ECE2024 Eposter Presentations Diabetes, Obesity, Metabolism and Nutrition (383 abstracts)
1Division of Molecular Genetics, Department of Pediatrics, Columbia University, New York, United States; 2Honor Health Research Institute, Scottsdale, United States; 3Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin und Humboldt-Universität zu Berlin, Institute for Experimental Pediatric Endocrinology, Berlin, Germany; 4Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, University of Ulm, Ulm, Germany; 5Division of Pediatric Endocrinology, Department of Pediatrics, Sophia Childrens Hospital and Obesity Center CGG, Erasmus University Medical Center, Rotterdam, Netherlands; 6Rhythm Pharmaceuticals, Inc., Boston, United States; 7Department of Pediatrics and Pediatric Endocrinology, Universidad Autónoma de Madrid, University Hospital Niño Jesús, CIBER Fisiopatología de la obesidad y nutrición (CIBEROBN), Instituto de Salud Carlos II; IMDEA Food Institute, Madrid, Spain; 8Assistance Publique Hôpitaux de Paris, Nutrition Department, Pitié-Salpêtrière Hospital; Sorbonne University, Inserm, Nutrition and Obesity, Systemic Approaches (NutriOmique) Research Group, Paris, France; 9Wellcome-MRC Institute of Metabolic Science and NIHR Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, United Kingdom
Background: Patients with proopiomelanocortin (POMC; including variants in POMC or PCSK1) or leptin receptor (LEPR) deficiency due to biallelic gene variants have impaired melanocortin-4 receptor signaling that leads to hyperphagia and early-onset, severe obesity. Setmelanotide treatment in this population improved weight-related measures and hunger severity and was well tolerated. Reported here are long-term extension (LTE) outcomes after 4 years of setmelanotide treatment.
Methods: Patients with POMC or LEPR deficiency who achieved clinical benefit and acceptable safety in a prior trial of setmelanotide could enroll in the LTE (NTC03651765) and continue setmelanotide for ≥5 years or transition to a commercial product or other clinical trials. This analysis reports weight outcomes and adverse events at 4 years of setmelanotide treatment for patients who achieved a clinically meaningful, age-appropriate, 1-year index trial weight response defined as either ≥10% weight reduction (age ≥18 years at baseline) or reduction of ≥5 percentage points in percent of the 95th percentile for BMI (%BMI95; age <18 years at baseline).
Results: A total of 24 patients entered the LTE with clinically meaningful weight response; 12 patients had 4 years of measurements and were included in this analysis. Of the 12 patients excluded, 3 pediatric patients transitioned to adulthood between the index trial and this analysis, 5 transitioned to commercial therapy, and 4 discontinued treatment. Compared with index trial baseline, the mean (SD) change in body weight was −32.6 kg (36.7) for patients aged ≥18 years (n=8) and −42.7 (22.44) percentage points in %BMI95 for patients aged <18 years (n=4). No new safety signals were observed between the index trial and the LTE.
Conclusions: Continuous setmelanotide treatment in patients with POMC or LEPR deficiency is supported by sustained meaningful benefit in weight-related measures with no new safety signals at 4 years of treatment in this population.