Safety and Efficacy Study of Serostim® Human Immunodeficiency Virus-Associated Adipose Redistribution Syndrome

Phase III, Multi-Center, Open, 12-Week, Follow-up Safety and Efficacy Study of Serostim® in Subjects With Human Immunodeficiency Virus-Associated Adipose Redistribution Syndrome (HARS)

In Serono Study 24380, the antecedent protocol to Study 25373, patients were randomly assigned in a 3.0-to-1.0 ratio to Groups A and B. All patients in Group A received recombinant human growth hormone (Serostim®) 4 mg daily (the "induction" phase) for the first 12 weeks, and then were re-randomized to receive either placebo or Serostim 2 mg on alternate days (roughly equivalent to 1 mg daily) during Weeks 12-36 (the "maintenance" phase). All patients in Group B initially received placebo from baseline to Week 24, and then received Serostim® 4 mg daily from Weeks 24 to 36 (Grunfeld, 2007).

In the follow-up Study 25373, any subject who was enrolled in Serono Study 24380 and was assigned to Group A, who fully completed all study visits without a major protocol violation, was eligible to enroll to receive re-treatment with Serostim at a dose of 4 mg daily for 12 weeks. During study 25373, safety was monitored by recording of adverse events and measurement of urinalysis and laboratory blood tests to assess fasting glucose, fasting insulin, and routine biochemistry and hematology parameters. At Week 12 or at the time of study termination, subjects underwent re-assessment of body composition via anthropometry measurements and dual photon absorptiometry (DXA) scanning. In addition, at study termination, measurements of insulin-like growth factor I (IGF-I), insulin-like growth binding protein 3 (IGFBP-3), fasting lipid profile, and oral glucose tolerance testing were obtained.

Study Overview

• Status: Completed
• Conditions: Human Immunodeficiency Virus-Associated Adipose Redistribution Syndrome
• Intervention / Treatment: Biological: Serostim

• Study Type: Interventional
• Enrollment (Actual): 126
• Phase: Phase 3

Contacts and Locations

Study Locations

• Canada
  • British Columbia
    • Vancouver, British Columbia, Canada
      • St Paul Hospital
• United States
  • Alabama
    • Birmingham, Alabama, United States
      • University of Alabama/Birmingham
  • California
    • Los Angeles, California, United States
      • Care Clinic
    • Palm Beach, California, United States
      • Private Practice
    • San Diego, California, United States
      • UCSD - AVRC (AntiViralResearchCenter)
    • San Francisco, California, United States
      • Kaiser Permanente
    • Torrence, California, United States
      • Harbor-UCLA Medical Center
    • West Hollywood, California, United States
      • AIDS Alliance
  • Connecticut
    • Norwalk, Connecticut, United States
      • Circle Medical LLC
  • District of Columbia
    • Washington, District of Columbia, United States
      • Private Practice
  • Florida
    • Fort Lauderdale, Florida, United States
      • Private Practice
    • Miami, Florida, United States
      • Care Resources
    • Miami, Florida, United States
      • Private Practice
    • North Miami Beach, Florida, United States
      • Private Practice
    • Sarasota, Florida, United States
      • Infectious Disease Associates
  • Georgia
    • Atlanta, Georgia, United States
      • AIDS Research Consortium of Atlanta
  • Illinois
    • Chicago, Illinois, United States
      • Rush University Medical Center
  • Massachusetts
    • Boston, Massachusetts, United States
      • Tufts University School of Medicine
    • Boston, Massachusetts, United States
      • Community Research Initiative of New England
  • Minnesota
    • Minneapolis, Minnesota, United States
      • Hennepin County Medical Center
  • New York
    • New York, New York, United States
      • Weill Medical College of Cornell University
    • New York, New York, United States
      • St. Luke's Roosevelt Hospital
    • New York, New York, United States
      • St. Vincents Catholic Medical Center
  • Texas
    • Austin, Texas, United States
      • Central Texas Clinical Research
  • Virginia
    • Annandale, Virginia, United States
      • IPD Research
  • Washington
    • Spokane, Washington, United States
      • Private Practice

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:

• Must meet all inclusion/exclusion criteria for Serono Study 25373, have participated in Serono Study 24380, must have been assigned to Group A, must have completed all treatments and procedures (including baseline, Week 12 and Week 36 Computerized Tomography (CT) and Dual-Energy X-ray Absorptiometry (DXA) Scans) and had no major protocol violation.
• Must be taking antiretroviral medications that are approved or are available under a Treatment Investigational New Drug (IND). Subjects must also agree not to discontinue or to change their regimen for the duration of the study except as judged medically necessary.
• Must be willing and able to comply with the protocol for the duration of the study.
• Must have voluntarily provided written informed consent and a subject authorization under Health Insurance Portability and Accountability Act of 1996 (HIPAA), prior to any study-related procedure that is not part of normal medical care, and with the understanding that the subject may withdraw consent at any time without prejudice to future medical care.

• If female, subjects must either:

  • Be post menopausal (=/>1 year) or surgically sterilized (i.e., have undergone tubal ligation or hysterectomy), or
  • Use a contraceptive method for the duration of the study such as: hormonal contraceptive,intra uterine device,diaphragm with spermicide, or condom with spermicide, and
  • Must be neither pregnant nor breast feeding.
  • Confirmation that female subjects of childbearing potential are not pregnant must be established by a negative pregnancy test prior to initiating first treatment.

A pregnancy test is not required if the subject is post menopausal or surgically sterilized.

Exclusion Criteria:

• Have any condition, which interferes with informed consent or protocol compliance including, but not limited to, active substance abuse and/or dementia.
• Have any active malignancy, except localized cutaneous Kaposi's sarcoma (fewer than 10 lesions, none of which are larger than 2 cm, and not on active therapy).
• Have active central nervous system (CNS) process associated with neurological findings.
• Have acute illness treated in an intensive care unit, e.g., due to complications following open heart or abdominal surgery, multiple accidental trauma, or acute respiratory failure.
• Have any medical condition in view of which the study doctor and/or Serono Medical/Therapeutic Director feels that it would be in the best interest of the subject not to participate in the follow-up study.

• Are unable to comply with the Concomitant Therapy restrictions as outlined in Section 5.5 and listed as follows:

  • Therapy for obesity including therapy with anorexigenic or fat reducing drugs.
  • Anti-diabetic or insulin sensitizing medications.
  • Systemic glucocorticoids.
  • Systemic chemotherapy, interferon or radiation therapy treatment.
  • Androgenic agents including, but not limited to, testosterone, nandrolone (Deca-durabolin), oxandrolone (Oxandrin), oxymetholone (Anadrol), dehydroepiandrosterone (DHEA), etc. (Testosterone replacement therapy for hypogonadism is the exception to this exclusion and will be allowed if started >30 days prior to Study Day 1 of Serono Study 24380).
  • Progestational agents, unless used for oral contraception or post-menopausal hormone replacement therapy.
  • Appetite stimulants such as dronabinol (Marinol), megestrol acetate (Megace), or cyproheptadine (Periactin).
  • Investigational agents, unless approved in advance by Serono's Medical Director. Specifically, experimental antiretroviral agents are disallowed, unless available under a treatment IND or expanded access program (30 days).
  • Liposuction or other elective plastic surgery.
  • Acquired Immune Deficiency Syndrome (AIDS) wasting therapy with growth hormone and/or prior treatment with growth hormone or a growth hormone releasing factor (for 12 months prior to the screening visit).
• Are participating in any other clinical studies (except Serono Study 24380). Observation studies are allowed, but prior written permission by Serono Medical/Therapeutic Director must be granted.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Non-Randomized
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Serostim; Serostim® 4 mg daily given for 12 weeks (following a prior 36-week treatment [Serono Study 24380] with Serostim® 4 mg daily given for 12 weeks, followed by 24-weeks of either Serostim® 2 mg every other day or Placebo every other day)	Biological: Serostim; Serostim® 4 mg daily given for 12 weeks (following a prior 36-week treatment [Serono Study 24380] with Serostim® 4 mg daily given for 12 weeks, followed by 24-weeks of either Serostim® 2 mg every other day or Placebo every other day); Other Names: mammalian cell-derived recombinant human growth hormone; r hGH

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Change From Baseline to Week 12 in Trunk Fat as Assessed by Dual-Energy X-Ray Absorptiometry (DXA) Scan	baseline to 12 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change From Baseline to Week 12 in Waist Circumference	Measured by anthropometry	baseline to 12 weeks
Change From Baseline to Week 12 in Insulin-like Growth Factor I	Circulating levels of IGF-I	baseline to 12 weeks
Oral Glucose Tolerance Testing - Change From Baseline to Week 12 in Fasting Insulin	Oral glucose tolerance testing	baseline to 12 weeks
Oral Glucose Tolerance Testing - Change From Baseline to Week 12 in 120 Minute Glucose	Oral glucose testing	baseline to 12 weeks
Oral Glucose Tolerance Testing - Change From Baseline to Week 12 in Fasting Glucose	Oral glucose testing	baseline to 12 weeks

Collaborators and Investigators

• Sponsor: EMD Serono

Publications and helpful links

General Publications

• Grunfeld C, Thompson M, Brown SJ, Richmond G, Lee D, Muurahainen N, Kotler DP; Study 24380 Investigators Group. Recombinant human growth hormone to treat HIV-associated adipose redistribution syndrome: 12 week induction and 24-week maintenance therapy. J Acquir Immune Defic Syndr. 2007 Jul 1;45(3):286-97. doi: 10.1097/QAI.0b013e3180691145.

Study record dates

Study Major Dates

• Study Start: February 1, 2005
• Primary Completion (Actual): January 1, 2006
• Study Completion (Actual): January 1, 2006

Study Registration Dates

• First Submitted: February 26, 2010
• First Submitted That Met QC Criteria: February 26, 2010
• First Posted (Estimate): March 1, 2010

Study Record Updates

• Last Update Posted (Estimate): August 7, 2013
• Last Update Submitted That Met QC Criteria: August 4, 2013
• Last Verified: August 1, 2013

More Information

Terms related to this study

• Keywords: Serostim; HARS
• Additional Relevant MeSH Terms: Pathologic Processes; RNA Virus Infections; Virus Diseases; Infections; Blood-Borne Infections; Communicable Diseases; Sexually Transmitted Diseases, Viral; Sexually Transmitted Diseases; Lentivirus Infections; Retroviridae Infections; Immune System Diseases; Disease; Slow Virus Diseases; HIV Infections; Syndrome; Acquired Immunodeficiency Syndrome; Immunologic Deficiency Syndromes; Physiological Effects of Drugs; Hormones, Hormone Substitutes, and Hormone Antagonists; Hormones
• Other Study ID Numbers: 25373 (NCT01077960)