/ml preparation on the other. Serum profiles of growth hormone were monitored by frequent measurements for 24 hr. Bioavailability and absorption dynamics were evaluated by the absorption fraction, F56 IU/12 IU, calculated from the mean integrated levels (AUC) of growth hormone, and the observed time, Tmax, to reach maximum concentration, Cmax. Levels of serum IGF-I, IGFBP-3, insulin and blood glucose were measured to study the short term metabolic effects of growth hormone. The absorption fraction, F (S.D.) was 1.034 (0.163). The 90% confidence interval was 0.934-1.144, which is included in the interval 0.8-1.25, implying that the two preparations are bioequivalent. Neither AUC (P = 0.90), Cmax (p = 0.47) or Tmax (P = 0.86) for the two formulations of growth hormone were significantly different. Similar levels of serum IGF-I, IGFBP-3, insulin and blood glucose were obtained.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- T Laursen
- Medical Department M (Diabetes & Endocrinology), Aarhus Kommunehospital, Denmark
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