Et forsøg med setmelanotid i erhvervet hypotalamisk fedme
Et fase 3, dobbeltblindt, randomiseret, placebokontrolleret forsøg for at evaluere effektiviteten og sikkerheden af setmelanotid hos patienter med erhvervet hypotalamisk fedme
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Faktiske)
Tilmelding
Fase
Fase
- Fase 3
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Physician Inquiry Clinical Trials
- Telefonnummer: (857) 264-4280
- E-mail: clinicaltrials@rhythmtx.com
Undersøgelse Kontakt Backup
- Navn: Rhythm Clinical Trials
- Telefonnummer: (857) 264-4280
- E-mail: clinicaltrials@rhythmtx.com
Studiesteder
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Ontario
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Toronto, Ontario, Canada, M5G 1X8
- Hospital for Sick Children
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Birmingham, Det Forenede Kongerige, B46NH
- Birmingham Women and Children's Hospital NHS Trust
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Hull, Det Forenede Kongerige, HU32RW
- Hull University Teaching Hospital
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London, Det Forenede Kongerige, WC1N 1EH
- UCL Great Ormond Street Institute of Child Health
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Alabama
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Birmingham, Alabama, Forenede Stater, 35233
- UAN Pediatric Endocrinology
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California
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San Diego, California, Forenede Stater, 92123
- Rady Children's Hospital
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Colorado
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Aurora, Colorado, Forenede Stater, 80045
- Children's Hospital Colorado
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Florida
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Gainesville, Florida, Forenede Stater, 32610-0296
- University of Florida
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Illinois
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Chicago, Illinois, Forenede Stater, 60611
- Ann and Robert H. Lurie Children's Hospital
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Iowa
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Iowa City, Iowa, Forenede Stater, 52242
- University of Iowa Stead Family Department of Pediatrics
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Massachusetts
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Boston, Massachusetts, Forenede Stater, 02115
- Brigham and Women's Hospital
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Boston, Massachusetts, Forenede Stater, 02115
- Boston Children's Hospital
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Minnesota
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Saint Paul, Minnesota, Forenede Stater, 55102
- Children's Minnesota
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New York
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New York, New York, Forenede Stater, 10032
- Columbia University Irving Medical Center
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New York, New York, Forenede Stater, 100029
- Icahn School of Medicine at Mount Sinai
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Ohio
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Columbus, Ohio, Forenede Stater, 43203
- Ohio State Wexner Medical Center
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Oklahoma
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Oklahoma City, Oklahoma, Forenede Stater, 73122
- Lynn Health Science Institute
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Pennsylvania
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Philadelphia, Pennsylvania, Forenede Stater, 19104
- Children's Hospital of Philadelphia
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Tennessee
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Nashville, Tennessee, Forenede Stater, 37232
- Vanderbilt University School of Medicine
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Washington
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Seattle, Washington, Forenede Stater, 98101
- Seattle Children's Hospital, Research and Foundation - Center for Integrative Brain Research
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Utrecht, Holland, 3584CS
- Prinses Maxima Center for Pediatric Oncology
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Aichi-ken
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Nagoya, Aichi-ken, Japan, 467-8602
- Nagoya City University Hospital
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Nagano
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Azumino, Nagano, Japan, 399-8288
- Nagano Children's Hospital
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Tokyo
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Minato, Tokyo, Japan, 105-8470
- Toranomon Hospital
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Hamburg, Tyskland, 20246
- Universitaetsklinikum Hamburg-Eppendorf (UKE) - Ambulanzzentrum des UKE GmbH
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München, Tyskland, 81667
- Medicover Neuroendokrinologie
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Oldenburg, Tyskland, 26133
- University Children's Hospital, Klinikum Oldenburg
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Ulm, Tyskland, 89075
- Universitaetsklinikum Ulm - Klinik fuer Kinder- und Jugendmedizin
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Beskrivelse
Nøgleinklusionskriterier:
- Dokumenteret bevis for erhvervet hypothalamus fedme (HO)
- Alder 4 år og ældre
- Vægtøgning forbundet med hypothalamusskaden og et BMI på ≥30 kg/m2 for patienter ≥18 år eller BMI ≥95. percentil for alder og køn for patienter 4 til <18 år
- Accepter at bruge en yderst effektiv præventionsform gennem hele undersøgelsen og i 90 dage efter undersøgelsen
Nøgleekskluderingskriterier:
- Diagnose af Prader-Willi syndrom (PWS) eller hurtigt opstået fedme med hypoventilation, hypothalamus, autonom dysregulering, neuroendokrin tumorsyndrom (ROHHADNET)
- Vægttab >2 % i de foregående 3 måneder for patienter i alderen ≥18 år eller >2 % reduktion i BMI for patienter i alderen 4 til <18 år
- Fedmekirurgi eller indgreb inden for de sidste 2 år
- Diagnose af alvorlige psykiatriske lidelser; enhver selvmordstanker, forsøg eller adfærd
- Aktuel, klinisk signifikant lunge-, hjerte-, metabolisk eller onkologisk sygdom
- Væsentlige dermatologiske fund relateret til melanom eller præ-melanom hudlæsioner (eksklusive ikke-invasiv basal- eller pladecellelæsion)
- Anamnese eller nær familiehistorie med hudkræft eller melanom
- Deltagelse i ethvert klinisk forsøg med et forsøgslægemiddel/-udstyr inden for 3 måneder før den første forsøgsdosis
- Tidligere indskrevet i et klinisk forsøg med setmelanotid eller tidligere eksponering for setmelanotid
- Manglende evne til at overholde injektionsregimen én gang dagligt (QD).
- Hvis kvinde, gravid og/eller ammer
- Patienter med fedme, der kan tilskrives andre genetiske eller syndromiske tilstande (f.eks. PPL [POMC, PCSK1, LEPR, samlet], BBS) før hypothalamusskaden.
- Hvis du får hormonsubstitutionsbehandling, har dosis været stabil i mindst 2 måneder før screening
Andre protokoldefinerede Inklusions-/Eksklusionskriterier kan være gældende.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Tredobbelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
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Eksperimentel: Setemelanotid
Randomiseret 2:1 (Setmelanotid: Placebo)
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Opløsning til daglig subkutan injektion
Andre navne:
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Placebo komparator: Placebo
Randomiseret 2:1 (Setmelanotid: Placebo)
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Placebo matchet til setmelanotid til daglig subkutan injektion
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Pivotal Cohort: Mean Percent Change From Baseline in Body Mass Index (BMI) After 52 Weeks on a Therapeutic Regimen
Tidsramme: Baseline, after approximately 52 Weeks on a Therapeutic Regimen (up to approximately 60 weeks)
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BMI was calculated as weight (kg)/height (m^2).
Least square (LS) mean and standard error (SE) were calculated using analysis of covariance (ANCOVA) model.
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Baseline, after approximately 52 Weeks on a Therapeutic Regimen (up to approximately 60 weeks)
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Pivotal Cohort: Percentage of Participants With ≥5% Reduction From Baseline in BMI (≥18 Years of Age) or ≥0.2-point Reduction From Baseline in BMI Z-score (<18 Years of Age)
Tidsramme: After approximately 52 Weeks on a Therapeutic Regimen (baseline up to approximately 60 weeks)
|
BMI was calculated as weight (kg)/height (m^2).
BMI Z-Score calculated for participants <18 years old only is a measure of relative weight adjusted for child's age, sex and height at the time of data collection.
The Z-Scores were calculated using the World Health Organization's WHO 2007 BMI SAS Macro Package.
A Z-score of 0 is equal to the mean of a reference population (i.e., healthy, age and sex-matched individuals).
A decrease in BMI Z-score (< 0) indicates a reduction in BMI from Baseline whereas an increase in BMI-Z score (> 0) indicated an increase in BMI from Baseline.
Baseline was defined as the most recent measurement prior to the first administration of study drug.
Results below represent the percentage of estimated participants with either ≥5% BMI reduction or ≥0.2 point reduction in BMI Z-score by age in each treatment arm as calculated through the MIANALYZE SAS procedure.
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After approximately 52 Weeks on a Therapeutic Regimen (baseline up to approximately 60 weeks)
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Pivotal Cohort: Percentage of Participants With ≥5% Reduction From Baseline in BMI
Tidsramme: After approximately 52 Weeks on a Therapeutic Regimen (baseline up to approximately 60 weeks)
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BMI was calculated as weight (kg)/height (m^2).
Results below represent the percentage of estimated participants with ≥5% BMI reduction in each treatment arm as calculated through the MIANALYZE SAS procedure.
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After approximately 52 Weeks on a Therapeutic Regimen (baseline up to approximately 60 weeks)
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Pivotal Cohort: Change From Baseline in Weekly Average Daily Most Hunger Score in Participants ≥12 Years of Age
Tidsramme: Baseline, after approximately 52 Weeks on a Therapeutic Regimen (up to approximately 60 weeks)
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Change from baseline in hunger scores for participants ≥12 years of age with acquired hypothalamic obesity was evaluated.
Hunger score ranged from 0= "not hungry at all" to 10= "hungriest possible" on an 11-point numeric rating scale.
On Daily Hunger Questionnaire, each of the 2 items (average hunger and most hunger) was scored separately and averaged on weekly basis.
LSM and SE were calculated using ANCOVA model.
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Baseline, after approximately 52 Weeks on a Therapeutic Regimen (up to approximately 60 weeks)
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Pivotal Cohort: Percentage of Participants (≥12 Years of Age) With a ≥2-point Reduction From Baseline in the Weekly Average Daily Most Hunger Score
Tidsramme: After approximately 52 Weeks on a Therapeutic Regimen (baseline up to approximately 60 weeks)
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Hunger score ranged from 0= "not hungry at all" to 10= "hungriest possible" on an 11-point numeric rating scale.
On Daily Hunger Questionnaire, each of the 2 items (average hunger and most hunger) was scored separately and averaged on weekly basis.
Results below represent the percentage of estimated participants ≥12 years of age with ≥2-point reduction in each treatment arm as calculated through the MIANALYZE SAS procedure.
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After approximately 52 Weeks on a Therapeutic Regimen (baseline up to approximately 60 weeks)
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Pivotal Cohort: Mean Change From Baseline in the Weekly Average of the Symptoms of Hyperphagia Composite Score in Participants ≥12 Years of Age
Tidsramme: Baseline, after approximately 52 Weeks on a Therapeutic Regimen (up to approximately 60 weeks)
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Participants ≥12 years of age who were able to self-report were administered the Symptoms of Hyperphagia: Patient (Version 1.0).
The questionnaire consisted of 4 items related to the frequency of a participant's hunger symptoms on a scale (Never, 1 or 2 times, 3 or more times) over the past 24 hours.
The scores on this scale range from 0 to 2 with higher scores indicating more hyperphagia.
Daily composite score was derived as the sum of daily answered questions divided by the number of answered questions per day.
The weekly average of the daily composite scores equals to the sum of daily composite scores divided by the number of days with a composite score within the 7 identified days prior to the visit.
LSM and SE were calculated using ANCOVA model.
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Baseline, after approximately 52 Weeks on a Therapeutic Regimen (up to approximately 60 weeks)
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Pivotal Cohort: Percentage of Participants With a ≥10% Reduction From Baseline in BMI
Tidsramme: After approximately 52 Weeks on a Therapeutic Regimen (baseline up to approximately 60 weeks)
|
BMI was calculated as weight (kg)/height (m^2).
Results below represent the percentage of estimated participants with ≥10% BMI reduction in each treatment arm as calculated through the MIANALYZE SAS procedure.
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After approximately 52 Weeks on a Therapeutic Regimen (baseline up to approximately 60 weeks)
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Pivotal Cohort: Percentage of Participants With a ≥10% Reduction From Baseline in Body Weight
Tidsramme: After approximately 52 Weeks on a Therapeutic Regimen (baseline up to approximately 60 weeks)
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Body weight was captured for analysis in kilograms.
Results below represent the percentage of estimated participants with ≥10% reduction in body weight in each treatment arm as calculated through the MIANALYZE SAS procedure.
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After approximately 52 Weeks on a Therapeutic Regimen (baseline up to approximately 60 weeks)
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Pivotal Cohort: Mean Percent Change From Baseline in Body Weight in Participants ≥18 Years
Tidsramme: Baseline, after approximately 52 Weeks on a Therapeutic Regimen (up to approximately 60 weeks)
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Body weight was captured for analysis in kilograms.
LSM and SE were calculated using ANCOVA model.
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Baseline, after approximately 52 Weeks on a Therapeutic Regimen (up to approximately 60 weeks)
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Pivotal Cohort: Mean Change From Baseline in BMI Z-Score in Participants <18 Years of Age
Tidsramme: Baseline, after approximately 52 Weeks on a Therapeutic Regimen (up to approximately 60 weeks)
|
BMI was calculated as weight (kg)/height (m^2).
BMI Z-Score calculated for participants <18 years old only is a measure of relative weight adjusted for child's age, sex and height at the time of data collection.
The Z-Scores were calculated using the World Health Organization's WHO 2007 BMI SAS Macro Package.
A Z-score of 0 is equal to the mean of a reference population (i.e., healthy, age and sex-matched individuals).
A decrease in BMI Z-score (< 0) indicates a reduction in BMI from Baseline whereas an increase in BMI-Z score (> 0) indicates an increase in BMI from Baseline.
Baseline was defined as the most recent measurement prior to the first administration of study drug.
LSM and SE were calculated using ANCOVA model.
|
Baseline, after approximately 52 Weeks on a Therapeutic Regimen (up to approximately 60 weeks)
|
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Pivotal Cohort: Mean Change From Baseline in Percent of BMI 95th Percentile in Participants <18 Years of Age
Tidsramme: Baseline, after approximately 52 Weeks on a Therapeutic Regimen (up to approximately 60 weeks)
|
BMI was calculated using participant's weight and height assessments, using the following formula: BMI = kg/m^2.
BMI percentile scores are measures of relative weight adjusted for child's age and gender.
The percent of the BMI 95th percentile score expresses the participant's BMI as a percentage of the Centers for Disease Control (CDC) 95th percentile reference population.
Baseline was defined as the most recent measurement prior to the first administration of study drug.
LSM and SE were calculated using ANCOVA model.
|
Baseline, after approximately 52 Weeks on a Therapeutic Regimen (up to approximately 60 weeks)
|
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Pivotal Cohort: Percentage of Participants <18 Years of Age With ≥0.2-Point Reduction From Baseline in BMI Z-Score
Tidsramme: After approximately 52 Weeks on a Therapeutic Regimen (baseline up to approximately 60 weeks)
|
BMI was calculated as weight (kg)/height (m^2).
BMI Z-Score calculated for participants <18 years old only is a measure of relative weight adjusted for child's age, sex and height at the time of data collection.
The Z-Scores were calculated using the World Health Organization's WHO 2007 BMI SAS Macro Package.
A Z-score of 0 is equal to the mean of a reference population (i.e., healthy, age and sex-matched individuals).
A decrease in BMI Z-score (< 0) indicates a reduction in BMI from Baseline whereas an increase in BMI-Z score (> 0) indicates an increase in BMI from Baseline.
Baseline was defined as the most recent measurement prior to the first administration of study drug.
Results below represent the percentage of estimated participants with ≥0.2 point reduction in BMI Z-score in each treatment arm and the difference between the treatment arms as calculated through the MIANALYZE SAS procedure.
|
After approximately 52 Weeks on a Therapeutic Regimen (baseline up to approximately 60 weeks)
|
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Pivotal Cohort: Percentage of Participants With BMI <30 kg/m^2 (Aged ≥18 Years) or <95th Percentile (Aged <18 Years) From Baseline
Tidsramme: After approximately 52 Weeks on a Therapeutic Regimen (baseline up to approximately 60 weeks)
|
BMI was calculated using participant's weight and height assessments, using the following formula: BMI = kg/m^2.
BMI Percentile scores are measures of relative weight adjusted for child's age and gender.
The percent of the BMI 95th percentile score expresses the participant's BMI as a percentage of the CDC 95th percentile reference population.
Baseline was defined as the most recent measurement prior to the first administration of study drug.
Results below represent the percentage of estimated participants with either BMI <30 kg/m^2 (aged ≥18 years) or <95th percentile (aged <18 years) in each treatment arm and the difference between the treatment arms as calculated through the MIANALYZE SAS procedure.
|
After approximately 52 Weeks on a Therapeutic Regimen (baseline up to approximately 60 weeks)
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Pivotal Cohort: Mean Change From Baseline in Physical Functioning Score and Total Score on the Impact of Weight on Quality of Life-Lite (IWQOL)
Tidsramme: Baseline, after approximately 52 Weeks on a Therapeutic Regimen (up to approximately 60 weeks)
|
The IWQOL-Lite-Clinical Trials (administered to participants ≥18 years of age) is a validated 20-item self-report measure of obesity-specific quality of life questionnaire.
It assessed 2 primary domains of obesity-related health-related quality of life (HRQoL): physical (7 items) and psychosocial (13 items).
Each item was rated on a scale from 0 (worst) to 100 (best), with higher scores indicating better levels of functioning.
It provided composite scores for each domain, as well as a total score, all ranging from 0 (worst) to 100 (best).
Higher scores reflect better levels of functioning and quality of life.
LSM and SE were calculated using ANCOVA model.
|
Baseline, after approximately 52 Weeks on a Therapeutic Regimen (up to approximately 60 weeks)
|
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Pivotal Cohort: Mean Change From Baseline in Total Score on the Impact of Weight on Quality of Life-Kids (IWQOL-Kids)
Tidsramme: Baseline, after approximately 52 Weeks on a Therapeutic Regimen (up to approximately 60 weeks)
|
The IWQOL-Kids (administered to participants between the ages of 11 and <18 years) is a validated 27-item self-report measure of weight-related quality of life for youth.
It provided a total score inclusive of 4 domains: physical comfort, body esteem, social life, and family relations.
Results below represent the total score, which is rated on a scale from 0 (worst) to 100 (best), with higher scores indicating better levels of functioning.
LSM and SE were calculated using ANCOVA model.
|
Baseline, after approximately 52 Weeks on a Therapeutic Regimen (up to approximately 60 weeks)
|
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Pivotal Cohort: Mean Change From Baseline in Waist Circumference
Tidsramme: Baseline, after approximately 52 Weeks on a Therapeutic Regimen (up to approximately 60 weeks)
|
Waist circumference was captured for analysis in centimeters.
LSM and SE were calculated using ANCOVA model.
|
Baseline, after approximately 52 Weeks on a Therapeutic Regimen (up to approximately 60 weeks)
|
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Pivotal Cohort: Change From Baseline in Systolic and Diastolic Blood Pressure
Tidsramme: Baseline, after approximately 52 Weeks on a Therapeutic Regimen (up to approximately 60 weeks)
|
Blood pressure was calculated in millimeters of mercury.
|
Baseline, after approximately 52 Weeks on a Therapeutic Regimen (up to approximately 60 weeks)
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Studiestol: David Meeker, MD, Rhythm Pharmaceuticals, Inc.
Publikationer og nyttige links
Generelle publikationer
- Miller JL, van Santen HM, Phillips SA, Hamilton J, Aberle J, Sathyapalan T, Mohamed Z, McCormack SE, Shoemaker AH, Kelsey MM, Ghalib L, Stalla G, Thaker VV, Habiby R, Ode KL, Wabitsch M, Dattani M, Abuzzahab MJ, Abdullatif H, Morgan R, Stefater-Richards M, Aroda VR, Friedrich C, Han JC, Ono H, Nagasaki K, Tanaka T, Isojima T, Arima H, Scimia C, Yuan G, Muller HL, Roth CL; TRANSCEND Trial Group. Setmelanotide for the Treatment of Acquired Hypothalamic Obesity. N Engl J Med. 2026 Jul 9;395(2):138-150. doi: 10.1056/NEJMoa2512275.
- Roth CL, Phillips SA, McCormack SE, Ode KL, Kelsey MM, Liu J, Ervin C, Mallya UG, Norcross L, Miller JL. Quality of life improvements with setmelanotide treatment in acquired hypothalamic obesity: TRANSCEND trial interview results from US participants. Front Behav Neurosci. 2026 Jul 15;20:1830070. doi: 10.3389/fnbeh.2026.1830070. eCollection 2026.
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Faktiske)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
- Urogenitale sygdomme
- Sygdomme i det endokrine system
- Mandlige urogenitale sygdomme
- Urogenitale sygdomme hos kvinder
- Kvinders urogenitale sygdomme og graviditetskomplikationer
- Gonadale lidelser
- Medfødte abnormiteter
- Forstyrrelser i seksuel udvikling
- Urogenitale abnormiteter
- Gonadal dysgenese
- Hypogonadisme
- Medfødte, arvelige og neonatale sygdomme og abnormiteter
- Seksuel infantilisme
- setmelanotid
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- RM-493-040
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
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