WHY A ONCE-WEEKLY THERAPY?
WHY A ONCE-WEEKLY THERAPY?
Understand how growth hormone deficiency (GHD) can affect pediatric and adult patients.
Understand how growth hormone deficiency (GHD) can affect pediatric and adult patients.
Patients with GHD continue to face challenges with daily injections1
Daily injections may present obstacles for patients and caregivers
Non-adherence to daily GH treatment is common and has been addressed in many studies2,3
Repeated injections are one of the main causes of non-adherence in pediatric-aged patients4
Children, adolescents, and their caregivers may struggle with continual daily injections over the long term1
GH=growth hormone; GHD=growth hormone deficiency
Missing
1 DAY
per week of daily
GH treatment
results in missing up to
52 DAYS
of treatment
in a year
which equates to missing
~1 YEAR
of doses over a 7-year
treatment period
In a systematic literature review and meta-analysis of medication adherence with once-weekly vs once-daily therapy,
Once-weekly treatment adherence was ~2X better than once‑daily treatment5,a
According to an LAGH Consensus Statement for pediatric GHD patients, developed independently by a panel of renowned pediatric endocrinology experts6:
- LAGH formulations offer a potential advantage over daily GH injections for children with GH deficiency in terms of reduced injection frequency and treatment burden; this may also be associated with improved adherence and treatment outcomes over time. However, long-term data is needed
- Parents/caregivers have shown a strong preference for the reduced frequency of LAGH preparations over daily GH formulations
- It is likely that most if not all children could be considered for a weekly administration regimen, particularly children or their caregivers who experience challenges with injections, as well as those at increased risk of non-adherence, frequent travel schedules, and split households
Consider if the flexibility of a once-weekly GH treatment option may impact your patient’s persistence and treatment experience
aMeta-analysis of observational studies which were conducted in patients with osteoporosis.5
GH=growth hormone; GHD=growth hormone deficiency; LAGH=long-acting growth hormone.
GHD occurs in adults and has associated symptoms and conditions
Adult GHD (AGHD) is most often acquired from7,8:
A pituitary tumor7,8
Including treatment with surgery and/or radiation8
Trauma to the brain7
Other patient subpopulations include subarachnoid hemorrhage, ischemic stroke, and infections in the central nervous system7
AGHD may also be idiopathic or due to other organic causes.7,8
Symptoms and associated conditions of adult GHD include7:
Reduced energy levels
Reduced muscle strength
Osteoporosis
Lipid abnormalities
Increased total body fat
Insulin resistance
Impaired cardiac function
Symptoms and associated conditions of adult GHD include7:
Reduced energy levels
Reduced muscle strength
Osteoporosis
Lipid abnormalities
Increased total body fat
Insulin resistance
Impaired cardiac function
Management of adult GHD
Per the American Association of Clinical Endocrinologists (AACE), identifying adult patients with GHD includes assessing8:
PATIENTS WITH CLINICAL FEATURES SUGGESTIVE OF AGHD
Patients with clinical features suggestive of AGHD, eg, patients with organic hypothalamic-pituitary disease and low-serum IGF-1 levels
PATIENTS WITH CLINICAL FEATURES SUGGESTIVE OF AGHD
eg, patients with organic hypothalamic-pituitary disease and low-serum IGF-1 levels
BIOCHEMICALLY PROVEN EVIDENCE OF AGHD
eg, GH stimulation testing
BIOCHEMICALLY PROVEN
EVIDENCE OF AGHD
eg, GH stimulation testing
Treatment options1,8
- With diagnosis confirmed, AACE recommends treating AGHD with growth hormone therapy8
- While once-daily GH treatment is considered the standard of care, according to GRS consensus, a once-weekly GH option may also help1
AGHD=adult growth hormone deficiency; GH=growth hormone; GHD=growth hormone deficiency; GRS=Growth Hormone Research Society; IGF-1=insulin-like growth factor-1.
Discover the pen
Discover the pen
Take a look at the features of the Sogroya® pen.
Take a look at the features of the Sogroya® pen.
How does it work?
How does it work?
Discover the science behind Sogroya®.
Discover the science behind Sogroya®.
Important Safety Information for Sogroya®
Contraindications
Sogroya® is contraindicated in patients with:
- acute critical illness after open-heart surgery, abdominal surgery, multiple accidental trauma, or acute respiratory failure because of the risk of increased mortality with use of Sogroya®
- hypersensitivity to Sogroya® or any of its excipients. Systemic hypersensitivity reactions have been reported postmarketing with somatropin
- pediatric patients with closed epiphyses
- active malignancy
- active proliferative or severe non-proliferative diabetic retinopathy
- pediatric patients with Prader-Willi syndrome who are severely obese, have a history of upper airway obstruction or sleep apnea, or have severe respiratory impairment due to risk of sudden death
Warnings & Precautions
- Increased Mortality in Patients with Acute Critical Illness: Increased mortality has been reported after treatment with somatropin in patients with acute critical illness due to complications following open-heart surgery, abdominal surgery, multiple accidental trauma, and in patients with acute respiratory failure
Indications and Usage
Sogroya® (somapacitan-beco) injection 5 mg, 10 mg, or 15 mg is indicated for the:
- treatment of pediatric patients aged 2.5 years and older who have growth failure due to inadequate secretion of endogenous growth hormone (GH)
- replacement of endogenous GH in adults with growth hormone deficiency (GHD)
Important Safety Information
Contraindications
Sogroya® is contraindicated in patients with:
- acute critical illness after open-heart surgery, abdominal surgery, multiple accidental trauma, or acute respiratory failure because of the risk of increased mortality with use of Sogroya®
- hypersensitivity to Sogroya® or any of its excipients. Systemic hypersensitivity reactions have been reported postmarketing with somatropin
- pediatric patients with closed epiphyses
- active malignancy
- active proliferative or severe non-proliferative diabetic retinopathy
- pediatric patients with Prader-Willi syndrome who are severely obese, have a history of upper airway obstruction or sleep apnea, or have severe respiratory impairment due to risk of sudden death
Warnings & Precautions
- Increased Mortality in Patients with Acute Critical Illness: Increased mortality has been reported after treatment with somatropin in patients with acute critical illness due to complications following open-heart surgery, abdominal surgery, multiple accidental trauma, and in patients with acute respiratory failure
- Severe Hypersensitivity: Serious systemic hypersensitivity reactions including anaphylactic reactions and angioedema have been reported postmarketing with use of somatropin. Inform patients and/or caregivers that such reactions are possible, and that prompt medical attention should be sought if an allergic reaction occurs
- Increased Risk of Neoplasms: There is an increased risk of malignancy progression with somatropin in patients with active malignancy. Any preexisting malignancy should be inactive, and its treatment complete prior to instituting Sogroya®. In childhood cancer survivors treated with radiation to the brain/head for their first neoplasm who developed subsequent GHD and were treated with somatropin, an increased risk of a second neoplasm has been reported. Monitor patients with a history of GHD secondary to an intracranial neoplasm for progression or recurrence of the tumor. Children with certain rare genetic causes of short stature have an increased risk of developing malignancies and should be carefully monitored for development of neoplasms. Monitor patients for increased growth or potential malignant changes of preexisting nevi. Advise patients/caregivers to report changes in the appearance of preexisting nevi
- Glucose Intolerance and Diabetes Mellitus: Treatment with somatropin may decrease insulin sensitivity, particularly at higher doses. New onset type 2 diabetes has been reported. Monitor glucose levels in all patients, especially in those with existing diabetes mellitus or with risk factors for diabetes mellitus, such as obesity, Turner syndrome or a family history of diabetes mellitus. The doses of antidiabetic agents may require adjustment when Sogroya® is initiated
- Intracranial Hypertension: Has been reported usually within 8 weeks of treatment initiation. Perform fundoscopic examination prior to initiation of treatment and periodically thereafter. If papilledema is identified, evaluate the etiology, and treat the underlying cause before initiating Sogroya®. If papilledema is observed, stop treatment. If intracranial hypertension is confirmed, Sogroya® can be restarted at a lower dose after intracranial hypertension signs and symptoms have resolved
- Fluid retention: May occur during Sogroya® therapy. Clinical manifestations of fluid retention (e.g. edema and nerve compression syndromes including carpal tunnel syndrome/paresthesia) are usually transient and dose dependent
- Hypoadrenalism: Patients receiving somatropin therapy who have or are at risk for corticotropin deficiency may be at risk for reduced serum cortisol levels and/or unmasking of central (secondary) hypoadrenalism. Patients treated with glucocorticoid replacement for previously diagnosed hypoadrenalism may require an increase in their maintenance or stress doses following initiation of Sogroya®. Monitor patients with known hypoadrenalism for reduced serum cortisol levels and/or need for glucocorticoid dose increases
- Hypothyroidism: Undiagnosed/untreated hypothyroidism may prevent an optimal response to Sogroya®. Monitor thyroid function periodically as hypothyroidism may occur or worsen after initiation of Sogroya®
- Slipped Capital Femoral Epiphysis in Pediatric Patients: Slipped capital femoral epiphysis may occur more frequently in patients undergoing rapid growth. Evaluate pediatric patients with the onset of a limp or complaints of persistent hip or knee pain
- Progression of Preexisting Scoliosis in Pediatric Patients: Monitor patients with a history of scoliosis for disease progression
- Pancreatitis: Cases of pancreatitis have been reported in patients receiving somatropin. The risk may be greater in pediatric patients compared to adults. Consider pancreatitis in patients with persistent severe abdominal pain
- Lipohypertrophy/Lipoatrophy: May occur if Sogroya® is administered at the same site over a long period of time. Rotate injection sites to reduce this risk
- Sudden death in Pediatric Patients with Prader-Willi Syndrome: There have been reports of fatalities after initiating therapy with somatropin in pediatric patients with Prader-Willi syndrome who had one or more of the following risk factors: severe obesity, history of upper airway obstruction or sleep apnea, or unidentified respiratory infection. Male patients with one or more of these factors may be at greater risk than females. Sogroya® is not indicated for the treatment of pediatric patients who have growth failure due to genetically confirmed Prader-Willi syndrome
- Laboratory Tests: Serum levels of inorganic phosphorus and alkaline phosphatase may increase after Sogroya® therapy. Serum levels of parathyroid hormone may increase with somatropin treatment
Adverse Reactions
- Pediatric patients with GHD: Adverse reactions reported in ≥5% of patients are nasopharyngitis, headache, pyrexia, pain in extremity, and injection site reaction
- Adult patients with GHD: Adverse reactions reported in >2% of patients are back pain, arthralgia, dyspepsia, sleep disorder, dizziness, tonsillitis, peripheral edema, vomiting, adrenal insufficiency, hypertension, blood creatine phosphokinase increase, weight increase, and anemia
Drug Interactions
- Glucocorticoids: Patients treated with glucocorticoid for hypoadrenalism may require an increase in their maintenance or stress doses following initiation of Sogroya®
- Cytochrome P450-Metabolized Drugs: Sogroya® may alter the clearance. Monitor carefully if used with Sogroya®
- Oral Estrogen: Patients receiving oral estrogen replacement may require higher Sogroya® dosages
- Insulin and/or Other Antihyperglycemic Agents: Dose adjustment of insulin and/or antihyperglycemic agent may be required for patients with diabetes mellitus
Please click here for Sogroya® Prescribing Information.
References:
- Christiansen JS, Backeljauw PF, Bidlingmaier M, et al. Growth Hormone Research Society perspective on the development of long-acting growth hormone preparations. Eur J Endocrinol. 2016;174(6):C1–C8. doi:10.1530/EJE-16-0111
- Graham S, Weinman J, Auyeung V. Identifying potentially modifiable factors associated with treatment non-adherence in paediatric growth hormone deficiency: a systematic review. Horm Res Paediatr. 2018;90(4):221-227. doi:10.1159/000493211
- Bagnasco F, Di Iorgi N, Roveda A, Gallizia A, Haupt R, Maghnie M; Adherence Investigators Group. Prevalence and correlates of adherence in children and adolescents treated with growth hormone: a multicenter Italian study. Endocr Pract. 2017;23(8):929-941. doi:10.4158/EP171786.OR
- Mameli C, Orso M, Calcaterra V, et al. Efficacy, safety, quality of life, adherence and cost-effectiveness of long-acting growth hormone replacement therapy compared to daily growth hormone in children with growth hormone deficiency: a systematic review and meta-analysis. Pharmacol Res. 2023;193:106805. doi:10.1016/j.phrs/2023.106805
- Iglay K, Cao X, Mavros P, Joshi K, Yu S, Tuncell K. Systematic literature review and meta-analysis of medication adherence with once-weekly versus once-daily therapy. Clin Ther. 2015;37(8):1813-1821.e1. doi:10.1016/j.clinthera.2015.05.505
- Maniatis A, Cutfield W, Dattani M, et al. Long-acting growth hormone therapy in pediatric growth hormone deficiency: a consensus statement. J Clin Endocrinol Metab. Published online December 3, 2024. doi:10.1210/clinem/dgae834
- National Organization for Rare Disorders (NORD). Growth hormone deficiency. Updated 2016. Accessed November 17, 2022. https://rarediseases.org/rare-diseases/growth-hormone- deficiency
- Yuen KCJ, Beverly MKB, Radovick S, et al. American Association of Clinical Endocrinologists and American College of Endocrinology guidelines for management of growth hormone deficiency in adults and patients transitioning from pediatric to adult care. Endocr Pract. 2019;25(11):1191-1232.