Long-term safety and efficacy of Omnitrope® in adults with growth hormone deficiency: Italian interim analysis of the PATRO Adults study

PURPOSE

To report the long-term effectiveness and safety of the recombinant human growth hormone Omnitrope^®, a somatropin biosimilar to Genotropin^®, in Italian patients with growth hormone deficiency (GHD) enrolled in the PATRO Adults study.

METHODS

The PATRO Adults study is an ongoing observational, longitudinal, non-interventional global post-marketing surveillance study, conducted in several European countries. The primary endpoint is long-term safety; secondary endpoints include the effectiveness of Omnitrope^®, which was assessed using serum insulin-like growth factor-1 levels, body composition, bone mineral density and lipid levels. Here we report the data from the Italian patients enrolled in the study.

RESULTS

Sixty-seven patients (mean age 50.4 years, 61.2% male) have been enrolled and have received a mean 45.4 ± 24.3 months of Omnitrope^®. A total of 55.2% of patients were reported to have experienced adverse events (AEs), including arthralgia, myalgia, abdominal distension and hypoaesthesia, and 4.5% had adverse drug reactions. Fourteen serious AEs have been recorded; none of these are considered related to the study drug. The effectiveness of Omnitrope^® was similar to other available somatropin preparations.

CONCLUSIONS

This study confirms the effectiveness and safety of Omnitrope^® in adult patients with GHD in Italy. However, due to the limited size of the study population, these results need to be further confirmed by the global PATRO Adults study.

[Physiopathology and therapy of foreign bodies in the upper digestive tract]

Fibroendoscopy is the treatment of choice for foreign oesophageal and gastric bodies. Whereas the presence of objects in the oesophagus demands immediate endoscopic removal, gastric localization does not require any emergency treatment except for cases of perforation or incarceration, as most foreign bodies (80-90%) are eliminated naturally. Only two weeks after ingestion, in the case of failed expulsion, is it necessary to proceed to endoscopic removal so as to prevent decubitus or perforation erosions. Endoscopic extraction is made difficult by the length and weight of the object, on by its smallness and lack of texture, which make it hard to get hold of. In the case of suture stitches, it may be hard to cut them because of the presence of a gastric mucosa reactive granulomatous inflammatory process. Contraindications to endoscopic extraction are the failure of the patient to cooperate, acute oesophagitis (peptic and due to caustics) and perforating in the stomach, due to congenital or acquired malformations, means that surgery is necessary. The elimination of foreign bodies depends on the correlation between shape and size of object and the anatomo-functional components of the digestive ways. With reference to an approximate geometric schematization of transit organs, the physiopathology of foreign bodies may be expressed by means of mathematical formulae whose manifold variables sometimes make the natural elimination of the bodies unpredictable.