1
|
Li Y, Young Na J, Zhu Y, Oh J, Zhao A, Jang IJ, Tang L. Pharmacokinetics, pharmacodynamics, safety, and tolerability of a single-dose riliprubart, an anti-C1s humanized monoclonal antibody in East-Asian Adults: results from a phase 1, randomized, open-label trial. Expert Opin Investig Drugs 2024. [PMID: 39171350 DOI: 10.1080/13543784.2024.2394186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 08/12/2024] [Accepted: 08/15/2024] [Indexed: 08/23/2024]
Abstract
OBJECTIVES This Phase 1 trial was planned toinvestigate the pharmacokinetics (PK), pharmacodynamics (PD), safety, andtolerability of a single dose of riliprubart in healthy East-Asian adultparticipants. METHODS A single-center, parallel-group,randomized, open-label, single-dose study was performed to evaluate the PK, PD,safety, and tolerability of riliprubart (50 mg/kg intravenous [IV] or 600 mg subcutaneous[SC]) in 37 healthy East-Asian (Chinese, Japanese, and Korean) participants. RESULTS Riliprubart was slowly absorbed after SCadministration (median tmax: 7.01-10.48 days) and showed a longhalf-life after IV or SC administration (mean: 9.52-11.0 weeks), with abioavailability of 74.6% after SC administration. The PD profiles, which areevaluated by classical complement pathway activity or CH50, were similar andlargely overlapped across East-Asian participants after a single IV or SC dose.Riliprubart was safe and well-tolerated in participants following a single IVor SC dose. CONCLUSIONS Riliprubart was safe and well toleratedand demonstrated favorable PK and PD profiles in healthy East-Asianparticipants following a single IV or SC dose. These results are comparable tofirst-in-human study results from non-East-Asian participants and support thesame dosing regimen of riliprubart for global simultaneous clinicaldevelopment. CLINICALTRIAL REGISTRATION https://cris.nih.go.kr(identifier: KCT0006571).
Collapse
Affiliation(s)
- Yingxin Li
- Translational Medicine and Clinical Pharmacology, Sanofi, Beijing, China
| | - Joo Young Na
- Division of Pharmaceutics and Pharmacology, College of Pharmacy, The Ohio State University, Columbus, OH, USA
| | | | - Jaeseong Oh
- Department of Clinical Pharmacology and Therapeutics, Seoul National University Hospital, Seoul, South Korea
| | | | - In-Jin Jang
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine, Seoul, South Korea
| | | |
Collapse
|
2
|
Kuribayashi R, Goto K, Hariu A, Kishioka Y. Revisions to the requirement of the Japanese clinical study data for biosimilar developments in Japan. Expert Opin Biol Ther 2024; 24:637-645. [PMID: 38970459 DOI: 10.1080/14712598.2024.2377300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 07/03/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND The 'Questions and Answers (Q&A)' document regarding Japanese biosimilar guideline elucidated that Japanese participant enrollment in at least one comparative clinical study was required for the marketing authorization application (MAA) of biosimilars in Japan. RESEARCH DESIGN AND METHODS To discuss the requirement of Japanese clinical study data for biosimilar development, the trend in comparative clinical studies conducted for approved biosimilars of monoclonal antibodies and fusion proteins was analyzed, and the consistency of the results between the overall population and the Japanese population according to the publicly available information was reviewed. RESULTS The number of comparative clinical studies enrolling Japanese participants was 25 cases, and the type and percentage were 13 (52%) and 12 (48%) cases of comparative pharmacokinetic study and comparative efficacy study, respectively. In all comparative clinical studies, consistent results between the overall population and the Japanese population were shown. CONCLUSIONS Our study indicated that Japanese participant enrollment in comparative clinical studies may not always be necessary for biosimilar development when certain conditions are satisfied. This has been described in the revised Q&A document published by the Ministry of Health, Labour and Welfare in January 2024.
Collapse
Affiliation(s)
- Ryosuke Kuribayashi
- Office of Cellular and Tissue-Based Products, Pharmaceuticals and Medical Devices Agency, Chiyoda-ku, Tokyo, Japan
- Office of Regulatory Science Research, Pharmaceuticals and Medical Devices Agency, Chiyoda-ku, Tokyo, Japan
| | - Kanoko Goto
- Office of Cellular and Tissue-Based Products, Pharmaceuticals and Medical Devices Agency, Chiyoda-ku, Tokyo, Japan
| | - Aya Hariu
- Office of Cellular and Tissue-Based Products, Pharmaceuticals and Medical Devices Agency, Chiyoda-ku, Tokyo, Japan
| | - Yasuhiro Kishioka
- Office of Cellular and Tissue-Based Products, Pharmaceuticals and Medical Devices Agency, Chiyoda-ku, Tokyo, Japan
| |
Collapse
|
3
|
Li XN, Xu HR, Cui E, Petersen KB, Ryding J, Ettrup A, Østergaard JB, Larsen F. Pharmacokinetics and Safety of Eptinezumab in Healthy Chinese Participants: A Randomized Clinical Trial. Clin Drug Investig 2023; 43:873-881. [PMID: 37917246 PMCID: PMC10632206 DOI: 10.1007/s40261-023-01315-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND AND OBJECTIVE Most evidence suggests that the pharmacokinetics of monoclonal antibodies (mAbs) are not meaningfully altered by patient characteristics, including racial/ethnic differences. Nevertheless, the pharmacokinetic profile of eptinezumab has not been evaluated in a Chinese population. This study was designed to confirm the hypothesis that the pharmacokinetic profile of the anti-calcitonin gene-related peptide mAb, eptinezumab, is similar in healthy Chinese individuals to that of healthy non-Asian individuals and non-Asian patients with migraine. METHODS Over a study period of 12 weeks, healthy adult Chinese participants (N = 20) were randomized (1:1) to receive a single intravenous dose of eptinezumab 100 mg (n = 10) or 300 mg (n = 10) in a prospective, single-site, open-label parallel-group trial. Blood samples for the evaluation of plasma eptinezumab concentrations were obtained over 84 days, and standard pharmacokinetic parameters were derived. RESULTS Mean maximum plasma concentrations (Cmax) of eptinezumab occurred 1.0-1.5 h post start of infusion, were similar between the 100 mg and 300 mg dose groups, and slowly declined in a biphasic manner. Cmax and area under the drug concentration-time curve (AUC) increased in a dose-proportional manner. Volume of distribution and clearance were similar between the 100 mg and 300 mg dose groups, and half-life was 22.5-28.1 days. Eptinezumab was generally well tolerated with no new safety signals identified. Only one participant, randomized to the 100 mg dose group, was positive for eptinezumab anti-drug antibodies, but negative for neutralizing antibodies, with no impact on pharmacokinetics. CONCLUSION The pharmacokinetic profile of eptinezumab in healthy Chinese individuals was generally similar to that reported for non-Asian populations with migraine, and eptinezumab was generally well tolerated. Evaluation of immunogenicity showed no evidence of an impact of anti-drug antibodies or neutralizing antibodies on safety profiles. This supports the globally approved doses of 100 mg and 300 mg as being appropriate for Chinese patients with episodic migraine or chronic migraine.
Collapse
Affiliation(s)
- Xue-Ning Li
- Department of Clinical Pharmacology, Fudan University, Shanghai, China.
- Department of Clinical Pharmacology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, China.
| | - Hong-Rong Xu
- Department of Clinical Pharmacology, Fudan University, Shanghai, China
| | - Ellen Cui
- Lundbeck (Beijing) Pharmaceuticals Consulting Co., Ltd., Beijing, China
| | | | | | | | | | | |
Collapse
|
4
|
Haranaka M, Tanaka T, Kim S, Bae Y, Jeon D, Choi E, Cha J, Lee S, Ogama Y. Pharmacokinetics and safety of CT-P17 (40 mg/0.4 ml) versus reference adalimumab: randomized study in healthy Japanese adults. Immunotherapy 2023; 15:149-161. [PMID: 36748363 DOI: 10.2217/imt-2022-0181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Aim: Comparing pharmacokinetics and safety of CT-P17 and EU-approved reference adalimumab (EU-adalimumab) in Japan. Materials & methods: Double-blind, parallel-group phase I trial at three hospitals. Healthy Japanese adults were randomized (1:1) to CT-P17 or EU-adalimumab (single 40-mg subcutaneous dose). The primary end point was pharmacokinetic equivalence for area under the concentration-time curve from time zero to infinity and maximum serum concentration. Results: Of the 205 randomized subjects (102 CT-P17, 103 EU-adalimumab), 204 received study drug. CT-P17 and EU-adalimumab were pharmacokinetically equivalent: 90% CIs for geometric least-squares mean ratios were within predefined 80-125% equivalence margins. Secondary pharmacokinetic end points, safety and immunogenicity were similar between the groups. Conclusion: CT-P17 had pharmacokinetics, safety and immunogenicity comparable to EU-adalimumab in healthy Japanese adults.
Collapse
Affiliation(s)
| | | | - SungHyun Kim
- Celltrion, Inc., Incheon, 22014, Republic of Korea
| | - YunJu Bae
- Celltrion, Inc., Incheon, 22014, Republic of Korea
| | - DaBee Jeon
- Celltrion, Inc., Incheon, 22014, Republic of Korea
| | - EunJin Choi
- Celltrion, Inc., Incheon, 22014, Republic of Korea
| | - JungBin Cha
- Celltrion, Inc., Incheon, 22014, Republic of Korea
| | - SangMi Lee
- Celltrion, Inc., Incheon, 22014, Republic of Korea
| | | |
Collapse
|
5
|
Kamal MA, Davis JD, Kovalenko P, Srinivasan K, Simpson EL, Nakahara T, Sugaya M, Igarashi A, Ardeleanu M, Xu C, Arima K. Pharmacokinetics, pharmacodynamics, and exposure-efficacy of dupilumab in adults with atopic dermatitis. Clin Transl Sci 2022; 15:2342-2354. [PMID: 35986664 PMCID: PMC9579381 DOI: 10.1111/cts.13363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 01/25/2023] Open
Abstract
The pharmacokinetics (PKs) and exposure-efficacy of dupilumab have not been fully described for adults with atopic dermatitis (AD). Our objectives were to analyze the PKs and exposure-efficacy of dupilumab in adults with AD and compare the results of Japanese and overall populations. Adults with moderate-to-severe AD were randomly assigned to dupilumab (300 mg weekly [qw] or every 2 weeks [q2w], 200 mg q2w, 300 mg every 4 weeks [q4w], or 100 mg q4w) or placebo for 16 weeks in a randomized, double-blind, placebo-controlled, dose-ranging phase IIb trial (NCT01859988). This analysis included 379 patients (58 Japanese). Functional dupilumab concentrations increased in a dose-dependent manner; at lower concentrations, increases were greater than dose-proportional because of nonlinear, target-mediated clearance. Dupilumab pharmacokinetics were comparable in Japanese and non-Japanese patients with similar body weights. Week 16 efficacy parameters, including Investigator's Global Assessment score 0/1, greater than or equal to 75% reduction from baseline in the Eczema Area and Severity Index (EASI), and percentage change from baseline in EASI and pruritus Numerical Rating Scale, generally increased with week 16 trough concentration; the plateau of these exposure-efficacy relationships occurred for most patients at exposures associated with the 300 mg q2w and 300 mg qw regimens. Japanese ethnicity did not remain in the population PK model as covariate with or without accounting for body weight differences. In Japanese and non-Japanese patients, efficacy responses increased with week 16 dupilumab trough concentrations in a similar manner. Dupilumab 300 mg qw and q2w regimens were recommended for further evaluation in larger phase III studies.
Collapse
Affiliation(s)
| | | | | | | | - Eric L. Simpson
- Department of DermatologyOregon Health & Science UniversityPortlandOregonUSA
| | - Takeshi Nakahara
- Department of DermatologyGraduate School of Medical Sciences, Kyushu UniversityFukuokaJapan
| | - Makoto Sugaya
- Department of DermatologyInternational University of Health and WelfareChibaJapan
| | | | | | | | | |
Collapse
|
6
|
Hirano M, Yamada M, Tanaka T, Koue T, Saito T, Higashimori M, Ochiai H, Yamamoto J, Yaguchi S, Mita S, Hara K. Surveys/Research Exploring Japanese Phase I Studies in Global Drug Development: Are They Necessary Prior to Joining Global Clinical Trials? Clin Pharmacol Drug Dev 2021; 10:1410-1418. [PMID: 34837487 PMCID: PMC9299455 DOI: 10.1002/cpdd.1044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 09/30/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Masaru Hirano
- Translational Medicine Japan, Novartis Institutes for Biomedical Research, Novartis Pharma K.K., Tokyo, Japan
| | - Masanori Yamada
- Clinical Pharmacology Asian Hub, GlaxoSmithKline K.K., Tokyo, Japan
| | - Toshiaki Tanaka
- Clinical Sciences, Research & Development Japan, Bayer Yakuhin Ltd., Tokyo, Japan
| | - Toshiko Koue
- Clinical Sciences, Research & Development Japan, Bayer Yakuhin Ltd., Tokyo, Japan
| | - Tomohisa Saito
- Clinical Pharmacology Department, Chugai Pharmaceutical Co., Ltd., Tokyo, Japan
| | | | - Hisao Ochiai
- Non-Clinical, Chemistry, Manufacturing and Control Development & Translational Medicine, Research & Development Institute, Merck Biopharma Co., Ltd., Tokyo, Japan
| | - Junichi Yamamoto
- Clinical Pharmacology, Strategy & Planning for East Asia Region, UCB Japan Co., Ltd., Tokyo, Japan.,Current address: Clinical Pharmacology, Research & Development, Biogen Japan Ltd., Tokyo, Japan
| | - Saori Yaguchi
- Clinical, Medical, Regulatory Development Division, Novo Nordisk Pharm Ltd., Tokyo, Japan
| | - Sachiko Mita
- Clinical Pharmacology Department, Quantitative Sciences Division, R&D, Janssen Pharmaceutical K.K., Tokyo, Japan
| | - Katsutoshi Hara
- Clinical Pharmacology Asian Hub, GlaxoSmithKline K.K., Tokyo, Japan
| | | |
Collapse
|
7
|
Shemesh CS, Chan P, Shao H, Xu DZ, Combs D, Vadhavkar S, Bruno R, Wu B. Atezolizumab and Bevacizumab in Patients with Unresectable Hepatocellular Carcinoma: Pharmacokinetic and Safety Assessments Based on Hepatic Impairment Status and Geographic Region. Liver Cancer 2021; 10:485-499. [PMID: 34721510 PMCID: PMC8527900 DOI: 10.1159/000515817] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 03/11/2021] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Phase 1b GO30140 and phase 3 IMbrave150 studies evaluated first-line atezolizumab + bevacizumab for unresectable hepatocellular carcinoma (HCC). Here, we evaluated pharmacokinetics (PK) and safety by hepatic impairment status and geographic region. METHODS Patients received atezolizumab 1,200 mg + bevacizumab 15 mg/kg IV every 3 weeks. Drug concentrations were evaluated by descriptive statistics and population PK. PK and adverse event frequencies were evaluated by hepatic impairment status and region. RESULTS 323 IMbrave150 patients and 162 GO30140 patients were PK evaluable. Compared with IMbrave150 patients who had normal hepatic function per the National Cancer Institute Organ Dysfunction Working Group (NCI-ODWG) criteria (n = 123), patients with mild impairment (n = 171) had a geometric mean ratio (GMR) of 0.92 for cycle 1 atezolizumab area under the concentration-time curve (AUC); patients with moderate impairment (n = 27) had a GMR of 0.88. Patients in Asia ([n = 162] vs. outside [n = 161]) had a GMR of 1.25 for cycle 1 atezolizumab AUC. Compared with GO30140 patients who had normal hepatic function (NCI-ODWG [n = 61]), patients with mild impairment (n = 92) had a GMR of 0.97 for cycle 1 peak bevacizumab concentrations; those with moderate impairment (n = 9) had a GMR of 0.94. Patients in Asia (n = 111) versus outside Asia (n = 51) had a GMR of 0.94 for cycle 1 peak bevacizumab concentration. PK results were generally comparable when evaluated based on additional hepatic functional definitions (Child-Pugh or albumin/bilirubin criteria) or study enrollment in Japan. No associations between atezolizumab PK and HCC etiology were seen. Adverse event frequencies were similar across evaluated groups. CONCLUSIONS IMbrave150 and GO30140 patients with unresectable HCC had varying baseline hepatic impairment and high enrollment from Asia. PK data demonstrated considerable exposure overlap across groups. Treatment was tolerable across groups. No need for dose adjustment based on mild or moderate hepatic impairment or region is recommended based on this analysis.
Collapse
Affiliation(s)
- Colby S. Shemesh
- Department of Clinical Pharmacology, Genentech Inc., South San Francisco, California, USA,*Colby S. Shemesh,
| | - Phyllis Chan
- Department of Clinical Pharmacology, Genentech Inc., South San Francisco, California, USA
| | - Hui Shao
- Safety Science, F. Hoffmann-La Roche Ltd., Beijing, China
| | - Derek-Zhen Xu
- Product Development Oncology, F. Hoffmann-La Roche Ltd., Shanghai, China
| | - Daniel Combs
- Department of Clinical Pharmacology, Genentech Inc., South San Francisco, California, USA
| | - Shweta Vadhavkar
- Department of Clinical Pharmacology, Genentech Inc., South San Francisco, California, USA
| | - René Bruno
- Clinical Pharmacology, Genentech-Roche, Marseille, France
| | - Benjamin Wu
- Department of Clinical Pharmacology, Genentech Inc., South San Francisco, California, USA
| |
Collapse
|
8
|
Ide T, Roy A, Imai Y, Vezina HE. Model-Based Determination of Elotuzumab Pharmacokinetics in Japanese Patients With Multiple Myeloma Incorporating Time-Varying M Protein. J Clin Pharmacol 2020; 61:64-73. [PMID: 32656777 DOI: 10.1002/jcph.1698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/21/2020] [Indexed: 11/11/2022]
Abstract
A population pharmacokinetic model was developed to evaluate the effects of Japanese ethnicity, prior line of therapy (0 or ≥1), time-varying M protein, and maintenance dosing regimens (10 mg/kg intravenously every 2 weeks or 20 mg/kg intravenously every 4 weeks beginning in cycle 19) on the pharmacokinetics of elotuzumab in patients with multiple myeloma treated with elotuzumab plus lenalidomide/dexamethasone. Elotuzumab pharmacokinetics were characterized by a 2-compartment model with parallel linear (nonspecific) and Michaelis-Menten elimination from the central compartment and target-mediated elimination from the peripheral compartment. Asian race on nonspecific clearance (CL) and central volume of distribution, prior line of therapy on CL, and maximum target-mediated elimination rate (Vmax ) were statistically significant but not considered clinically relevant (magnitude < 20%). Time-varying M protein on Vmax was statistically significant, and the magnitude was >20%; however, clinical implications in the setting of combination therapy were not expected. Model-predicted steady-state elotuzumab exposure in cycle 12 were similar in Japanese and non-Japanese patients and in Japanese patients with 0 and ≥1 prior lines of therapy. Elotuzumab 20 mg/kg intravenously every 4 weeks beginning in cycle 19 produced time-averaged concentrations similar to elotuzumab 10 mg/kg intravenously every 2 weeks, although maximum and minimum concentrations after elotuzumab 20 mg/kg intravenous every-4-week dosing were slightly higher and lower, respectively. In conclusion, the current analysis demonstrates that Japanese ethnicity, prior line of therapy, time-varying M protein, and change in elotuzumab dosing regimen in cycle 19 have no clinically meaningful impact on elotuzumab pharmacokinetics and exposure in Japanese patients with multiple myeloma.
Collapse
Affiliation(s)
| | - Amit Roy
- Bristol-Myers Squibb, Tokyo, Japan
| | | | | |
Collapse
|
9
|
Okamoto H, Dirks NL, Rosario M, Hori T, Hibi T. Population pharmacokinetics of vedolizumab in Asian and non-Asian patients with ulcerative colitis and Crohn's disease. Intest Res 2020; 19:95-105. [PMID: 32635680 PMCID: PMC7873400 DOI: 10.5217/ir.2019.09167] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 03/17/2020] [Indexed: 12/25/2022] Open
Abstract
Background/Aims Vedolizumab is indicated for moderately-to-severely active ulcerative colitis (UC) and Crohn’s disease (CD). Because multiple factors may result in different pharmacokinetics and clinical efficacies, understanding determinants of vedolizumab clearance may enhance dose and treatment strategies. The aim was to characterize vedolizumab pharmacokinetics in Asian and non-Asian UC and CD patients. Methods Population pharmacokinetic analysis for repeated measures, using data from 5 studies, was conducted using nonlinear mixed-effects modeling. A Bayesian estimation approach in NONMEM 7.3 was utilized to leverage the predominantly sparse data available for this analysis with results from a prior population pharmacokinetic analysis of vedolizumab. Results Vedolizumab pharmacokinetics were described by a 2-compartment model with parallel linear and nonlinear elimination. Using reference covariate values, linear elimination half life of vedolizumab was 24.7 days for anti-vedolizumab antibody (AVA)-negative patients and 18.1 days for AVA-positive patients; linear clearance (CLL) was 0.165 L/day for AVA-negative patients and 0.246 L/day for AVA-positive patients; central (Vc) and peripheral compartment volumes of distribution were 3.16 L and 1.84 L, respectively. Interindividual variabilities (percent coefficient of variation) were 30.8% for CLL and 19% for Vc; interoccasion variability on CLL was 20.3%; residual variance was 17.8%. For albumin, body weight and AVA, only extreme values were identified as potentially clinically important predictors of CLL. The effect of race (Asian/non-Asian) and diagnosis (UC/CD) on CLL was negligible and likely not of clinical importance. Conclusions Pharmacokinetic parameters were similar in Asian and non-Asian patients with moderately-to-severely active UC and CD. This analysis supports use of vedolizumab flat-fixed dosing in these patients. (Clinicaltrials.gov Identifiers: NCT00783718 (GEMINI 1); NCT00783692 (GEMINI 2). CCT 101; NCT02039505 and CCT-001; NCT02038920)
Collapse
Affiliation(s)
| | | | - Maria Rosario
- Takeda Development Center Americas Inc, Cambridge, MA, USA
| | | | - Toshifumi Hibi
- Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| |
Collapse
|
10
|
New paradigm for expediting drug development in Asia. Drug Discov Today 2020; 25:491-496. [PMID: 31926136 DOI: 10.1016/j.drudis.2019.12.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 12/20/2019] [Accepted: 12/30/2019] [Indexed: 12/21/2022]
Abstract
Some Asian regulators currently require Phase I data in Asians before joining global Phase II/III trials. Here, we discuss inherent limitations of Phase I ethnic sensitivity studies (ESS) to identify potential interethnic differences. We review recent new drug applications (NDAs) for Japan and China to critically assess the value of separate ESSs in Asian populations. Given that the observed value of ESS was limited, we propose a new global drug development paradigm: if relevant safety, pharmacokinetic (PK), and pharmacogenetic (PG) data are available from the original Phase I study population, it might be possible to extrapolate those data to Asian populations for their inclusion in Phase II/III trials, without an ESS. This could help to streamline drug development in Asia while still addressing regulatory requirements.
Collapse
|
11
|
Luo D, Baheti G, Tortorici MA, Hofmann J, Rojavin MA. Pharmacometric Analysis of IgPro10 in Japanese and Non-Japanese Patients With Primary Immunodeficiency. Clin Ther 2020; 42:196-209.e5. [PMID: 31910997 DOI: 10.1016/j.clinthera.2019.11.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 11/04/2019] [Accepted: 11/20/2019] [Indexed: 01/11/2023]
Abstract
PURPOSE Immunoglobulin (Ig) G replacement therapy, administered intravenously (IVIG) or subcutaneously (SCIG), is the standard treatment in patients with primary immunodeficiencies (PID). We aimed to characterize the pharmacokinetic (PK) characteristics of serum IgG following administration of IgPro10 every 3 or 4 weeks in Japanese patients with PID, and compare with PK in non-Japanese patients. A previously developed population PK (PPK) model was validated, and predicted parameters were compared with the results from the clinical study. METHODS The previously developed PPK model, containing IgG concentration data from 5 non-Japanese studies, was supplemented with data from 3 Japanese studies of IgPro10 or IgPro20 to compare the IgG PK parameters between Japanese and non-Japanese patients. The model was externally validated by simulating IgG concentration-time profiles in Japanese patients to predict serum IgG PK characteristics and to compare them with observed Japanese PK data from Study IgPro10_3004. FINDINGS The analysis included 4502 serum IgG concentration values (from 34 Japanese and 168 non-Japanese patients). PPK estimates from the current analysis demonstrated a clearance (CL) of 0.139 L/d, central volume (V2) of 4.01 L, inter-compartmental clearance (Q) of 0.30 L/d, and peripheral volume of 3.51 L. These results were consistent with those from the previously published PPK model, with similar bootstrap means and 95% CIs. Goodness-of-fit criteria indicated that the final PPK model was consistent with observed data, with no systemic bias in model prediction. Prediction-corrected visual predictive checks confirmed a good description of data on both SCIG and IVIG. PK parameters were equivalent between Japanese and non-Japanese patients. Body weight was determined to be a significant covariate on both CL and V2. Simulated and observed AUC and maximum and minimum serum IgG concentrations were similar, with 90% CIs overlapping between simulated and observed IgG concentrations in Japanese patients. IMPLICATIONS PK parameter estimates of serum IgG were similar between Japanese and non-Japanese patients with PID. The PPK model, updated with Japanese data, was consistent with the previously published PPK model and could accurately predict both individual and population serum IgG concentration-time profiles following IgPro10 IV infusions every 3 or 4 weeks. EudraCT identifier: 2016-001631-12.
Collapse
Affiliation(s)
- Dandan Luo
- CSL Behring LLC, King of Prussia, PA, USA.
| | | | | | | | | |
Collapse
|
12
|
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.
Collapse
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
| |
Collapse
|
13
|
HURBIN F, LU Q, T. BACCARA-DINET M, TAKAGI Y, SHITARA Y, HORIUCHI S, Thomas DiCIOCCIO A, KOBAYASHI M, BRUNET A. Pharmacokinetics and Pharmacodynamics of Alirocumab, and Effects on PCSK9 and Low-Density Lipoprotein Cholesterol, in Japanese and Non-Japanese Patients. ACTA ACUST UNITED AC 2019. [DOI: 10.3999/jscpt.50.73] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Fabrice HURBIN
- Pharmacokinetics, Dynamics and Metabolism, Sanofi, Montpellier, France
| | - Qiang LU
- Pharmacokinetics, Dynamics and Metabolism, Sanofi, Bridgewater, MA, US
| | | | - Yoshiharu TAKAGI
- Biostatistics, Biostatistics & Programming, Clinical Sciences & Operations, Research & Development, Sanofi K.K., Tokyo, Japan
| | - Yoshihisa SHITARA
- Pharmacokinetics, Dynamics and Metabolism, Sanofi K.K., Tokyo, Japan
| | - Seiko HORIUCHI
- Translational Medical and Clinical Pharmacology, Translational Medicine and Early Development, Sanofi K.K.,Tokyo, Japan
| | | | | | - Aurélie BRUNET
- Pharmacokinetics, Dynamics and Metabolism, Sanofi, Bridgewater, MA, US
| |
Collapse
|
14
|
Ogasawara K, Alexander GC. Use of Population Pharmacokinetic Analyses Among FDA-Approved Biologics. Clin Pharmacol Drug Dev 2019; 8:914-921. [PMID: 30707505 DOI: 10.1002/cpdd.658] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 01/10/2019] [Indexed: 11/09/2022]
Abstract
Biologics, especially monoclonal antibodies, are increasingly important in the pharmaceutical marketplace. Population pharmacokinetic (PK) analyses could be useful to guide the need for dose adjustments among special populations, yet it is unknown how commonly such analyses are performed during biologics development. We summarized the characteristics of population PK models of biologics and examined their role in informing the drug labels. To do so, we extracted relevant characteristics of 86 biologics approved by the U.S. Food and Drug Administration's Center for Drug Evaluation and Research between 2003 and 2017. Ninety-four percent of monoclonal antibodies (51 of 54 biologics), 75% of fusion proteins with Fc receptor (6 of 8 biologics), and 33% of other proteins (8 of 24 biologics) included population PK analyses. Of these analyses, approximately half (45%) used a 2-compartment model with linear clearance as the base model structure. Body size was the most frequently included covariate in the final models (included in 94% of the 64 biologics in which covariate analysis was performed), although age (11%), sex (35%), race (26%), and renal function (27%) were also included in some models. In 70% to 90% of cases in which the effect of these covariates was examined, information regarding the effect of these on PK was included in the label. These results suggest that population PK analyses provide important information about the impact of intrinsic factors on the PK in the label of biologics by the U.S. Food and Drug Administration.
Collapse
Affiliation(s)
- Ken Ogasawara
- Center for Drug Safety and Effectiveness, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - G Caleb Alexander
- Center for Drug Safety and Effectiveness, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Division of General Internal Medicine, Department of Medicine, Johns Hopkins Medicine, Baltimore, MD, USA
| |
Collapse
|
15
|
Wang C, Zheng Q, Zhang M, Lu H. Lack of ethnic differences in the pharmacokinetics and pharmacodynamics of evolocumab between Caucasian and Asian populations. Br J Clin Pharmacol 2018; 85:114-125. [PMID: 30225890 DOI: 10.1111/bcp.13767] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 08/23/2018] [Accepted: 09/12/2018] [Indexed: 12/30/2022] Open
Abstract
AIMS To evaluate the potential ethnic differences in the pharmacokinetics (PK) and pharmacodynamics (PD) of evolocumab in Caucasian and Asian populations using population PK/PD modelling analysis. METHODS Data from different ethnic groups in 5 Phase I clinical trials, including two American studies, one Japanese study and two Chinese studies, were chosen for model building and evaluation. A target-mediated drug disposition model together with an indirect response model best captured evolocumab binding and the removal of unbound proprotein convertase subtilisin/kexin type 9 (PCSK9) as well as a reduction in circulating low-density lipoprotein cholesterol (LDL-C). Ethnicity and other related factors (body weight, target expression level etc.) were analysed as potential covariates. RESULTS The estimated linear clearance and volume of evolocumab were 0.24 l day-1 and 2.75 l, respectively, which was consistent with the previous modelling results from the American trials. The time course of the LDL-C reduction was described by an indirect response model with the elimination rate of LDL-C being modulated by unbound PCSK9. The concentration of unbound PCSK9 associated with the half-maximal inhibition of LDL-C elimination was 1.28 nmol l-1 . Both the PK and PD characteristics were consistent between the Caucasian and Asian populations. CONCLUSION The target-mediated drug disposition model successfully described the PK and PD characteristics of evolocumab, and this analysis found no significant differences in the PK/PD relationship for its LDL-C lowering effects between Caucasians and Asians.
Collapse
Affiliation(s)
- Chen Wang
- Amgen Asia R&D Center, Zhangjiang High-Tech Park, Shanghai, China.,Center for Drug Clinical Research, Shanghai University of Traditional Chinese Medicine, Zhangjiang High-Tech Park, Shanghai, China
| | - Qingshan Zheng
- Center for Drug Clinical Research, Shanghai University of Traditional Chinese Medicine, Zhangjiang High-Tech Park, Shanghai, China
| | - Mingqiang Zhang
- Amgen Asia R&D Center, Zhangjiang High-Tech Park, Shanghai, China
| | - Hong Lu
- Amgen Asia R&D Center, Zhangjiang High-Tech Park, Shanghai, China
| |
Collapse
|
16
|
Current state of biosimilars in Mexico: The position of the Mexican College of Rheumatology, 2016. ACTA ACUST UNITED AC 2017; 14:127-136. [PMID: 28807650 DOI: 10.1016/j.reuma.2017.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 07/04/2017] [Accepted: 07/06/2017] [Indexed: 12/30/2022]
Abstract
The present document is a position statement of the Mexican College of Rheumatology on the use of biosimilars in rheumatic diseases. This position considers that biosimilars should be considered as interchangeable, that automatic substitution without previous notice in stable patients during follow-up is not ethical, that the approval of a biosimilar should only be given after exhaustive review of preclinical and clinical data marked by Mexican regulations, that it should be clearly stated in the nomenclature of biologic drugs which is the innovator and which is the biosimilar, that it is not correct to choose a biosimilar as treatment based only on economic reasons or extrapolate indications based only on the approval of the innovator and in the absence of safety and efficacy data for the biosimilar.
Collapse
|
17
|
Chigutsa E, Long AJ, Wallin JE. Exposure-Response Analysis of Necitumumab Efficacy in Squamous Non-Small Cell Lung Cancer Patients. CPT-PHARMACOMETRICS & SYSTEMS PHARMACOLOGY 2017; 6:560-568. [PMID: 28569042 PMCID: PMC5572351 DOI: 10.1002/psp4.12209] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 05/12/2017] [Accepted: 05/15/2017] [Indexed: 12/24/2022]
Abstract
We sought to describe the exposure-response relationship of necitumumab efficacy in squamous non-small cell lung cancer patients and evaluate intrinsic and extrinsic patient descriptors that may guide dosing. SQUIRE was a phase III study comparing necitumumab in combination with gemcitabine and cisplatin vs. gemcitabine and cisplatin alone in 1,014 patients. An integrated model for tumor size dynamics and overall survival was developed, where reduction in tumor size results in a decrease in survival hazard. The change in tumor size was characterized using linear growth and first-order shrinkage. Overall survival was described using a combination of a Weibull function and Gompertz function for the hazard, with dynamic tumor size being a predictor for the hazard. Although body weight resulted in higher clearance and lower exposure, simulations showed that an 800 mg flat dose provided optimal response regardless of body weight.
Collapse
Affiliation(s)
- E Chigutsa
- PKPD&Pharmacometrics, Eli Lilly, Indianapolis, Indiana, USA
| | - A J Long
- PKPD&Pharmacometrics, Eli Lilly, Indianapolis, Indiana, USA
| | | |
Collapse
|
18
|
Ethnic sensitivity assessment of the antibody-drug conjugate trastuzumab emtansine (T-DM1) in patients with HER2-positive locally advanced or metastatic breast cancer. Cancer Chemother Pharmacol 2016; 78:547-58. [PMID: 27423671 DOI: 10.1007/s00280-016-3099-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 06/27/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE Trastuzumab emtansine (T-DM1) is indicated for previously treated HER2-positive metastatic breast cancer. Ethnic sensitivity assessment of T-DM1 was conducted using data from eight clinical studies to ensure that the clinically recommended dose is appropriate across ethnicities. METHODS Four approaches were used: (1) non-compartmental analysis (NCA) comparing pharmacokinetic parameters of T-DM1 and relevant analytes across ethnic groups, (2) population pharmacokinetic (popPK) analysis assessing the impact of ethnicity on pharmacokinetics, (3) comparison of T-DM1 pharmacokinetics in Japanese patients versus the global population, and (4) exposure-response analyses assessing the impact of ethnicity on safety and efficacy. RESULTS NCA pharmacokinetic parameters (T-DM1, total trastuzumab, DM1) were comparable across ethnic groups; mean cycle 1 T-DM1 AUCinf was 475, 442, and 518 day µg/mL for white (n = 461), Asian (n = 68), and others (n = 57), respectively. PopPK analysis showed that ethnicity (white, Asian, and others) was not a significant covariate for T-DM1 pharmacokinetics (n = 671). Additionally, visual predictive check plots indicated that observed pharmacokinetic profiles in Japanese patients (n = 42) were within the prediction interval generated from the final PopPK model. Exposure-response analyses showed that ethnicity was not a significant covariate impacting efficacy or hepatotoxicity risk, but there was a trend of greater thrombocytopenia risk among Asians versus non-Asians, which could not be explained by similar exposure between the ethnic groups. Most Asians with thrombocytopenia were able to continue T-DM1 using dose-adjustment rules recommended for the global population. CONCLUSIONS These results suggest that T-DM1 pharmacokinetics are comparable across ethnic groups and that use of the current dosing regimen is appropriate across ethnicities.
Collapse
|
19
|
Nemoto O, Furue M, Nakagawa H, Shiramoto M, Hanada R, Matsuki S, Imayama S, Kato M, Hasebe I, Taira K, Yamamoto M, Mihara R, Kabashima K, Ruzicka T, Hanifin J, Kumagai Y. The first trial of CIM331, a humanized antihuman interleukin-31 receptor A antibody, in healthy volunteers and patients with atopic dermatitis to evaluate safety, tolerability and pharmacokinetics of a single dose in a randomized, double-blind, placebo-controlled study. Br J Dermatol 2015; 174:296-304. [PMID: 26409172 DOI: 10.1111/bjd.14207] [Citation(s) in RCA: 127] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2015] [Indexed: 12/18/2022]
Abstract
BACKGROUND The cytokine interleukin-31 (IL-31) is considered to be responsible for the development of pruritus in humans. At present, no available evidence has been provided on the safety and efficacy of blocking the IL-31 signal in humans for the amelioration of pruritus in atopic dermatitis (AD). CIM331 is a humanized antihuman IL-31 receptor A (IL-31RA) monoclonal antibody, which binds to IL-31RA to inhibit subsequent IL-31 signalling. OBJECTIVES To assess the tolerability, safety, pharmacokinetics and preliminary efficacy of CIM331 in healthy Japanese and white volunteers, and Japanese patients with AD. METHODS In this randomized, double-blind, placebo-controlled phase I/Ib study, CIM331 was administered in a single subcutaneous dose. The primary outcomes were safety and tolerability; the exploratory analysis was efficacy. RESULTS No deaths, serious adverse events (AEs) or discontinuations due to AEs were reported in any part of the study. No dose-dependent increase in the incidence of AEs occurred in any part of the study. In healthy volunteers, all AEs occurred once in the placebo groups, and increased creatine phosphokinase was more common in the CIM331 groups. In patients with AD, CIM331 reduced pruritus visual analogue scale score to about -50% at week 4 with CIM331 compared with -20% with placebo. CIM331 increased sleep efficiency and decreased the use of hydrocortisone butyrate. CONCLUSIONS A single subcutaneous administration of CIM331 was well tolerated in healthy volunteers and patients with AD. It decreased pruritus, sleep disturbance and topical use of hydrocortisone. CIM331 may become a novel therapeutic option for AD by inhibiting IL-31.
Collapse
Affiliation(s)
- O Nemoto
- Kojinkai, Kita13-Jo Naika-Hifuka Clinic, Hokkaido, Japan
| | - M Furue
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - H Nakagawa
- Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan
| | - M Shiramoto
- Medical Co. LTA Hakata Clinic, Fukuoka, Japan
| | - R Hanada
- Medical Co. LTA Sumida Hospital, Tokyo, Japan
| | - S Matsuki
- Medical Co. LTA Kyushu Clinical Pharmacology Research Clinic, Fukuoka, Japan
| | - S Imayama
- Medical Co. LTA Kyushu Clinical Pharmacology Research Clinic, Fukuoka, Japan
| | - M Kato
- Kojinkai, Kita13-Jo Naika-Hifuka Clinic, Hokkaido, Japan
| | - I Hasebe
- Kojinkai, Kita13-Jo Naika-Hifuka Clinic, Hokkaido, Japan
| | - K Taira
- Medical Co. LTA Kyushu Clinical Pharmacology Research Clinic, Fukuoka, Japan
| | - M Yamamoto
- Translational Clinical Research Division, Chugai Pharmaceutical Co., Ltd., Tokyo, Japan
| | - R Mihara
- Translational Clinical Research Division, Chugai Pharmaceutical Co., Ltd., Tokyo, Japan
| | - K Kabashima
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - T Ruzicka
- Department of Dermatology and Allergology, Ludwig-Maximilian-University Munich, Munich, Germany
| | - J Hanifin
- Department of Dermatology, Oregon Health and Science University, Portland, OR, U.S.A
| | - Y Kumagai
- Kitasato University School of Medicine, Kitasato Clinical Research Center, Kanagawa, Japan
| |
Collapse
|