This study is a Phase 2/3, multicenter, double-blind, randomized, parallel-group, placebo-controlled, dose-finding trial of Serostim® (mammalian cell-derived recombinant human growth hormone, r-hGH) versus placebo in subjects with human immunodeficiency virus-associated adipose tissue redistribution syndrome (HARS). The primary study objective is to determine whether Serostim® treatment reduces adipose tissue maldistribution more effectively than placebo. The primary co-endpoints are derived from measures of visceral adipose tissue assessed by computerized tomography (CT) and the ratio of trunk; and limb fat assessed by dual-energy X-Ray absorptiometry (DXA) scans. Anthropometric measures, physical exams, quality of life assessments, serial photographs, and various laboratory measures will be used to address secondary objectives. These secondary objectives relate to the impact of Serostim® on Physician and subject assessments of change in body shape, health-related quality of life, attitude towards medication compliance, metabolic markers, fat redistribution, and safety. On Day 1, eligible subjects will be randomized in a 1:1:1 ratio to receive daily Serostim®, Serostim® and placebo given on alternate days, or daily placebo. Serostim® doses will be based on body weight, with a maximum dose of 4 milligram (mg). Therapy will continue for 12 weeks. Treatment will then be altered and the new treatment will be continued through Week 24. Interim Study Visits will be required at Weeks 2 and 4 (Treatment Period 1) and at Weeks 14 and 16 (Treatment Period 2). Subjects will be offered to be enrolled into a maintenance Protocol (Study 23056) at Week 24.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
245
Serostim® will be administered subcutaneously (daily or given on alternate days with matched placebo), at a dose based on body weight measured at Baseline, with a maximum daily dose of 4 mg up to Week 24.
Matching placebo will be administered subcutaneously (daily or given on alternate days with Serostim®), up to Week 24.
Change from Baseline in absolute area of visceral adipose tissue quantified by Computerized Tomography (CT) scan at Week 12
Time frame: Baseline and Week 12
Change from Baseline in the ratio of trunk fat to limb fat quantified by Dual-Energy X-Ray Absorptiometry (DXA) scan at Week 12
Time frame: Baseline and Week 12
Change from Baseline in composite sum of the visceral adipose tissue and the ratio of trunk fat to limb fat at Week 12
Time frame: Baseline and Week 12
Dorsal fat area in the transverse plane, as measured by Computerized Tomography (CT) Scan
Time frame: Baseline, Week 12 and 24
Weight measured on a calibrated scale
Time frame: Baseline, Week 12 and 24
Absolute values of maximal chest, waist, and hip circumference
Time frame: Baseline, Week 12 and 24
Waist/hip ratio
Time frame: Baseline, Week 12 and 24
Absolute value of dorsocervical fat
Time frame: Baseline, Week 12 and 24
Absolute value of total body fat as quantified by DXA scan
Time frame: Baseline, Week 12 and 24
Absolute value of trunk and Limb fat quantified by DXA scan
Time frame: Baseline, Week 12 and 24
Absolute value of Lean body mass as quantified by DXA scan
Time frame: Baseline, Week 12 and 24
Absolute concentration of serum insulin and glucose
Time frame: Baseline, Week 12 and 24
Absolute concentration of fasting serum triglyceride, total cholesterol, Low density lipoprotein (LDL), High density lipoprotein (HDL) and very low density lipoprotein (VLDL)
Time frame: Baseline, Week 12 and 24
High density lipoprotein (HDL)/Low density lipoprotein (LDL) ratio
Time frame: Baseline, Week 12 and 24
Change from Baseline in Serial Photography Parameters of chest and abdomen at Week 12 and 24
Time frame: Baseline, Week 12 and 24
Health related Quality of life
Time frame: Baseline, Week 4, 12 and 24
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