Recombinant or urinary human chorionic gonadotropin in ovulation induction?

Human chorionic gonadotrophin pharmaceutical formulations of urinary origin display high levels of contaminant proteins-A label-free quantitation proteomics study

To determine whether there is a measurable protein background in different formulations of urinary and recombinant human chorionic gonadotropin (hCG). Primary outcome measures: identification of contaminant proteins in urinary‐derived formulations of hCG; secondary outcome measures: quantitative values of contaminant proteins in different batches of urinary –derived hCG formulations. It was found that urinary‐derived batches have high presence of contaminant proteins beside the active substance. The relative amount of contaminant proteins and hCG differs strongly between different batches.

Analytical characterization of recombinant hCG and comparative studies with reference product

INTRODUCTION

Regulatory agencies recommend a stepwise approach for demonstrating biosimilarity between a proposed biosimilar and reference biological product emphasizing for functional and structural characterization to trace if there is any difference which may impact safety and efficacy. We studied the comparative structural and biological attributes of recombinant human chorionic gonadotropin (rhCG), SB005, with reference product, Ovidrel® and Ovitrelle®. Recombiant hCG was approved in 2000 by the US Food and Drug Administration for the induction of final follicular maturation, early luteinization in infertile women as part of assisted reproductive technology program. It is also indicated for the induction of ovulation and pregnancy in ovulatory infertile patients whose cause of infertility is not due to ovarian failure.

MATERIALS AND METHODS

Primary structure was studied by intact mass analysis, peptide fingerprinting, peptide mass fingerprinting and sequence coverage analysis. Higher order structure was studied by circular dichroism, ultraviolet-visible spectroscopy, fluorescence spectroscopy, and disulfide bridge analysis. Different isoforms of reference product and SB005 were identified using capillary isoelectric focusing and capillary zone electrophoresis. Glycosylation was studied by N-glycan mapping using LC-ESI-MS, point of glycosylation, released glycan analysis using ultra performance liquid chromatography and sialic acid analysis. Product related impurities such as oligomer content analysis and oxidized impurities were studied using size exclusion chromatography and reverse phase high performance liquid chromatography, respectively. Biological activity in term of potency of reference product and SB005 was studied by in vivo analysis.

RESULTS AND CONCLUSION

In this study we have compared analytical similarity of recombinant rhCG (SB005) produced at Sun Pharmaceuticals with the reference product with respect to its primary, higher order structure, isoforms, charge variants, glycosylation, sialyation pattern, pharmacodynamic and in vivo efficacy. Our studies show that the in house produced rhCG has a high degree of structural and functional similarity with the reference product available in the market.

Human Chorionic Gonadotropin as a Pivotal Endocrine Immune Regulator Initiating and Preserving Fetal Tolerance

The pregnancy hormone, human chorionic gonadotropin (hCG), is crucially involved in processes such as implantation and placentation, two milestones of pregnancy whose successful progress is a prerequisite for adequate fetal growth. Moreover, hCG determines fetal fate by regulating maternal innate and adaptive immune responses allowing the acceptance of the foreign fetal antigens. As one of the first signals provided by the embryo to its mother, hCG has the potential to regulate very early pregnancy-driven immune responses, allowing the establishment and preservation of fetal tolerance. This mini review focuses on how hCG modulates the adaptive arm of the immune system including dendritic cells as key regulators of adaptive immune responses.

Pharmacokinetics and Safety Profile of DA-3803, a Proposed Biosimilar of Recombinant Human Chorionic Gonadotropin, in Healthy Subjects

BACKGROUND AND OBJECTIVE

DA-3803 is a proposed biosimilar of recombinant human chorionic gonadotropin (r-hCG), which is a therapeutic protein used to treat infertility. We compared the pharmacokinetics and safety profiles of DA-3803 (test) with those of a conventional formulation (Ovidrel(®), reference).

METHODS

A single-blind, randomized, single-dose, two-period, two-sequence, crossover study was conducted in 32 healthy subjects. In each period, 250 μg of r-hCG of the test or reference formulation was administered subcutaneously with a 3-week washout period. Serial blood samples were obtained for pharmacokinetic analysis and blood levels of human chorionic gonadotropin (hCG) were determined. The geometric mean ratios (GMRs) with 90 % confidence intervals (CIs) for the maximum (peak) plasma concentration (C max) and the area under the plasma concentration-time curve (AUC) were estimated.

RESULTS

Among the 32 subjects, 27 completed the study. No serious adverse events were observed. The mean concentration-time profiles of the test formulation tended to be higher than those of the reference formulation. The mean C max values of the two products were similar (142 mIU/mL for reference vs. 143 mIU/mL for test), but the mean AUC from time zero to infinity (AUC∞) values of the test drug were approximately 25 % higher than those of the reference drug (9403 mIU·h/mL for reference vs. 11,817 mIU·h/mL for test). The GMR (90 % CI) of the test formulation to the reference formulation for C max, AUC from time zero to the last measurable time (AUClast), and AUC∞ were 1.03 (0.93-1.14), 1.25 (1.18-1.33), and 1.27 (1.19-1.35), respectively.

CONCLUSION

A single subcutaneous injection of either DA-3803 or Ovidrel(®) was safe and well-tolerated. A comparative pharmacokinetics study showed that DA-3803 was bioequivalent to Ovidrel(®) in the C max value but non-equivalent in the AUC value. These pharmacokinetic differences may not be expected to affect therapeutic efficacy of these two drugs, but further clinical studies are warranted to confirm their therapeutic equivalence.