Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K38/00—Medicinal preparations containing peptides
  • A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
  • A61K38/17—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
  • A61K38/1703—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans from vertebrates
  • A61K38/1709—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans from vertebrates from mammals
  • A61K38/1754—Insulin-like growth factor binding proteins
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K38/00—Medicinal preparations containing peptides
  • A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
  • A61K38/17—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
  • A61K38/22—Hormones
  • A61K38/30—Insulin-like growth factors, i.e. somatomedins, e.g. IGF-1, IGF-2
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P11/00—Drugs for disorders of the respiratory system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P27/00—Drugs for disorders of the senses
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/0012—Galenical forms characterised by the site of application
  • A61K9/0019—Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/0012—Galenical forms characterised by the site of application
  • A61K9/0053—Mouth and digestive tract, i.e. intraoral and peroral administration

Definitions

• the length of a normal pregnancy or gestation is considered to be 40 weeks (280 days) from the date of conception. Infants born before 37 weeks gestation are considered premature and may be at risk for complications. Advances in medical technology have made it possible for infants born as young as 23 weeks gestational age (17 weeks premature) to survive. Infants born prematurely are at higher risk for death or serious complications due to their low birth weight and the immaturity of their body systems. Low birthweight, defined by a cut-off of 2,500 g, serves as a marker for high risk newborns, as it is correlated with prenatal risk factors, intrapartum complications and neonatal disease, and is composed largely of preterm births.
• the lungs, digestive system, and nervous system are not fully developed in premature babies, and are particularly vulnerable to complications.
• the most prevalent medical problems encountered in preterm infants are retinopathy of prematurity, developmental delay, mental retardation, bronchopulmonary dysplasia (BPD), necrotizing enterocolitis, and intraventricular hemorrhage.
• Chronic Lung Disease is a particularly complicated and life threatening condition in premature infants. Premature infants, especially those extremely premature infants, are at very high risk for developing chronic lung disease, with bronchopulmonary dysplasia (BPD) at term being an early manifestation.
• BPD bronchopulmonary dysplasia
• the present invention provides an effective treatment of Chronic Lung Disease (CLD) in premature infants.
• CLD Chronic Lung Disease
• the invention is, in part, based on the insights that a combination of IGF-1 and insulin-like growth factor binding protein-3 (IGFBP-3) can improve not only the short term outcomes but also the longer term conditions related to chronic lung disease, resulting in significantly improved growth and development arch of infants born extremely premature starting immediately after birth when cut off from the maternal supply of IGF-1 and through its replacement.
• IGFBP-3 insulin-like growth factor binding protein-3
• a method of treating Chronic Lung Disease comprising administering to a subject in need of treatment, a composition comprising insulin-like growth factor-1 (IGF-1) or an agonist or an analog thereof.
• a method of treating CLD comprising administering to a subject in need of the treatment, a composition comprising the IGF-I or agonist or analog thereof comprising IGF-1 and an IGF binding protein.
• the composition comprises the IGF-I or agonist or analog thereof and also comprises IGF-1 and insulin-like growth factor binding protein-3 (IGFBP-3).
• the subject in need of the treatment is an infant.
• the subject is a premature infant, wherein the infant is prematurely born by at least 1 week, 2 weeks, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks, 2 months, 10 weeks or 3 months.
• the subject in need of the treatment is administered a composition comprising the IGF-I or agonist or analog, wherein the composition is administered subcutaneously, intravenously, intramuscularly, or orally.
• the IGF-I or agonist or analog thereof is administered intravenously.
• the IGF-I or agonist or analog thereof is administered at a dosage of about 100 to 500 micrograms/kg/24 hours.
• the IGF-I or agonist or analog thereof is administered at a dosage of between 100 micrograms/kg/24 hours and 450 micrograms/kg/24 hours.
• the IGF-I or agonist or analog thereof is administered at a dosage of between 150 micrograms/kg/24 hours and 400 micrograms/kg/24 hours. In some embodiments, the IGF-I or agonist or analog thereof is administered at a dosage of between 200 micrograms/kg/24 hours and 400 micrograms/kg/24 hours. In some embodiments, the IGF-I or agonist or analog thereof is administered at a dosage of between 250 micrograms/kg/24 hours and 400 micrograms/kg/24 hours. In some embodiments, the IGF-I or agonist or analog thereof is administered at a dosage of about 250 micrograms/kg/24 hours.
• the IGF-I or agonist or analog thereof is administered at a dosage of about 400 micrograms/kg/24 hours. In some embodiments, the IGF-I or agonist or analog thereof is administered from the time of birth up to post-menstrual age (PMA) of about 24-34 weeks. PMA is defined as the age in weeks of an infant in weeks when he or she is discharged from hospital, or the age of death, or first birthday, whichever comes first. It is calculated as the sum of (i) the product of total gestation weeks and seven, (ii) the number of gestation days, and (iii) the days of length of stay in the hospital after birth.
• PMA post-menstrual age
• the IGF-I or agonist or analog thereof is administered from the time of birth up to PMA of about 28 to 32 weeks. In some embodiments, the IGF-I or agonist or analog thereof is administered from the time of birth up to PMA of about 29 weeks plus 6 days.
• the subject has reduced IGF-1 serum levels. In some embodiments, the reduced IGF-1 serum levels are below 60 micrograms/L. In some embodiments, the reduced IGF-1 serum levels are below 50 micrograms/L. In some embodiments, the reduced IGF-1 serum levels are below 40 micrograms/L. In some embodiments, the reduced IGF-1 serum levels are about 30 to 50 micrograms/L.
• the IGF-1 is recombinantly produced. In some embodiments, the IGFBP-3 is recombinantly produced. In some embodiments, the IGF-1 and the IGFBP-3 are complexed prior to administration to the subject. In some embodiments, the IGF-1 and IGFBP-3 are complexed in equimolar amounts.
• the method provided herein comprises embodiments where the administration of the IGF-I or agonist or analog results in reduced incidence of Chronic Respiratory Morbidity (CRM) through 12 months corrected age (CA).
• the corrected age of an infant is the adjusted age of the infant based on his or her due date. Taking the term of the pregnancy to be 40 weeks (i.e., due date), a prematurely born infant gets a corrected age where the excess time it has existed outside the mother's body is subtracted from its real age.
• the administration of the IGF-I or agonist or analog results in reduced incidence of Bronchopulmonary Dysplasia (BPD) through postmenstrual age (PMA) 24 weeks to 12 months.
• BPD Bronchopulmonary Dysplasia
• PMA postmenstrual age
• the administration of the IGF-I or agonist or analog results in reduced incidence of BPD through PMA 24 weeks, 28 weeks, 30 weeks, 32 weeks, 34 weeks, 36 weeks, or 38, or 40 weeks, 45 weeks, 50 weeks, or 52 weeks.
• the administration of the IGF-I or agonist or analog results in reduced incidence of BPD through PMA 6 months, 8 months, 10 months, or 12 months.
• the administration of the IGF-I or agonist or analog thereof results in reduced incidence of Severe Intraventricular Hemorrhage (IVH) Grade III or IV through postmenstrual age (PMA) 24 weeks, 30 weeks, 36 weeks, 40 weeks, 6 months, 8 months, 10 months, or 12 months.
• IVH Intraventricular Hemorrhage
• PMA postmenstrual age
• the administration of the IGF-I or agonist or analog thereof results in reduced incidence of retinopathy of prematurity (ROP) through postmenstrual age (PMA) 24 weeks, 30 weeks, 36 weeks, 40 weeks, 6 months, 8 months, 10 months, or 12 months.
• ROP retinopathy of prematurity
• PMA postmenstrual age
• the method disclosed herein comprises embodiments where the administration of the IGF-I or agonist or analog results in increased Functional Status as Assessed by PREMature Infant Index (PREMII) through postmenstrual age (PMA) 24 weeks, 30 weeks, 32 weeks, 34 weeks, 36 weeks, 38 weeks, 40 weeks, 50 weeks, 6 months, 8 months, 10 months, or 12 months.
• PREMII PREMature Infant Index
• PMA postmenstrual age
• the present invention provides methods and compositions for treating Chronic Lung Disease.
• the compositions and methods provided herein are particularly effective in treating Chronic Lung Disease in premature infants, especially those extremely premature infants.
• a method of the invention involves administering to a subject in need of treatment (e.g., a premature infant) insulin-like growth factor-1 (IGF-1) or an agonist or an analog thereof.
• IGF-I or agonist or analog thereof contains IGF-1 and an IGF binding protein (e.g., insulin-like growth factor binding protein-3 (IGFBP-3)).
• Preterm or “preterm birth” or “prematurity” or “premature infant” or “premature baby”, or grammatical equivalents refers to birth of a patient prior to 40 weeks of gestation or weighing 10% less than the average for the patient's gestational age.
• a premature infant refers to an infant that was prematurely born by at least 1 week, 2 weeks, 3 weeks, 4 weeks, 1 month, 2 months, or 3 months.
• IGF-I refers to insulin-like growth factor I from any species, including bovine, ovine, porcine, equine, and human, preferably human, and, if referring to exogenous administration, from any source, whether natural, synthetic, or recombinant, provided that it will bind IGF binding protein at the appropriate site. IGF-I can be produced recombinantly, for example, as described in PCT publication WO 95/04076.
• IGFBP insulin-like growth factor binding protein
• IGFBP-7 insulin-like growth factor binding protein-7
• PSF prostacyclin-stimulating factor
• ESM-1 endothelial cell-specific molecule
• IGFBP-3 refers to insulin-like growth factor binding protein 3.
• IGFBP-3 is a member of the insulin-like growth factor binding protein family.
• IGFBP-3 may be from any species, including bovine, ovine, porcine and human, in native-sequence or variant form, including but not limited to naturally-occurring allelic variants.
• IGFBP-3 may be from any source, whether natural, synthetic or recombinant, provided that it will bind IGF-I at the appropriate sites. IGFBP-3 can be produced recombinantly, as described in PCT publication WO 95/04076.
• a “therapeutic composition,” as used herein, is defined as comprising IGF-I, an analog thereof, or IGF-I in combination with its binding protein, IGFBP-3 (IGF-I/IGFBP-3 complex).
• the therapeutic composition may also contain other substances such as water, minerals, carriers such as proteins, and other excipients known to one skilled in the art.
• IGF-I insulin growth factor-I
• analogs of IGF-I are compounds having the same therapeutic effect as IGF-I in humans or animals. These can be naturally occurring analogs of IGF-I (e.g., truncated IGF-I) or any of the known synthetic analogs of IGF-I. See, for example, U.S. Pat. No. 5,473,054 for analog compounds of IGF-I.
• “Agonists” of IGF-I are compounds, including peptides, which are capable of increasing serum and tissue levels of IGF, especially IGF-I, in a mammal and particularly in a human. See, for example, U.S. Pat. No. 6,251,865 for IGF agonist molecules.
• Developmental delay shall mean abnormal neurogenesis which has the potential of leading to slowed mental progression in achieving developmental milestones. Developmental delay can, in some cases, be determined by means of electroencephalogram.
• Subject as used herein means any mammal, including humans. In certain embodiments of the present invention the subject is an adult, an adolescent or an infant. Also contemplated by the present invention are the administration of the pharmaceutical compositions and/or performance of the methods of treatment in-utero.
• treatment refers to any administration of a therapeutic composition (e.g., IGF-1 or an agonist or an analog thereof) that partially or completely alleviates, ameliorates, relieves, inhibits, delays onset of, prevents, reduces severity of and/or reduces incidence of one or more symptoms or features of a particular disease, disorder, and/or condition (e.g., Chronic lung disease).
• a therapeutic composition e.g., IGF-1 or an agonist or an analog thereof
• Such treatment may be of a subject who does not exhibit signs of the relevant disease, disorder and/or condition and/or of a subject who exhibits only early signs of the disease, disorder, and/or condition.
• Such treatment may be of a subject who exhibits one or more established signs of the relevant disease, disorder and/or condition.
• control individual is an individual afflicted with the same form of Chronic Lung Disease as the individual being treated, who is about the same age as the individual being treated (to ensure that the stages of the disease in the treated individual and the control individual(s) are comparable).
• the present invention may be used to treat any type of Chronic Lung Disease (CLD) including CLD that occurs in the adult especially the elderly and infants especially those premature or extremely premature infants.
• CLD involves a spectrum of diseases and disorders, including but not limited to COPD (emphysema and chronic bronchitis), asthma, cystic fibrosis, restrictive lung disease, and persistent infections.
• Lung injury may be caused by:
• IGF-1 or an Agonist or an Analog Thereof
• IGF-1 or an agonist or an analog thereof may be used to practice the present invention.
• IGF-I is a well-known regulator of postnatal growth and metabolism. See, Baker J, Liu J P, Robertson E J, Efstratiadis A. It has a molecular weight of approximately 7.5 kilodaltons (Kd). Most circulating IGF is bound to the IGF-binding protein, and more particularly to the IGFBP-3. IGF-I may be measured in blood serum to diagnose abnormal growth-related conditions.
• a therapeutic composition suitable for treatment of CLD according to the present invention contains an IGF-1 and an IGF-1 binding protein such as IGF binding-proteins (IGFBPs). At least six distinct IGF binding-proteins (IGFBPs) have been identified in various tissues and body fluids.
• IGFBPs IGF binding-proteins
• a suitable therapeutic composition according to the present invention contains IGF-1 and IGFBP-3. IGF-1 and IGFBP-3 may be used as a protein complex or separately.
• IGF-I and IGF-I binding proteins such as IGFBP-3 may be purified from natural sources or produced by recombinant means. For instance, purification of IGF-I from human serum is well known in the art (Rinderknecht et al. (1976) Proc. Natl. Acad. Sci. USA 73:2365-2369). Production of IGF-I by recombinant processes is shown in EP 0128733, published in December of 1984. IGFBP-3 may be purified from natural sources using a process such as that shown by Baxter et al. (1986, Biochem. Biophys. Res. Comm. 139:1256-1261).
• IGFBP-3 may be synthesized recombinantly as discussed by Sommer et al., pp. 715-728, Modern Concepts Of Insulin-Like Growth Factors (E. M. Spencer, ed., Elsevier, N.Y., 1991). Recombinant IGFBP-3 binds IGF-I in a 1:1 molar ratio.
• the present invention provides compositions and methods for treating a patient suffering from a Chronic Lung Disease (CLD), in particular, CLD associated with prematurity.
• CLD Chronic Lung Disease
• the present invention may be used to treat a premature infant who is suffering from CLD or complication associated with CLD.
• the present invention may be used to treat infant who is prematurely born by at least 1 week, 2 weeks, 3 weeks, 4 weeks, 1 month, 2 months, or 3 months.
• the present invention may be used to treat extremely premature infant.
• IGF-I or an analog thereof is administered in combination with IGF binding protein capable of binding IGF-I.
• the IGF binding protein capable of binding IGF-I is IGF binding protein 3 (IGFBP-3).
• a composition comprising equimolar amounts of IGF-I and IGF-binding protein may be used.
• the IGF-I and IGF binding protein are complexed prior to administration.
• the complex may be formed by mixing approximately equimolar amounts of IGF-I and IGF binding protein dissolved in physiologically compatible carriers such as normal saline, or phosphate buffered saline solution.
• physiologically compatible carriers such as normal saline, or phosphate buffered saline solution.
• a concentrated solution of recombinant human IGF-I and a concentrated solution of recombinant human IGF binding protein are mixed together for a sufficient time to form an equimolar complex.
• recombinant human IGF-I and recombinant human IGF binding protein are combined to form a complex during purification as described in International Patent Application No. WO 96/40736.
• IGF-I or an analog thereof may be suitably administered to a patient, alone or as part of a pharmaceutical composition, comprising the IGF-I or an analog thereof together with one or more acceptable carriers thereof and optionally other therapeutic ingredients.
• the carrier(s) must be “acceptable” in the sense of being compatible with the other ingredients of the formulation and not deleterious to the recipient thereof.
• compositions of the invention include those suitable for oral, nasal, topical (including buccal and sublingual), or parenteral (including subcutaneous, intramuscular, intravenous and intradermal) administration.
• the formulations may conveniently be presented in unit dosage form, e.g., tablets and sustained release capsules, and in liposomes, and may be prepared by any methods well known in the art of pharmacy. See, for example, Remington's Pharmaceutical Sciences, Mack Publishing Company, Philadelphia, Pa. (17th ed. 1985).
• Such preparative methods include the step of bringing into association with the molecule to be administered ingredients such as the carrier which constitutes one or more accessory ingredients.
• ingredients such as the carrier which constitutes one or more accessory ingredients.
• the compositions are prepared by uniformly and intimately bringing into association the active ingredients with liquid carriers, liposomes or finely divided solid carriers or both, and then if necessary shaping the product.
• compositions of the present invention suitable for oral administration may be presented as discrete units such as capsules, cachets or tablets each containing a predetermined amount of the active ingredient; as a powder or granules; as a solution or a suspension in an aqueous liquid or a non-aqueous liquid; or as an oil-in-water liquid emulsion or a water-in-oil liquid emulsion, or packed in liposomes and as a bolus, etc.
• a tablet may be made by compression or molding, optionally with one or more accessory ingredients.
• Compressed tablets may be prepared by compressing in a suitable machine the active ingredient in a free-flowing form such as a powder or granules, optionally mixed with a binder, lubricant, inert diluent, preservative, surface-active or dispersing agent.
• Molded tablets may be made by molding in a suitable machine a mixture of the powdered compound moistened with an inert liquid diluent.
• the tablets optionally may be coated or scored and may be formulated so as to provide slow or controlled release of the active ingredient therein.
• compositions suitable for parenteral administration include aqueous and non-aqueous sterile injection solutions which may contain anti-oxidants, buffers, bacteriostats and solutes which render the formulation isotonic with the blood of the intended recipient; and aqueous and non-aqueous sterile suspensions which may include suspending agents and thickening agents.
• the formulations may be presented in unit-dose or multi-dose containers, for example, sealed ampules and vials, and may be stored in a freeze dried (lyophilized) condition requiring only the addition of the sterile liquid carrier, for example water for injections, immediately prior to use.
• Extemporaneous injection solutions and suspensions may be prepared from sterile powders, granules and tablets.
• the inventive methods disclosed herein provide for the parenteral an oral administration of IGF-I, an analog or an agonist thereof, or IGF-I or an analog in combination with IGF binding protein complex to infants in need of such treatment.
• Parenteral administration includes, but is not limited to, intravenous (IV), intramuscular (IM), subcutaneous (SC), intraperitoneal (IP), intranasal, and inhalant routes.
• IGF-I, an agonist or an analog thereof are preferably administered orally.
• IV, IM, SC, and IP administration may be by bolus or infusion, and may also be by slow release implantable device, including, but not limited to pumps, slow release formulations, and mechanical devices.
• the formulation, route and method of administration, and dosage will depend on the disorder to be treated and the medical history of the patient.
• the IGF-I or agonist or analog thereof is administered intravenously.
• a pharmaceutical composition according to the present invention may be administered at various doses.
• a suitable dosage may range from about 100 to 500 micrograms/kg/24 hours.
• a suitable dosage may be or greater than about 100 micrograms/kg/24 hours, 150 micrograms/kg/24 hours, 200 micrograms/kg/24 hours, 250 micrograms/kg/24 hours, 300 micrograms/kg/24 hours, 350 micrograms/kg/24 hours, 400 micrograms/kg/24 hours, 450 micrograms/kg/24 hours, or 500 micrograms/kg/24 hours.
• a pharmaceutical composition according to the invention is administered from the time of birth up to post-menstrual age (PMA) of about 24-34 weeks, up to PMA of about 28 to 32 weeks, up to PMA of about 29 weeks plus 6 days.
• PMA post-menstrual age
• the method provided herein comprises embodiments where the administration of the IGF-I or agonist or analog results in reduced incidence of Chronic Respiratory Morbidity (CRM) through 12 months corrected age (CA).
• CCM Chronic Respiratory Morbidity
• CA 12 months corrected age
• the administration of the IGF-I or agonist or analog results in reduced incidence of Bronchopulmonary dysplasia (BPD) through postmenstrual age (PMA) 36 weeks, 40 weeks, 6 months, 8 months, 10 months, or 12 months.
• the administration of the IGF-I or agonist or analog thereof results in reduced incidence of Severe Intraventricular Hemorrhage (IVH) Grade III or IV through postmenstrual age (PMA) 36 weeks, 40 weeks, 6 months, 8 months, 10 months, or 12 months.
• IVH Severe Intraventricular Hemorrhage
• PMA postmenstrual age
• the administration of the IGF-I or agonist or analog thereof results in reduced incidence of retinopathy of prematurity (ROP) through postmenstrual age (PMA) 36 weeks, 40 weeks, 6 months, 8 months, 10 months, or 12 months.
• ROP retinopathy of prematurity
• PMA postmenstrual age
• the method disclosed herein comprises embodiments where the administration of the IGF-I or agonist or analog results in increased Functional Status as Assessed by PREMature Infant Index (PREMII) through postmenstrual age (PMA) 36 weeks, 40 weeks, 6 months, 8 months, 10 months, or 12 months.
• PREMII PREMature Infant Index
• PMA postmenstrual age
• compositions of the complex may be semi-solid or liquid preparations, such as liquids, suspensions, and the like.
• Physiologically compatible carriers are those that are non-toxic to recipients at the dosages and concentrations employed and are compatible with other ingredients of the formulation.
• the formulation preferably does not include oxidizing agents and other compounds that are known to be deleterious to polypeptides.
• physiologically compatible carriers include, but are not limited to, normal saline, serum albumin, 5% dextrose, plasma preparations, and other protein-containing solutions.
• the carrier may also include detergents or surfactants.
• an IGF-I an agonist or analog thereof in the manufacture of a therapeutic composition for treating a complication of preterm birth.
• an article of manufacture comprising packaging material and a pharmaceutical agent contained within the packaging material.
• the packaging material comprises a label which indicates that the pharmaceutical may be administered, for a sufficient term at an effective dose, for treating and/or preventing complications associated with preterm birth.
• the pharmaceutical agent comprises IGF-I, an agonist or an analog thereof together with a pharmaceutically acceptable carrier.
• rhIGF-1/rhIGFBP-3 insulin like growth factor -1/insulin-like growth factor binding protein-3
• the purpose of this study is to determine if an investigational drug comprising rhIGF-1/rhIGFBP-3 (henceforth, the therapeutic composition) can reduce respiratory complications in extremely premature babies through 12 months corrected age (CA), as compared to extremely premature babies receiving standard neonatal care alone.
• CA corrected age
• Study Subjects The subjects are between gestational age (GA) of 23 weeks+0 days and 27 weeks+6 days. Subjects include both sexes. At least fifty subjects are included in the study.
• the exclusion criteria include detectable gross malformation, known or suspected chromosomal abnormality, genetic disorder or syndrome, according to the investigator's opinion.
• the exclusion criteria also include persistent blood glucose level less than ( ⁇ ) 2.5 millimoles per liter (mmols/L) at the baseline visit to exclude severe congenital abnormalities of glucose metabolism; clinically significant neurological disease according to the investigator's opinion; monozygotic multiples; and any other condition that may pose risk to the subject or interfere with the subject's ability to be compliant with the protocol or interfere with the interpretation of results. If the subject is participating or plans to participate in a clinical study of another investigational study drug, device, or procedure (participation in observational studies is permitted on a case-by-case basis) are excluded. If the subject or subject's parent or legally authorized representative(s) is unable to comply with the protocol or is unlikely to be available for long-term follow-up as determined by the investigator, the subject is also excluded.
• the primary purpose of the study is prevention of Bronchopulmonary Dysplasia and Chronic Lung Disease. It is an open label study, and the intervention model will be Parallel Assignment. The conditions monitored will be BPD and CLD.
• Micrograms/Kg/24 hours of the therapeutic composition is administered to one group of participants (Group A) by intravenous administration (IV) from birth up to postmenstrual age (PMA) 29 weeks+6 days.
• IV intravenous administration
• PMA postmenstrual age
• PMA postmenstrual age
• PMA postmenstrual age
• CRM Chronic Respiratory Morbidity
• CA Months Corrected Age
• CA Time Frame: Baseline through 12 Months Corrected Age
• CRM will be measured by respiratory health care utilization and respiratory symptoms.
• BPD Bronchopulmonary Dysplasia
• PMA Postmenstrual Age
• the secondary outcomes also include
• the drug Mecasermin Rinfabate that is IGF-1/IGFBP3
• the drug Mecasermin Rinfabate was administered as continuous intravenous infusion in subjects from Study Day 0 (day of birth) up to and including PMA 29 weeks+6 days, when the subject's endogenous production of IGF-1 is considered sufficient to maintain physiologic serum IGF-1 levels. After discontinuation of study drug infusion, each subject will be followed to PMA 40 weeks ⁇ 4 days.
• the study was intended to determine the rhIGF-1/rhIGFBP-3 Dose, Administered as a Continuous Infusion (CI), required to establish and maintain longitudinal serum IGF-1 levels within physiological levels in premature infants, to prevent retinopathy of prematurity.
• CI Continuous Infusion

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  • 2020-03-11 PH PH12020500489A patent/PH12020500489A1/en unknown
  • 2020-03-12 ZA ZA2020/01568A patent/ZA202001568B/en unknown
  • 2020-04-07 CO CONC2020/0004244A patent/CO2020004244A2/es unknown
  • 2020-09-08 EC ECSENADI202055797A patent/ECSP20055797A/es unknown
• 2021
  • 2021-05-11 US US17/317,152 patent/US20220088132A1/en active Pending
• 2023
  • 2023-08-01 JP JP2023125304A patent/JP2023145646A/ja active Pending

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