Assessment of the Ability of Subjects With Acromegaly or Their Partners to Administer Somatuline Autogel (SALSA)

A Multi Center Open Label Study to Assess the Ability of Subjects With Acromegaly or Their Partners to Administer Somatuline Autogel

The purpose of this study is to determine whether subjects with acromegaly (or their partners) are able to self administer Somatuline Autogel at home.

Study Overview

• Status: Completed
• Conditions: Acromegaly
• Intervention / Treatment: Drug: Somatuline Autogel (lanreotide acetate); Behavioral: Home administration

Detailed Description

Clinical experience with Somatuline Autogel to date has raised the possibility of self or partner injection. Previous microparticle somatostatin analogue formulations required careful reconstitution and as a result the cost of the analogues and the inconvenience of reconstitution meant self or partner injection was not a viable option.

Somatuline Autogel does not require reconstitution as it comes ready-mixed in a pre-filled syringe, thus making it more user-friendly than its predecessor and introducing the possibility of self or partner injection.

Patients with acromegaly often travel considerable distances every 28 days in order to receive their somatostatin analogue injections in the clinic. If Somatuline Autogel can be safely administered unsupervised, while maintaining disease control, this could offer patients considerable benefits in terms of reduced frequency of visits to the clinic.

This study is designed to allow suitably motivated patients with acromegaly or their partners to learn how to successfully inject Somatuline Autogel while maintaining their mean GH level control. Disease control in these patients will be assessed by comparing their GH and IGF-1 levels to accepted medical standards for control of acromegaly and by comparing the levels of GH and IGF-1 control achieved with baseline values.

• Study Type: Interventional
• Enrollment (Actual): 59
• Phase: Phase 3

Contacts and Locations

Study Locations

• United States
  • California
    • La Mesa, California, United States, 91942
      • Diabetes and Endocrine Associates
    • Los Angeles, California, United States, 90048
      • Cedars Sinai Medical Center
  • Colorado
    • Denver, Colorado, United States, 80220
      • Denver VA Medical Center
  • Illinois
    • Chicago, Illinois, United States, 60611
      • Northwestern University The Feinberg School of Medicine
  • Maryland
    • Baltimore, Maryland, United States, 21287
      • Johns Hopkins University
  • Massachusetts
    • Boston, Massachusetts, United States, 02114
      • Massachussetts General Hospital
  • New York
    • New York, New York, United States, 10032
      • Columbia University
    • New York, New York, United States, 10010
      • NYU School of Medicine
    • Williamsville, New York, United States, 14221
      • Sisters of Charity Hospital, Buffalo
  • Oregon
    • Portland, Oregon, United States, 97239
      • Oregon Health and Science University
  • Texas
    • Dallas, Texas, United States, 75231
      • Research Institute of Dallas
    • Houston, Texas, United States, 77030
      • Baylor College of Medicine
    • Houston, Texas, United States, 77230
      • University of Texas M.D. Anderson Cancer Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• The subject must give signed informed consent before any study-related activities.
• The partner, if applicable, must give signed informed consent before administration of Somatuline Autogel.
• The subject must be able to understand the protocol requirements.
• The subject must have a clinical diagnosis of acromegaly due to pituitary tumor.
• The subject must be treated with a long-acting somatostatin analogue with or without a dopamine agonist and have been on the current medical regimen for at least 3 months prior to screening and have IGF-1 levels no higher than 10% above the upper limit of the normal range for age and gender at the screening visit or be somatostatin analogue naïve (if the subject is treated with a dopamine agonist he/she must have been on the current dose for at least 3 months prior to screening).
• Subjects who are treated with a dopamine agonist have to stay on their current dose for the duration of the study.
• Switch subjects must have had their last pre-study routine clinical treatment with Sandostatin LAR between 28 and 35 days before Visit 2 (enrollment).
• The subject must be able to store the study medication in a refrigerator in his/her own or his/her partner's home.
• The subject must be ≥18 years of age.
• Female subjects of childbearing potential must use adequate contraception.
• Female subjects of childbearing potential who are taking oral contraceptives must agree to stay on their current contraceptive dose for the duration of the study.
• The partner, if applicable, must be ≥18 years of age.

Exclusion Criteria:

• The subject has had pituitary surgery (adenomectomy) within 3 months prior to screening.
• The subject has received pituitary radiotherapy within 3 years prior to screening.
• The subject has received a GH receptor antagonist within 6 months prior to screening.
• The subject is currently on a higher dose of Sandostatin LAR than 30mg q28d
• The subject is pregnant or breastfeeding.
• The subject has clinically significant renal or hepatic abnormalities.
• The subject has a symptomatic, untreated biliary lithiasis.
• The subject has uncontrolled diabetes or thyroid disease.
• The subject has a known hypersensitivity to any of the test materials or related compounds.
• The subject is unable or unwilling to comply with the protocol.
• The subject has received any investigational drug within 30 days prior to screening.
• The subject has participated in a medical device study within 30 days prior to screening.
• The subject has previously participated in this study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Somatuline Autogel (lanreotide acetate); Somatuline Autogel (lanreotide acetate) Injection	Drug: Somatuline Autogel (lanreotide acetate); Injections; Behavioral: Home administration; Questionnaire

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The Percentage of Subjects or Their Partners That Are Competent to Self-administer Somatuline Autogel at the End of the Study, (Week 24/Early Termination), as Assessed by the Competence Questionnaire Score.	The primary efficacy endpoint was the percentage of patients (Switch and other) or their partners who were competent to self-administer lanreotide at the end of the study (Week 24/Early Termination), as assessed by the Assessment of Competence Questionnaire (0 = 'No' and 1 = 'Yes').	24 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Percentage of Switch Subjects Who Find Self-administration of Somatuline Autogel Convenient as Assessed by the Subject Convenience Questionnaire Score.	Experienced Convenience of Somatuline® Autogel® Injections was assessed by the subject as: Very convenient; somewhat convenient; neither convenient nor inconvenient; Neither convenient nor inconvenient; Somewhat inconvenient; very inconvenient.	24 weeks
Percentage of Switch Subjects That Have IGF-1 Levels Within the Normal Range for Age and Gender at the End of the Study	Blood sample was collected while subject is in a fasting state or non-fasting state for measuring the level of IGF-1.	24 weeks
Percentage of Switch Subjects That Have Glucose Suppressed GH Levels ≤ 2.5 ng/ml at the End of the Study, Week 24/Termination.	Blood samples taken before and 60 and 120 min after glucose load from fasting patient.	24 Weeks
Change of GH Concentration Levels From Basaeline to Week 24 in Switch Patients	Blood samples taken before and 60 and 120 min after glucose load from fasting patient.	24 Weeks
Total Symptom Questionnaire Score at Week 24/Termination	Acromegaly symptoms are sweating, snoring, joint pain, headache and fatigue. Each symptom was scored as -2 = 'always', -1 = 'most of the time', 0 = 'sometimes', 1 = 'rarely and 2 = 'never'. The total score was used to evaluate symptom control in each patient at Week 0 and Week 24/Termination. The total worst score is -10 and best score is 10.	24 Weeks
Total Health Care Professional Convenience Questionnaire Score at Week 24/Termination	Healthcare professional convenience questionnaires are: Confident the Subject Properly Administering the Injection; Subject Complained About Pain When Administering the Injection; Subject Appreciated the Option of Self-Injection at Home. Each Healthcare professional convenience questionnaire was scored -2, -1, 0, 1 and 2; from most negative to most positive response. A total score across all questions was calculated and was used to evaluate the convenience. The worst total score is -6 and best total score is 6.	24 weeks

Collaborators and Investigators

• Sponsor: Ipsen
• Investigators: Study Director: Ipsen Medical Director, Ipsen (formerly Tercica)

Publications and helpful links

General Publications

• Salvatori R, Nachtigall LB, Cook DM, Bonert V, Molitch ME, Blethen S, Chang S; SALSA Study Group. Effectiveness of self- or partner-administration of an extended-release aqueous-gel formulation of lanreotide in lanreotide-naive patients with acromegaly. Pituitary. 2010 Jun;13(2):115-22. doi: 10.1007/s11102-009-0207-x.

Study record dates

Study Major Dates

• Study Start: April 1, 2007
• Primary Completion (Actual): December 1, 2008
• Study Completion (Actual): December 1, 2008

Study Registration Dates

• First Submitted: March 12, 2007
• First Submitted That Met QC Criteria: March 12, 2007
• First Posted (Estimate): March 14, 2007

Study Record Updates

• Last Update Posted (Actual): November 20, 2020
• Last Update Submitted That Met QC Criteria: November 4, 2020
• Last Verified: November 1, 2020

More Information

Terms related to this study

• Keywords: Acromegaly; growth hormone; IGF-1; lanreotide; Somatostatin Analogs; Somatuline® Autogel®; Inappropriate Growth Hormone Secretion Syndrome; Somatotropin Hypersecretion Syndrome; Inappropriate GH Secretion Syndrome
• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Endocrine System Diseases; Musculoskeletal Diseases; Hypothalamic Diseases; Bone Diseases; Bone Diseases, Endocrine; Hyperpituitarism; Pituitary Diseases; Acromegaly; Antineoplastic Agents; Lanreotide
• Other Study ID Numbers: MS315