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Understanding Inter-Individual Variability in Monoclonal Antibody Disposition. Antibodies (Basel) 2019; 8:antib8040056. [PMID: 31817205 PMCID: PMC6963779 DOI: 10.3390/antib8040056] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 11/22/2019] [Accepted: 11/27/2019] [Indexed: 12/29/2022] Open
Abstract
Monoclonal antibodies (mAbs) are currently the largest and most dominant class of therapeutic proteins. Inter-individual variability has been observed for several mAbs; however, an understanding of the underlying mechanisms and factors contributing to inter-subject differences in mAb disposition is still lacking. In this review, we analyze the mechanisms of antibody disposition and the putative mechanistic determinants of inter-individual variability. Results from in vitro, preclinical, and clinical studies were reviewed evaluate the role of the neonatal Fc receptor and Fc gamma receptors (expression and polymorphism), target properties (expression, shedding, turnover, internalization, heterogeneity, polymorphism), and the influence of anti-drug antibodies. Particular attention is given to the influence of co-administered drugs and disease, and to the physiological relevance of covariates identified by population pharmacokinetic modeling, as determinants of variability in mAb pharmacokinetics.
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Moriya Y, Kogame A, Tagawa Y, Morohashi A, Kondo T, Asahi S, Benet LZ. The Enhancement of Subcutaneous First-Pass Metabolism Causes Nonlinear Pharmacokinetics of TAK-448 after a Single Subcutaneous Administration to Rats. Drug Metab Dispos 2019; 47:1004-1012. [PMID: 31201213 DOI: 10.1124/dmd.119.087148] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 06/03/2019] [Indexed: 11/22/2022] Open
Abstract
2-(N-acetyl-D-tyrosyl-trans-4-hydroxy-L-prolyl-L-asparaginyl-L-threonyl-L-phenylalanyl) hydrazinocarbonyl-L-leucyl-Nω-methyl-L-arginyl-L-tryptophanamide monoacetate (TAK-448, RVT-602), a kisspeptin analog, has been developed as a therapeutic agent for prostate cancer. The purpose of the present study is to clarify the mechanism of the less than dose-proportional nonlinear pharmacokinetics of TAK-448 after subcutaneous administration to rats. The plasma pharmacokinetics of TAK-448 and radiolabeled TAK-448 ([14C]TAK-448) were examined after subcutaneous and intravenous administrations to rats. [14C]TAK-448 was also subcutaneously injected together with protease inhibitors. The effects of the protease inhibitors on the in vitro metabolism of [14C]TAK-448 were investigated using rat skin homogenates. In a dose-ascending study, less than dose-proportional nonlinear pharmacokinetics were observed after subcutaneous administration with limited absorption of TAK-448 at the highest dose level contrary to the linear pharmacokinetics following intravenous dosing, indicating enhancement of subcutaneous metabolism with dose escalation. The systemic absorption of unchanged TAK-448 recovered when protease inhibitors were subcutaneously coadministered, suggested the involvement of subcutaneous proteases in the first-pass metabolism. An in vitro metabolism study suggests that serine protease could be responsible for the subcutaneous metabolism of TAK-448. Dose-dependent enhancement of first-pass metabolism appears to contribute to the less than dose-proportional nonlinear pharmacokinetics of TAK-448 after subcutaneous administrations to rats.
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Affiliation(s)
- Yuu Moriya
- Drug Metabolism and Pharmacokinetics Research Laboratories, Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, Kanagawa, Japan (Y.M., A.K., Y.T., A.M., S.A.); Analytical Development, Pharmaceutical Sciences, Takeda Pharmaceutical Company Limited, Osaka, Japan (T.K.); and University of California San Francisco, Department of Bioengineering and Therapeutic Sciences, Schools of Pharmacy and Medicine, San Francisco, California (L.Z.B.)
| | - Akifumi Kogame
- Drug Metabolism and Pharmacokinetics Research Laboratories, Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, Kanagawa, Japan (Y.M., A.K., Y.T., A.M., S.A.); Analytical Development, Pharmaceutical Sciences, Takeda Pharmaceutical Company Limited, Osaka, Japan (T.K.); and University of California San Francisco, Department of Bioengineering and Therapeutic Sciences, Schools of Pharmacy and Medicine, San Francisco, California (L.Z.B.)
| | - Yoshihiko Tagawa
- Drug Metabolism and Pharmacokinetics Research Laboratories, Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, Kanagawa, Japan (Y.M., A.K., Y.T., A.M., S.A.); Analytical Development, Pharmaceutical Sciences, Takeda Pharmaceutical Company Limited, Osaka, Japan (T.K.); and University of California San Francisco, Department of Bioengineering and Therapeutic Sciences, Schools of Pharmacy and Medicine, San Francisco, California (L.Z.B.)
| | - Akio Morohashi
- Drug Metabolism and Pharmacokinetics Research Laboratories, Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, Kanagawa, Japan (Y.M., A.K., Y.T., A.M., S.A.); Analytical Development, Pharmaceutical Sciences, Takeda Pharmaceutical Company Limited, Osaka, Japan (T.K.); and University of California San Francisco, Department of Bioengineering and Therapeutic Sciences, Schools of Pharmacy and Medicine, San Francisco, California (L.Z.B.)
| | - Takahiro Kondo
- Drug Metabolism and Pharmacokinetics Research Laboratories, Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, Kanagawa, Japan (Y.M., A.K., Y.T., A.M., S.A.); Analytical Development, Pharmaceutical Sciences, Takeda Pharmaceutical Company Limited, Osaka, Japan (T.K.); and University of California San Francisco, Department of Bioengineering and Therapeutic Sciences, Schools of Pharmacy and Medicine, San Francisco, California (L.Z.B.)
| | - Satoru Asahi
- Drug Metabolism and Pharmacokinetics Research Laboratories, Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, Kanagawa, Japan (Y.M., A.K., Y.T., A.M., S.A.); Analytical Development, Pharmaceutical Sciences, Takeda Pharmaceutical Company Limited, Osaka, Japan (T.K.); and University of California San Francisco, Department of Bioengineering and Therapeutic Sciences, Schools of Pharmacy and Medicine, San Francisco, California (L.Z.B.)
| | - Leslie Z Benet
- Drug Metabolism and Pharmacokinetics Research Laboratories, Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, Kanagawa, Japan (Y.M., A.K., Y.T., A.M., S.A.); Analytical Development, Pharmaceutical Sciences, Takeda Pharmaceutical Company Limited, Osaka, Japan (T.K.); and University of California San Francisco, Department of Bioengineering and Therapeutic Sciences, Schools of Pharmacy and Medicine, San Francisco, California (L.Z.B.)
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Wu Z, Chui CK, Hong GS, Khoo E, Chang S. Glucose-insulin regulation model with subcutaneous insulin injection and evaluation using diabetic inpatients data. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2013; 111:347-356. [PMID: 23756090 DOI: 10.1016/j.cmpb.2013.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Revised: 05/02/2013] [Accepted: 05/02/2013] [Indexed: 06/02/2023]
Abstract
Closed-loop insulin delivery systems often implement glucose measurement and insulin administration in the subcutis. However some existing models for glucose-insulin system ignored the dynamics of subcutaneous glucose and subcutaneously-injected insulin. This paper reports a two-compartment model that includes glucose and insulin dynamics in subcutis, and its evaluation using patient data. Clinical information such as glucose level, insulin dosage, insulin injection time and meals of anonymous diabetes inpatients was collected. Measured glucose level of the diabetic inpatients agrees with that of computer simulation. Due to the lack of glucose-insulin model with subcutaneously-injected insulin for type 2 diabetic patients, our model was compared with existing model for type 1 subjects. The new glucose-insulin model can mimic dynamics of glucose and insulin under the disturbance of insulin injections and meals. Model parameters were estimated using nonlinear least square method and their effect on pathology and physiology of diabetes were analyzed.
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Affiliation(s)
- Zimei Wu
- EA 04-06, Control and Mechatronics Lab 1, Department of Mechanical Engineering, 9 Engineering Drive 1, National University of Singapore, Singapore 117576, Singapore.
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Søeborg T, Rasmussen CH, Mosekilde E, Colding-Jørgensen M. Bioavailability and variability of biphasic insulin mixtures. Eur J Pharm Sci 2011; 46:198-208. [PMID: 21703346 DOI: 10.1016/j.ejps.2011.06.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Accepted: 06/07/2011] [Indexed: 11/30/2022]
Abstract
Absorption of subcutaneously administered insulin is associated with considerable variability. Some of this variability was quantitatively explained for both soluble insulin and insulin suspensions in a recent contribution to this journal (Søeborg et al., 2009). In the present article, the absorption kinetics for mixtures of insulins is described. This requires that the bioavailability of the different insulins is considered. A short review of insulin bioavailability and a description of the subcutaneous depot thus precede the presentation of possible mechanisms associated with subcutaneous insulin degradation. Soluble insulins are assumed to be degraded enzymatically in the subcutaneous tissue. Suspended insulin crystals form condensed heaps that are assumed to be degraded from their surface by invading macrophages. It is demonstrated how the shape of the heaps affects the absorption kinetics. Variations in heap formation thus explain some of the additional variability associated with suspended insulins (e.g. NPH insulins) compared to soluble insulins. The heap model also describes how increasing concentrations of suspended insulins lead to decreasing bioavailability and lower values of Cmax. Together, the findings constitute a comprehensive, quantitative description of insulin absorption after subcutaneous administration. The model considers different concentrations and doses of soluble insulin, including rapid acting insulin analogues, insulin suspensions and biphasic insulin mixtures. The results can be used in both the development of novel insulin products and in the planning of the treatment of insulin dependent diabetic patients.
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Affiliation(s)
- Tue Søeborg
- Novo Nordisk A/S, Novo Allé, DK-2880 Bagsværd, Denmark
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Takeyama M, Ishida T, Kokubu N, Komada F, Iwakawa S, Okumura K, Hori R. Enhanced bioavailability of subcutaneously injected insulin by pretreatment with ointment containing protease inhibitors. Pharm Res 1991; 8:60-4. [PMID: 1901649 DOI: 10.1023/a:1015878222769] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The present study was undertaken to develop an ointment preparation containing a protease inhibitor for stabilizing subcutaneously injected insulin. The ointment containing the protease inhibitor, gabexate mesilate or nafamostat mesilate, was applied to the skin around the insulin injection site. Three results were obtained. First, gabexate and nafamostat inhibited insulin degradation in subcutaneous tissue homogenates in vitro. Second, after application of gabexate or nafamostat ointment, an appreciable amount of gabexate or nafamostat appeared in the subcutaneous tissue of rats or hairless mice and their concentrations were comparable to those seen in the in vitro experiment. Third, insulin degradation at the subcutaneous injection site in the rat was depressed after pretreatment with gabexate or nafamostat ointment. Pretreatment with gabexate or nafamostat ointment increased the plasma immunoreactive insulin (IRI) levels and the hypoglycermic effect of insulin in healthy volunteers. These results indicate that gabexate or nafamostat ointments stabilize subcutaneously injected insulin.
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Affiliation(s)
- M Takeyama
- Department of Pharmacy, Kagawa Medical School, Japan
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Okumura K, Kiyohara Y, Komada F, Iwakawa S, Hirai M, Fuwa T. Improvement in wound healing by epidermal growth factor (EGF) ointment. I. Effect of nafamostat, gabexate, or gelatin on stabilization and efficacy of EGF. Pharm Res 1990; 7:1289-93. [PMID: 2128896 DOI: 10.1023/a:1015946123697] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The healing effect of human epidermal growth factor (hEGF) on open wounds was studied in rats. No improvement in wound healing was found by topical application of EGF alone to open wound sites. We found an ointment containing EGF and a protease inhibitor, nafamostat mesilate or gabexate mesilate, or gelatin accelerated the healing rate of open wounds. Significant increases in the dry weight of the wound site granulation tissue, uronic acid (as an index of acid mucopolysaccharide) and hydroxyproline (as an index of collagen) were observed by treatment with EGF ointment containing nafamostat compared with the controls. The effects of the protease inhibitor on wound healing were dose dependent. Nafamostat was more efficient than gabexate or gelatin on wound healing. The degradation of 125I-EGF in wound tissue homogenate was significantly decreased in the presence of a protease inhibitor, such as nafamostat or gabexate, or gelatin. These findings indicate that the stabilization of EGF at the wound site is an important factor in permitting the expression of its healing effects and suggest that the ointment containing EGF and a stabilizing agent would be a suitable dosage form for acceleration of wound repair.
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Affiliation(s)
- K Okumura
- Department of Hospital Pharmacy, School of Medicine, Kobe University, Japan
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