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Yan S, Zhao X, Xie Q, Du W, Ma Q, Zhu T, Deng H, Qian L, Zheng S, Cui Y. Pharmacokinetic/LDL-C and exposure-response analysis of tafolecimab in Chinese hypercholesterolemia patients: Results from phase I, II, and III studies. Clin Transl Sci 2023; 16:2791-2803. [PMID: 37877498 PMCID: PMC10719486 DOI: 10.1111/cts.13674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 09/23/2023] [Indexed: 10/26/2023] Open
Abstract
Tafolecimab, a novel fully human monoclonal antibody targeting PCSK9, has been assessed in Chinese healthy volunteers and patients with hypercholesterolemia. This analysis is to develop and qualify a population pharmacokinetics (PopPKs)/LDL-C model to characterize tafolecimab PK and LDL-C profiles, evaluate the impact of potential covariates on tafolecimab, estimate individual predicted exposure, and LDL-C decreasing, furthermore, explore exposure-response relationship to support clinical use. Data from six clinical trials in China were used to develop the PopPK/LDL-C model. A Michaelis-Menten approximation of the target-mediated drug disposition (TMDD) model was used to describe PK data and indirect response (IDR) model was developed to estimate the LDL-C profile. A stochastic approximation expectation maximization algorithm was applied to estimate PopPK/LDL-C parameters. The PK/LDL-C time course data for tafolecimab were well described by TMDD/IDR model. Baseline covariates resulting in statistically significant changes in PK/LDL-C parameters included: body weight and sex on absorption rate constant; body weight, sex, and unbound PCSK9 on central volume; body weight and sex on clearance; baseline LDL-C on first-order rate constants for the removal of an effect); and disease and sex on maximum effect. However, the magnitudes of changes associated with these covariates do not necessitate dose adjustment. Exposure-efficacy relationship indicated that the nadir of LDL-C reduction achieved with the steady-state trough plasma concentration (Ctrough ) of tafolecimab at 5 μg/mL, and no further LDL-C decreasing with the increasing Ctrough . There was no exposure dependency observed in exposure-safety exploration. The PopPK/LDL-C model was successfully developed, validated, and predicted tafolecimab/LDL-C concentrations and individual exposures.
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Affiliation(s)
- Shuling Yan
- Innovent Biologics (Suzhou) Co. Ltd.JiangsuChina
| | - Xia Zhao
- Department of PharmacyPeking University First HospitalBeijingChina
- Institute of Clinical PharmacologyPeking UniversityBeijingChina
| | - Qiushi Xie
- Innovent Biologics (Suzhou) Co. Ltd.JiangsuChina
| | - Weijuan Du
- Innovent Biologics (Suzhou) Co. Ltd.JiangsuChina
| | - Qingyang Ma
- Innovent Biologics (Suzhou) Co. Ltd.JiangsuChina
| | - Tongkang Zhu
- Innovent Biologics (Suzhou) Co. Ltd.JiangsuChina
| | - Huan Deng
- Innovent Biologics (Suzhou) Co. Ltd.JiangsuChina
| | - Lei Qian
- Innovent Biologics (Suzhou) Co. Ltd.JiangsuChina
| | - Shirui Zheng
- Innovent Biologics (Suzhou) Co. Ltd.JiangsuChina
| | - Yimin Cui
- Department of PharmacyPeking University First HospitalBeijingChina
- Institute of Clinical PharmacologyPeking UniversityBeijingChina
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Grinshpun B, Thorsteinson N, Pereira JN, Rippmann F, Nannemann D, Sood VD, Fomekong Nanfack Y. Identifying biophysical assays and in silico properties that enrich for slow clearance in clinical-stage therapeutic antibodies. MAbs 2021; 13:1932230. [PMID: 34116620 PMCID: PMC8204999 DOI: 10.1080/19420862.2021.1932230] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Understanding the pharmacokinetic (PK) properties of a drug, such as clearance, is a crucial step for evaluating efficacy. The PK of therapeutic antibodies can be complex and is influenced by interactions with the target, Fc-receptors, anti-drug antibodies, and antibody intrinsic factors. A growing body of literature has linked biophysical properties of antibodies, particularly nonspecific-binding propensity, hydrophobicity and charged regions to rapid clearance in preclinical species and selected human PK studies. A clear understanding of the connection between biophysical properties and their impact on PK would allow for early selection and optimization of antibodies and reduce costly attrition during clinical trials due to sub-optimal human clearance. Due to the difficulty in obtaining large and unbiased human PK data, previous studies have focused mostly on preclinical PK. For this study, we obtained and curated the most comprehensive clinical PK dataset to date and calculated accurate estimates of linear clearance for 64 monoclonal antibodies ranging from investigational candidates in Phase 2 trials to marketed products. This allows for the first time a deep analysis of the influence of biophysical and sequence-based in silico properties directly on human clearance. We use statistical analysis and a Random Forest classifier to identify properties that have the greatest influence in our dataset. Our findings indicate that in vitro poly-specificity assay and in silico estimated isoelectric point can discriminate fast and slow clearing antibodies, extending previous observations on preclinical clearance. This provides a simple yet powerful approach to select antibodies with desirable PK during early-stage screening.
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Affiliation(s)
- Boris Grinshpun
- Discovery & Development Technologies, Drug Disposition & Design, EMD Serono Research & Development Institute, Inc, Billerica, MA, USA
| | - Nels Thorsteinson
- Department of Scientific Services, Chemical Computing Group ULC, Montreal, Quebec, Canada
| | - Joao Ns Pereira
- Discovery & Development Technologies, Drug Disposition & Design, Merck Healthcare KGaA, Darmstadt, Germany
| | - Friedrich Rippmann
- Discovery & Development Technologies, Drug Disposition & Design, Merck Healthcare KGaA, Darmstadt, Germany
| | - David Nannemann
- Discovery & Development Technologies, Drug Disposition & Design, EMD Serono Research & Development Institute, Inc, Billerica, MA, USA
| | - Vanita D Sood
- Discovery & Development Technologies, Drug Disposition & Design, EMD Serono Research & Development Institute, Inc, Billerica, MA, USA
| | - Yves Fomekong Nanfack
- Discovery & Development Technologies, Drug Disposition & Design, EMD Serono Research & Development Institute, Inc, Billerica, MA, USA
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Liu C, Lu H, Yuan F, Chen WL, Xu HR, Li H, Hsu CP, Egbuna O, Wu J, Dias C, Abosaleem B, Rana J, Monsalvo ML, Li XN, Yu Z. A Phase 1, Randomized, Double-Blind, Single-Dose, Placebo-Controlled Safety, Tolerability, And Pharmacokinetic/Pharmacodynamic Study Of Evolocumab In Healthy Chinese Subjects. Clin Pharmacol 2019; 11:145-153. [PMID: 31695519 PMCID: PMC6816231 DOI: 10.2147/cpaa.s208033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 09/04/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose Evolocumab is a human monoclonal antibody that reduces circulating low-density lipoprotein cholesterol (LDL-C) by inhibiting proprotein convertase subtilisin/kexin type 9 (PCSK9). Data on evolocumab pharmacokinetics and pharmacodynamics are derived mostly from Caucasian populations. The objectives of this study were to characterize the single-dose pharmacokinetic and pharmacodynamic parameters, safety, and tolerability of evolocumab in healthy Chinese subjects. Subjects and methods This was a phase 1, randomized, double-blind, placebo-controlled study (CTR20150465). Two parallel cohorts were randomized 5:1 to receive single subcutaneous injections of either evolocumab (140 mg or 420 mg) or placebo. Pharmacokinetics, pharmacodynamics, and safety were evaluated through day 85. The primary endpoints were maximum concentration (Cmax) and area under the drug concentration-time curve from time 0 to time of last quantifiable concentration (AUClast). Results Thirty-six men (median age 26) were enrolled to receive evolocumab 140 mg (n=15), evolocumab 420 mg (n=15), or placebo (n=6). After 140 mg and 420 mg evolocumab, mean (SD) Cmax was 13.8 (3.6 μg/mL and 67.6 (15.2) μg/mL, respectively, and mean (SD) AUClast was 166 (55) day·μg/mL and 1110 (274) day·μg/mL, respectively. LDL-C declined reversibly, with reductions of 70% at 140 mg and 71% at 420 mg. Maximum effects on LDL-C and PCSK9 levels were reached by day 15 and 24 hrs, respectively, at 140 mg, and by day 22 and 4 hrs, respectively, at 420 mg. No serious adverse events occurred and the overall incidence of treatment-emergent adverse events was similar for evolocumab and placebo: 26.7% (140 mg) and 33.3% (placebo); 66.7% (420 mg) and 66.7% (placebo). Conclusion In this population of healthy Chinese subjects, single 140 mg and 420 mg doses of evolocumab exhibited nonlinear kinetics and more than dose-proportional increases in exposure, were associated with up to 71% reduction in LDL-C, and demonstrated a safety profile similar to placebo.
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Affiliation(s)
- Chao Liu
- Department of Clinical Pharmacology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Hong Lu
- Clinical Pharmacology and Early Development, Amgen China R & D Center, Shanghai, People's Republic of China
| | - Fei Yuan
- Department of Clinical Pharmacology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Wei-Li Chen
- Department of Clinical Pharmacology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Hong-Rong Xu
- Department of Clinical Pharmacology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Hui Li
- Department of Clinical Pharmacology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Cheng-Pang Hsu
- Research & Development, Amgen Inc., Thousand Oaks, CA, USA
| | - Ogo Egbuna
- Research & Development, Amgen Inc., Thousand Oaks, CA, USA
| | - Jihua Wu
- Clinical Pharmacology and Early Development, Amgen China R & D Center, Shanghai, People's Republic of China
| | - Clapton Dias
- Research & Development, Amgen Inc., Thousand Oaks, CA, USA
| | | | - Jitesh Rana
- Research & Development, Amgen Inc., Thousand Oaks, CA, USA
| | | | - Xue-Ning Li
- Department of Clinical Pharmacology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Zhigang Yu
- Clinical Development, Amgen China R & D Center, Shanghai, People's Republic of China
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