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Trial · Interventional

CompletedPhase 3Results postedRegistry data

Setmelanotide in Pediatric Participants With Rare Genetic Diseases of Obesity

Overview

Status
Completed
Phase
Phase 3
Enrollment
12 participants (actual)
Sponsor
Rhythm Pharmaceuticals, Inc. · Industry
Design
Randomized · Open label (no masking)
Countries
4 countries

United States, Australia, Spain, United Kingdom

Start
8 Mar 2022
Primary completion
18 Sept 2023
Completion
8 Nov 2024
First posted
19 Jul 2021
Last update posted
27 Nov 2024
Conditions
Bardet-Biedl Syndrome · POMC Deficiency Obesity · PCSK1 Deficiency Obesity · LEPR Deficiency Obesity

Timeline

1 trial · 1 completed · 1 with posted results

  • Completed
  • Ongoing
  • Not yet recruiting
  • Stopped
  • Estimated dates (est.)
  • Results posted
2022202320242025
  1. Ph 3

    Setmelanotide in Pediatric Participants With Rare Genetic Diseases of Obesity

    NCT04966741

    8 Mar 2022 to 8 Nov 2024

Registry summary

Text and fields below are the sponsor's entries at ClinicalTrials.gov, shown as posted.

This is a phase 3 open-label, clinical study to evaluate the efficacy, safety and tolerability of setmelanotide over 1 year of treatment, in pediatric participants aged 2 to \<6 years with obesity due to either biallelic variants of the pro-opiomelanocortin (POMC), proprotein convertase subtilisin/kexin type 1 (PCSK1) or leptin receptor (LEPR) genes or Bardet-Biedl Syndrome (BBS).

Interventions

  • SetmelanotideDrug

Arms2

  • Experimental

    Setmelanotide: PPL Group

    Participants with POMC)/PCSK1/LEPR biallelic mutations collectively referred to as PPL received setmelanotide at a dose of 0.5 milligrams (mg) per day (QD) via SC injection for 52 weeks. The dose was escalated by increments of 0.5 mg every 2 weeks, if tolerated, at the dose escalation visits (Weeks 2, 4, and 6) to a maximum dose of 0.5 to 2.0 mg QD with the maximum dose based on body weight. Following the last dose in this study, participants who were considered likely to benefit from continued setmelanotide treatment and who had completed this trial could be eligible to enter an open-label long-term extension (LTE) trial with setmelanotide.

  • Experimental

    Setmelanotide: BBS Group

    Participants with BBS received setmelanotide at a dose of 0.5 mg QD via SC injection for 52 weeks. The dose was escalated by increments of 0.5 mg every 2 weeks, if tolerated, at the dose escalation visits (Weeks 2, 4, and 6) to a maximum dose of 0.5 to 2.0 mg QD with the maximum dose based on body weight. Following the last dose in this study, participants who were considered likely to benefit from continued setmelanotide treatment and who had completed this trial could be eligible to enter an open-label long-term extension (LTE) trial with setmelanotide.

Primary outcomes2

Outcomes the sponsor listed as primary.

  1. Percentage of Participants With Greater Than or Equal to (≥) 0.2 Reduction of BMI Z-Score From Baseline to Week 52

    Time frame · Baseline up to Week 52

    Registry description

    A "responder" was defined as a decrease from baseline to 52 weeks in the participant's BMI z-score of ≥0.2. BMI was calculated using participant's weight and height assessments, using the following formula: BMI = kg/m\^2. The BMI Z-scores were based on the World Health Organization's Child Growth Standards 2007 and indicated the number of standard deviations away from the mean. A Z-score of 0 was equal to the mean of a reference population (i.e., healthy, age and sex-matched individuals). A decrease of BMI Z-score (\< 0) indicated a reduction in BMI from Baseline whereas an increase of BMI-Z score (\> 0) indicated an increase in BMI from Baseline. Baseline was defined as the most recent measurement prior to the first administration of study drug.

  2. Mean Percent Change From Baseline in BMI

    Time frame · Baseline, Week 52

    Registry description

    Mean percent change from baseline to Week 52 in BMI was reported. BMI was calculated using participant's weight and height assessments, using the following formula: BMI = kg/m\^2. Baseline was defined as the most recent measurement prior to the first administration of study drug.

Secondary outcomes(7)
  1. Mean Absolute Change From Baseline in BMI Z-score

    Time frame · Baseline, Week 52

    Registry description

    Mean absolute change from baseline to Week 52 in BMI Z-score was reported. BMI was calculated using participant's weight and height assessments, using the following formula: BMI = kg/m\^2. The BMI Z-scores were based on the World Health Organization's Child Growth Standards 2007 and indicated the number of standard deviations away from the mean. A Z-score of 0 was equal to the mean of a reference population (i.e., healthy, age and sex-matched individuals). A decrease of BMI Z-score (\< 0) indicated a reduction in BMI from Baseline whereas an increase of BMI-Z score (\> 0) indicated an increase in BMI from Baseline. Baseline was defined as the most recent measurement prior to the first administration of study drug.

  2. Mean Change From Baseline in Percent of the 95th Percentile of BMI

    Time frame · Baseline, Week 52

    Registry description

    Mean change from baseline to Week 52 in percent of the 95th percentile of BMI was reported. BMI was calculated using participant's weight and height assessments, using the following formula: BMI = kg/m\^2. BMI Percentile-scores are measures of relative weight adjusted for child age and gender. The percent of the BMI 95th percentile score expresses the participant's BMI as a percentage of the Centers for Disease Control (CDC) 95th percentile reference population. Baseline was defined as the most recent measurement prior to the first administration of study drug.

  3. Mean Change From Baseline in Bone Age

    Time frame · Baseline, Week 52

    Registry description

    Mean change from baseline to Week 52 in bone age was reported. A standard bone age measurement (of the hand/wrist area) was obtained at the beginning and the end of the trial to monitor for growth related safety concerns. Baseline was defined as the most recent measurement prior to the first administration of study drug.

  4. Number of Participants With Shift From Baseline in Ages & Stages Questionnaires, Third Edition (ASQ-3)

    Time frame · From Baseline to Week 52

    Registry description

    ASQ-3: developmental screening questionnaire that consists of 5 areas: communication, gross motor, fine motor, problem solving, and personal-social. Each area has 6 questions scored as Yes=10 points, Sometimes=5 points, and Not yet=0 points. A child can score between 0-60 points for each area with total score range: 0 to 300; higher scores are indicative of improvement. Total area score is then compared to age-adjusted standardized score cutoff (determined by developers of tool) which indicate whether child's development appears to be on schedule according to these categories: Below=Total analysis score (TAS) is below cutoff. Further assessment with professional may be needed; Monitor=TAS is close to cutoff. Provide learning activities and monitor; Above= TAS is above cutoff, and child's development appears to be on schedule. Shift from baseline for each developmental area of assessment according to these 3 outcome categories was reported. Total score was not applicable.

  5. Change From Baseline in Body Weight

    Time frame · Baseline, Week 52

    Registry description

    Change from baseline to Week 52 in body weight was reported.

  6. Number of Participants With Treatment-emergent Adverse Events (TEAEs)

    Time frame · From first dose of study drug up to Week 56

    Registry description

    An adverse event (AE) was any untoward medical occurrence in a clinical study participant, temporally associated with the use of a study intervention, whether or not considered related to the study intervention. A TEAE was defined as any AE that started or worsened in intensity on or after the date of the first administration of study drug.

  7. Number of Participants With TEAEs Graded by Severity

    Time frame · From first dose of study drug up to Week 56

    Registry description

    A TEAE was any untoward medical occurrence in a clinical study participant, temporally associated with the use of a study intervention, whether or not considered related to the study intervention. A TEAE was defined as any AE that started or worsened in intensity on or after the date of the first administration of study drug. TEAEs were graded according to Common Terminology Criteria for Adverse Events (CTCAE) criteria. Grade 1- Mild; Grade 2- Moderate; Grade 3- Severe; Grade 4- Life Threatening; Grade 5- Death related to AE.

Posted results

Values are shown as posted at ClinicalTrials.gov, with their units. PepBank has not converted, pooled or compared them.

Primary outcome results

Primary outcomeNumber· Baseline up to Week 52

Percentage of Participants With Greater Than or Equal to (≥) 0.2 Reduction of BMI Z-Score From Baseline to Week 52

GroupValue (percentage of participants)
Setmelanotide: PPL Group85.7
Setmelanotide: BBS Group80.0
Primary outcomeMean· Baseline, Week 52

Mean Percent Change From Baseline in BMI

GroupValue (percent change)Spread
Setmelanotide: PPL Group-25.59711.4911
Setmelanotide: BBS Group-9.7198.8383
Secondary and other outcome results(6)
Secondary outcomeMean· Baseline, Week 52

Mean Absolute Change From Baseline in BMI Z-score

GroupValue (Z-score)Spread
Setmelanotide: PPL Group-5.1851.8585
Setmelanotide: BBS Group-1.3311.2295
Secondary outcomeMean· Baseline, Week 52

Mean Change From Baseline in Percent of the 95th Percentile of BMI

GroupValue (percentage relative to 95th percentile)Spread
Setmelanotide: PPL Group-47.59517.3280
Setmelanotide: BBS Group-14.46213.8571
Secondary outcomeMean· Baseline, Week 52

Mean Change From Baseline in Bone Age

GroupValue (years)Spread
Setmelanotide: PPL Group1.0201.0733
Setmelanotide: BBS Group0.7000.8367
Secondary outcomeCount of participants· From Baseline to Week 52

Number of Participants With Shift From Baseline in Ages & Stages Questionnaires, Third Edition (ASQ-3)

GroupValue (Participants)
Setmelanotide: PPL Group5
Setmelanotide: BBS Group2
Secondary outcomeMean· Baseline, Week 52

Change From Baseline in Body Weight

GroupValue (kilograms)Spread
Setmelanotide: PPL Group-7.1395.0834
Setmelanotide: BBS Group-0.3272.9572
Secondary outcomeCount of participants· From first dose of study drug up to Week 56

Number of Participants With Treatment-emergent Adverse Events (TEAEs)

GroupValue (Participants)
Setmelanotide: PPL Group7
Setmelanotide: BBS Group5

Adverse events, as posted

Adverse events as posted: participants affected out of participants at risk, by group
GroupDeathsSerious eventsOther events
Setmelanotide: PPL GroupParticipants with POMC/PCSK1/LEPR biallelic mutations collectively referred as PPL received setmelanotide at a dose of 0.5 mg QD via SC injection for 52 weeks. The dose was escalated by increments of 0.5 mg every 2 weeks, if tolerated, at the dose escalation visits (Weeks 2, 4, and 6) to a maximum dose of 0.5 to 2.0 mg QD with the maximum dose based on body weight. Following the last dose in this study, participants who were considered likely to benefit from continued setmelanotide treatment and who had completed this trial could be eligible to enter an open-label long-term extension (LTE) trial with setmelanotide.0 / 70 / 77 / 7
Setmelanotide: BBS GroupParticipants with BBS received setmelanotide at a dose of 0.5 mg QD via SC injection for 52 weeks. The dose was escalated by increments of 0.5 mg every 2 weeks, if tolerated, at the dose escalation visits (Weeks 2, 4, and 6) to a maximum dose of 0.5 to 2.0 mg QD with the maximum dose based on body weight. Following the last dose in this study, participants who were considered likely to benefit from continued setmelanotide treatment and who had completed this trial could be eligible to enter an open-label LTE trial with setmelanotide.0 / 50 / 55 / 5

Each cell reads participants affected / participants at risk, as the registry posted them.

Registry data comes from ClinicalTrials.gov. Study results come from studies, not from the registry. How PepBank works

Studies1

Studies that cite this trial.

Studies with results

1 study on this page

Indexing hint: Clinical trial · 2025

16 results

Setmelanotide in patients aged 2-5 years with rare MC4R pathway-associated obesity (VENTURE): a 1 year, open-label, multicenter, phase 3 trial.

Argente et al. 2025The lancet. Diabetes & endocrinologycited by 33

PMID 39549719DOI 10.1016/s2213-8587(24)00273-0PUB-39549719

Full text at the publisher16 results

Eligibility

Who could join, as posted.

Sex
All
Age
from 2 Years up to 5 Years
Healthy volunteers
Not accepted
Inclusion and exclusion criteria, as posted
Key Inclusion Criteria: 1. Participants must have obesity due to either: 1. POMC, PCSK1, or LEPR deficiency, confirmed by genetic testing demonstrating biallelic variants that are interpreted as pathogenic, likely pathogenic, or of undetermined significance (VUS) by the American College of Medical Genetics and Genomics criteria (ACMG), or 2. BBS confirmed clinical and genetic diagnosis 2. Age between 2 to \<6 years at the time of informed consent 3. Obesity, defined as body mass index (BMI) ≥97th percentile for age and gender and body weight of at least 15 kilograms (kg) at the time of enrollment. 4. Symptoms or behaviors of hyperphagia 5. Parent or guardian of study participant is able to understand and comply with the requirements of the study (including QD injection regimen and all other study procedures) and is able to understand and sign the written consent/assent. Key Exclusion Criteria 1. Glycated hemoglobin (HbA1c) \>9.0% at screening 2. History of significant liver disease 3. Glomerular filtration rate (GFR) \<60 milliliter per minute per 1.73 meter square (mL/min/1.73 m\^2) 4. History or close family history of melanoma, or participant history of oculocutaneous albinism. 5. Significant dermatologic findings relating to melanoma or pre-melanoma skin lesions (excluding non-invasive basal or squamous cell lesion) 6. Participation in any clinical study with an investigational drug/device within 3 months prior to the first day of dosing. 7. Previously enrolled in a clinical study involving setmelanotide or any previous exposure to setmelanotide. 8. Significant hypersensitivity to any excipient in the study drug. 9. Inadequate hepatic function 10. Any other uncontrolled endocrine, metabolic or medical condition(s) known to impact body weight Other protocol defined Inclusion/Exclusion criteria may apply.

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