COSCIENS Biopharma Inc T.CSCI

Perplexity Ai

[prophetoffactz]

Based on the unexpected results from the DETECT trial, there are a few potential reasons why children who were thought to be growth hormone deficient based on other tests produced growth hormone in response to macimorelin:

1. Higher sensitivity of macimorelin: Macimorelin may be more potent at stimulating growth hormone release compared to the standard tests (arginine and clonidine). This could reveal residual growth hormone production capacity that was not detected by less sensitive tests.
2. False positives from standard tests: The press release suggests that the comparator tests (arginine and clonidine) may have led to a high false positive rate for growth hormone deficiency. This means some children may have been incorrectly classified as GH deficient by these tests.
3. Different mechanism of action: Macimorelin is a ghrelin mimetic, which stimulates GH release through a different pathway than arginine or clonidine. This unique mechanism may activate GH production in children who don't respond to other stimuli.
4. Variability in GH secretion: Growth hormone secretion can be pulsatile and affected by various factors. Macimorelin may have captured GH production at times when other tests did not.
5. Higher GH cutoff for macimorelin: The study found an optimal GH cutoff of 25.59 ng/mL for macimorelin, much higher than the 7-10 ng/mL used for existing tests. This higher threshold may have led to different classifications of GH status.
6. Potential issues with the comparator tests: There may be limitations or inaccuracies in the standard tests that were not previously recognized.
7. Heterogeneity of GH deficiency: Some children may have partial GH deficiency or other subtle abnormalities in the GH axis that respond differently to various stimuli.

These unexpected results highlight the complexity of diagnosing growth hormone deficiency and suggest that macimorelin may provide new insights into GH production in children. Further analysis and research will be needed to fully understand the implications of these findings.