ECE2024 Eposter Presentations Pituitary and Neuroendocrinology (214 abstracts)
1Endocrinology United, Department of Internal Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy; 2Department of Internal Medicine and Michigan Neuroscience Institute, University of Michigan, Ann Arbor, MI, United States; 3Department of Endocrinology, Pamukkale University Faculty of Medicine, Denizli, Turkey; 4Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Centre Serbia, Medical Faculty of Belgrade, Belgrade, Serbia; 5Interregional Clinical Diagnostic Center, Kazan, Russian Federation; 6Endocrinology Department of Moscow Regional Research Clinical Institute, Moscow, Russian Federation; 7Department of Endocrinology, Jagiellonian University Medical College, Krakow, Poland; 8Department of Endocrinology and Metabolism, Kocaeli University Faculty of Medicine, Kocaeli, Turkey; 9Division of Endocrinology, Mayo Clinic, Rochester, MN, United States; 10Departments of Neurosurgery and Medicine, Stanford University School of Medicine, Stanford, CA, United States; 11Camurus AB, Lund, Sweden
Background: Acromegaly, a rare, chronic disorder, results from excessive growth hormone (GH) and insulin-like growth factor 1 (IGF-1). The need for convenient therapies that provide effective disease control led to the development of CAM2029, a novel, subcutaneous, octreotide depot designed for convenient monthly self-administration using pre-filled syringes/injection pens. In a 24-week Phase 3 trial (ACROINNOVA 1, NCT04076462) CAM2029 achieved superior IGF-1 control vs placebo (72.2 vs 37.5%; P=0.0018) in patients with acromegaly controlled with standard of care (SoC; octreotide long-acting repeatable/lanreotide Autogel) at screening. Interim data from another CAM2029 Phase 3 trial (52-week, open-label [ACROINNOVA 2; NCT04125836]) are reported here, focusing on patients new to CAM2029.
Methods: ACROINNOVA 2 enrolled patients from ACROINNOVA 1 (reported separately), and new to CAM2029 patients with controlled or uncontrolled IGF-1 (≤2x upper limit of normal [ULN]) on stable SoC for ≥3 months. New patients received once-monthly CAM2029 20 mg for up to 52 weeks. The primary endpoint was adverse events (AEs). Secondary endpoints included the proportion of patients with IGF-1 ≤1x ULN (weeks 50/52 mean); the combined IGF-1/GH response; IGF-1 change from baseline; severity score of acromegaly clinical signs/symptoms, assessed using the Acromegaly Index of Severity (AIS). Baseline values reflect SoC treatment.
Results: Eighty-one new to CAM2029 patients were enrolled. At data cut-off (23 May 2023), 61 patients completed treatment at week 52, 15 were ongoing and 5 had discontinued. No new or unexpected safety signals were observed. The most common treatment-emergent AEs were injection-site reactions: new to CAM2029, 38.3%; overall population, 43%; none were Grade 3. The proportion of patients achieving IGF/GH control increased during CAM2029 treatment (Table 1). Estimated IGF-1 response (linear probability model, patients with evaluable data at weeks 50/52) increased 21.9% (95% confidence interval [CI]: 9.6, 34.1) from baseline to weeks 50/52. AIS score significantly decreased from SoC baseline to week 52 (mean of 1.3 [95% CI: 2.1, 0.5]).
Endpoint | Baseline | Weeks 50/52 |
n/Nall*(%) | ||
IGF ≤x ULN (weeks 50/52 mean) | 12/81 (14.8) | 20/60 (33.3) |
IGF ≤x ULN (weeks 50/52 mean) and GH <2.5 μg/l (week 52) | 12/81 (14.8) | 18/60 (30.0) |
*Patients with evaluable data. |
Conclusions: CAM2029 improved IGF-1/GH control and clinical symptoms in patients new to CAM2029. CAM2029 was well tolerated with a safety profile consistent with SoC. ACROINNOVA 2 reinforces the efficacy and safety of CAM2029 for treating acromegaly, including in patients with uncontrolled disease despite treatment with current SoC.