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Limpikirati PK, Mongkoltipparat S, Denchaipradit T, Siwasophonpong N, Pornnopparat W, Ramanandana P, Pianpaktr P, Tongchusak S, Tian MT, Pisitkun T. Basic regulatory science behind drug substance and drug product specifications of monoclonal antibodies and other protein therapeutics. J Pharm Anal 2024; 14:100916. [PMID: 39035218 PMCID: PMC11259812 DOI: 10.1016/j.jpha.2023.12.006] [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: 07/24/2023] [Revised: 11/04/2023] [Accepted: 12/07/2023] [Indexed: 07/23/2024] Open
Abstract
In this review, we focus on providing basics and examples for each component of the protein therapeutic specifications to interested pharmacists and biopharmaceutical scientists with a goal to strengthen understanding in regulatory science and compliance. Pharmaceutical specifications comprise a list of important quality attributes for testing, references to use for test procedures, and appropriate acceptance criteria for the tests, and they are set up to ensure that when a drug product is administered to a patient, its intended therapeutic benefits and safety can be rendered appropriately. Conformance of drug substance or drug product to the specifications is achieved by testing an article according to the listed tests and analytical methods and obtaining test results that meet the acceptance criteria. Quality attributes are chosen to be tested based on their quality risk, and consideration should be given to the merit of the analytical methods which are associated with the acceptance criteria of the specifications. Acceptance criteria are set forth primarily based on efficacy and safety profiles, with an increasing attention noted for patient-centric specifications. Discussed in this work are related guidelines that support the biopharmaceutical specification setting, how to set the acceptance criteria, and examples of the quality attributes and the analytical methods from 60 articles and 23 pharmacopeial monographs. Outlooks are also explored on process analytical technologies and other orthogonal tools which are on-trend in biopharmaceutical characterization and quality control.
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Affiliation(s)
- Patanachai K. Limpikirati
- Department of Food and Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Pathumwan, Bangkok, 10330, Thailand
- Pharmaceutical Sciences and Technology (PST) Graduate Program, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Pathumwan, Bangkok, 10330, Thailand
- Center of Excellence in Systems Biology (CUSB), Faculty of Medicine, Chulalongkorn University, Pathumwan, Bangkok, 10330, Thailand
| | - Sorrayut Mongkoltipparat
- Department of Food and Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Pathumwan, Bangkok, 10330, Thailand
| | - Thinnaphat Denchaipradit
- Department of Food and Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Pathumwan, Bangkok, 10330, Thailand
| | - Nathathai Siwasophonpong
- Department of Food and Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Pathumwan, Bangkok, 10330, Thailand
| | - Wudthipong Pornnopparat
- Department of Food and Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Pathumwan, Bangkok, 10330, Thailand
| | - Parawan Ramanandana
- Department of Food and Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Pathumwan, Bangkok, 10330, Thailand
- Pharmaceutical Sciences and Technology (PST) Graduate Program, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Pathumwan, Bangkok, 10330, Thailand
- Center of Excellence in Systems Biology (CUSB), Faculty of Medicine, Chulalongkorn University, Pathumwan, Bangkok, 10330, Thailand
- Department of Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, Huachiew Chalermprakiet University, Bang Phli, Samut Prakan, 10540, Thailand
| | - Phumrapee Pianpaktr
- Department of Food and Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Pathumwan, Bangkok, 10330, Thailand
- Pharmaceutical Sciences and Technology (PST) Graduate Program, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Pathumwan, Bangkok, 10330, Thailand
- Center of Excellence in Systems Biology (CUSB), Faculty of Medicine, Chulalongkorn University, Pathumwan, Bangkok, 10330, Thailand
| | - Songsak Tongchusak
- Center of Excellence in Systems Biology (CUSB), Faculty of Medicine, Chulalongkorn University, Pathumwan, Bangkok, 10330, Thailand
| | - Maoxin Tim Tian
- Center of Excellence in Systems Biology (CUSB), Faculty of Medicine, Chulalongkorn University, Pathumwan, Bangkok, 10330, Thailand
| | - Trairak Pisitkun
- Center of Excellence in Systems Biology (CUSB), Faculty of Medicine, Chulalongkorn University, Pathumwan, Bangkok, 10330, Thailand
- Division of Research Affairs, Faculty of Medicine, Chulalongkorn University, Pathumwan, Bangkok, 10330, Thailand
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Xiang D, Li N, Liu L, Yu H, Li X, Zhao T, Liu D, Gong X. Development and validation of enzyme-linked immunosorbent assays for the measurement of infliximab and anti-drug antibody levels. Heliyon 2023; 9:e21858. [PMID: 38034789 PMCID: PMC10682623 DOI: 10.1016/j.heliyon.2023.e21858] [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: 05/25/2023] [Revised: 09/11/2023] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
Infliximab and its anti-drug antibody (ADA) serum concentrations exhibit a strong correlation with clinical response and loss of response. The use of therapeutic drug monitoring to measure the concentration of infliximab and ADA can facilitate clinical decision-making, helping patients attain optimal therapeutic effects. However, there are still limitations to the existing infliximab and its ADA detection methods. Therefore, this study aimed to develop and validate enzyme-linked immunosorbent assay (ELISA)-based methods for measuring infliximab and its ADA levels in human plasma according to the general recommendations for immunoassays. Free infliximab is bound by recombinant TNF-α and detected using HRP-labeled anti-human antibody. The ADA is captured by on-plate-coated infliximab and recognized by biotin-labeled infliximab. Two bridging ELISA assays were developed and after assay optimization and validation, these assays have been applied in ten patients with inflammatory bowel disease (IBD). In infliximab detection assay, a standard curve ranging from 0.10 μg/mL to 8.0 μg/mL with great precision and accuracy has been established. Drug tolerance of the ADA assay was that 100 ng/mL ADA could tolerate at least 5.0 μg/mL infliximab in the plasma using a commercially available monoclonal anti-infliximab antibody as the positive control. The ADA screening and confirmatory assays achieved a sensitivity of 36.74 ng/mL and 37.15 ng/mL, respectively. All other assay characteristics met the requirements. The mean concentration of infliximab in eight patients with IBD was 7.88 (1.87-21.1) μg/mL, and the ADA levels were all negative. Moreover, the concentrations of infliximab in the remaining two patients were below the LLOQ and the ADAs were positive. Thus, accurate and sensitive ELISA methods have been developed and validated for the detection of infliximab and its ADA concentrations and have been successfully applied to clinical therapeutic drug monitoring.
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Affiliation(s)
- Dong Xiang
- Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ninghong Li
- Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Department of Pharmacy, Nanchang First Hospital, Nanchang, 330008, China
| | - Lu Liu
- Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Hengyi Yu
- Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiping Li
- Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Tinghui Zhao
- Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Dong Liu
- Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xuepeng Gong
- Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
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Quantification of infliximab and adalimumab in human plasma by a liquid chromatography tandem mass spectrometry kit and comparison with two ELISA methods. Bioanalysis 2022; 14:831-844. [PMID: 35735172 DOI: 10.4155/bio-2022-0057] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background: This study compared the performance of plasma infliximab and adalimumab quantification using a commercially available kit (mAbXmise kit) and mass spectrometry readout to that of two ELISA methods in patients treated for inflammatory bowel disease. Methods & results: The mAbXmise method based on liquid chromatography tandem mass spectrometry (LC-MS/MS) was linear from 2 to 100 μg/ml. It was validated according to international guidelines. Regarding cross-validation for infliximab (n = 70), the mean bias with LC-MS/MS assay was approximately threefold higher with the commercial ELISA assay compared with the in-house ELISA (-6.1 vs -1.8 μg/ml, respectively). The mean bias between the LC-MS/MS assay and in-house ELISA was -1.2 μg/ml for adalimumab (n = 35). Conclusion: The LC-MS/MS method is a powerful alternative to immunoassays to monitor concentrations of infliximab and adalimumab.
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Co-formulations of adalimumab with hyaluronic acid / polyvinylpyrrolidone to combine intraarticular drug delivery and viscosupplementation. Eur J Pharm Biopharm 2022; 177:39-49. [PMID: 35691537 DOI: 10.1016/j.ejpb.2022.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/01/2022] [Accepted: 06/06/2022] [Indexed: 11/24/2022]
Abstract
Polymer-based formulations present an attractive strategy in intraarticular drug-delivery to refrain biologicals from early leakage from the joint. In this study, co-formulations of hyaluronic acid and polyvinylpyrrolidone were investigated for their potential as viscosupplements and their influence on the transsynovial loss of adalimumab. For this purpose, polymer mixtures were evaluated for their viscosity and elasticity behavior while their influence on the permeation of adalimumab across a porcine ex-vivo synovial membrane was determined. Hyaluronic acid showed strong shear thinning behavior and exhibited high viscosity and elasticity at low motions, while combinations with polyvinylpyrrolidone provided absorption and stiffness at high mechanical stress, so that they can potentially restore the rheological properties of the synovial fluid over the range of joint motion. In addition, the formulations showed significant influence on transsynovial permeation kinetics of adalimumab and hyaluronic acid, which could be decelerated up to 5- and 3-fold, respectively. Besides viscosity effects, adalimumab was retained primarily by an electrostatic interaction with hyaluronic acid, as detected by isothermal calibration calorimetry. Furthermore, polymer-mediated stabilization of the antibody activity was detected. In summary, hyaluronic acid - polyvinylpyrrolidone combinations can be efficiently used to prolong the residence of adalimumab in the joint cavity while simultaneously supplying viscosupplementation.
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Sirmai L, Pelletier AL, Gault N, Zallot C, Bouguen G, Bouchard D, Roland Nicaise P, Peyneau M, Sironneau S, Bittencourt MDC, Petitcollin A, Fernandez P, Roblin X, Siproudhis L, Abramowitz L. Relationship between clinical remission of perianal fistulas in Crohn’s disease and serum adalimumab concentrations: A multi-center cross-sectional study. World J Gastroenterol 2022; 28:961-972. [PMID: 35317057 PMCID: PMC8908286 DOI: 10.3748/wjg.v28.i9.961] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/25/2021] [Accepted: 01/29/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Crohn’s disease (CD) is complicated by perianal fistulas in approximately 20% of patients. Achieving permanent fistula closure remains a challenge for physicians. An association between serum anti-tumor necrosis factor-α concentrations and clinical outcomes in patients with CD has been demonstrated; however, little information is available on serum adalimumab (ADA) concentrations and remission of perianal fistulas in such patients.
AIM To study the relationship between serum ADA concentrations and clinical remission of CD-associated perianal fistulas.
METHODS This cross-sectional study of patients with CD-associated perianal fistulas treated with ADA was performed at four French hospitals between December 2013 and March 2018. At the time of each serum ADA concentration measurement, we collected information about the patients and their fistulas. The primary study endpoint was clinical remission of fistulas defined as the absence of drainage (in accordance with Present’s criteria), with a PDAI ≤ 4, absence of a seton and assessment of the overall evaluation as favorable by the proctologist at the relevant center. We also assessed fistula healing [defined as being in clinical and radiological (magnetic resonance imaging, MRI) remission] and adverse events.
RESULTS The study cohort comprised 34 patients who underwent 56 evaluations (patients had between one and four evaluations). Fifteen patients had clinical remissions (44%), four of whom had healed fistulas on MRI. Serum ADA concentrations were significantly higher at evaluations in which clinical remission was identified than at evaluations in which it was not [14 (10-16) vs 10 (2-15) μg/mL, P = 0.01]. Serum ADA concentrations were comparable at the times of evaluation of patients with and without healed fistulas [11 (7-14) vs 10 (4-16) μg/mL, P = 0.69]. The adverse event rate did not differ between different serum ADA concentrations.
CONCLUSION We found a significant association between high serum ADA concentrations and clinical remission of CD-associated perianal fistulas.
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Affiliation(s)
- Laura Sirmai
- Division of Hepato-Gastroenterology and Digestive Oncology, Bichat Claude Bernard University Hospital, Paris 75018, France
- Division of Hepato-Gastroenterology, Hospital Croix Saint Simon, Paris 75020, France
| | - Anne-Laure Pelletier
- Division of Hepato-Gastroenterology and Digestive Oncology, Bichat Claude Bernard University Hospital, Paris 75018, France
| | - Nathalie Gault
- Division of Epidemiology, Biostatistics and Clinical Research, University Hospital Center Bichat, Paris 75018, France
- National Institute of Health and Medical Research CIC-EC1425, University Hospital Center Bichat, Paris 75018, France
| | - Camille Zallot
- Division of Gastroenterology, Nancy Regional and University Hospital Center, Nancy 54035, France
| | - Guillaume Bouguen
- Imphy CIC 1414 Group and Division of Gastroenterology and Hepatology, University Hospital of Rennes, Pontchaillou, Rennes 35033, France
| | | | | | - Marine Peyneau
- Division of Immunology, University Hospital Center Bichat, Paris 75018, France
- Inflammation, Microbiome and Immunosurveillance, Faculty of Pharmacy, Université Paris-Saclay, Châtenay-Malabry 92290, France
| | | | - Marcelo De Carvalho Bittencourt
- Division of Immunology, Nancy Regional and University Hospital Center, Nancy 54000, France
- University of Lorraine, CNRS UMR 7365, IMoPA, Nancy 54000, France
| | - Antoine Petitcollin
- Department of Clinical and Biological Pharmacology and Pharmacovigilance, Pharmacoepidemiology and Drug Information Center, Rennes University Hospital, Rennes 35700, France
| | - Pedro Fernandez
- Division of Radiology, University Hospital Center Bichat, Paris 75018, France
- Orangerie Center, Le Perreux-sur-Marne 94170, France
| | - Xavier Roblin
- Division of Gastroenterology, CHU Saint Etienne, Saint-Priest-en-Jarez 42270, France
| | - Laurent Siproudhis
- Imphy CIC 1414 Group and Division of Gastroenterology and Hepatology, University Hospital of Rennes, Pontchaillou, Rennes 35033, France
| | - Laurent Abramowitz
- Division of Gastroenterology and Hepatology and Proctology, University Hospital Center Bichat, Paris 75018, France
- Ramsay GDS Clinique Blomet, Paris 75018, France
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Wadhwa M, Bird C, Atkinson E, Cludts I, Rigsby P. The First WHO International Standard for Adalimumab: Dual Role in Bioactivity and Therapeutic Drug Monitoring. Front Immunol 2021; 12:636420. [PMID: 33936049 PMCID: PMC8082443 DOI: 10.3389/fimmu.2021.636420] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/19/2021] [Indexed: 12/17/2022] Open
Abstract
The expanded availability of adalimumab products continues to widen patient access and reduce costs with substantial benefit to healthcare systems. However, the long-term success of these medicines is highly dependent on maintaining consistency in quality, safety and efficacy while minimizing any risk of divergence during life-cycle management. In recognition of this need and demand from global manufacturers, the World Health Organization (WHO) Expert Committee on Biological standardization established the WHO 1st International standard (IS) for Adalimumab (coded 17/236) in October 2019 with a defined unitage ascribed to each of the individual bioactivities evaluated in the study namely, TNF-α binding, TNF-α neutralization, complement dependent cytotoxicity and antibody-dependent cellular cytotoxicity. For development of the IS, two candidate standards were manufactured as per WHO recommendations. Analysis of extensive datasets generated by testing of a common set of samples including the candidate standards by multiple stakeholders including regulatory agencies using their own qualified assays in a large international collaborative study showed comparable biological activity for the tested candidates for the different activities. Use of a common standard significantly decreased the variability of bioassays and improved agreement in potency estimates. Data from this study clearly supports the utility of the IS as an important tool for assuring analytical assay performance, for bioassay calibration and validation, for identifying and controlling changes in bioactivity during life-cycle management and for global harmonization of adalimumab products. In addition, in a separate multi-center study which included involvement of hospital and clinical diagnostic laboratories, the suitability of the adalimumab IS for therapeutic drug monitoring assays was examined by analysis of data from testing of a common blind coded panel of adalimumab spiked serum samples representative of the clinical scenario along with the IS and in-house standards in diverse immunoassays/platforms. Both commercially available and in-house assays that are routinely used for assessing adalimumab trough levels were included. Excellent agreement in estimates for adalimumab content in the spiked samples was observed regardless of the standard or the method with inter-laboratory variability also similar regardless of the standard employed. This data, for the first time, provides support for the extended applicability of the IS in assays in use for therapeutic drug monitoring based on the mass content of the IS. The adalimumab IS, in fulfilling clinical demand, can help toward standardizing and harmonizing clinical monitoring assays for informed clinical decisions and/or personalized treatment strategies for better patient outcomes. Collectively, a significant role for the adalimumab IS in assuring the quality, safety and efficacy of adalimumab products globally is envisaged.
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Affiliation(s)
- Meenu Wadhwa
- Biotherapeutics Division, National Institute for Biological Standards and Control, Medicines and Healthcare Products Regulatory Agency, Potters Bar, United Kingdom
| | - Chris Bird
- Biotherapeutics Division, National Institute for Biological Standards and Control, Medicines and Healthcare Products Regulatory Agency, Potters Bar, United Kingdom
| | - Eleanor Atkinson
- Analytical and Biological Sciences Division, National Institute for Biological Standards and Control, Medicines and Healthcare Products Regulatory Agency, Potters Bar, United Kingdom
| | - Isabelle Cludts
- Biotherapeutics Division, National Institute for Biological Standards and Control, Medicines and Healthcare Products Regulatory Agency, Potters Bar, United Kingdom
| | - Peter Rigsby
- Analytical and Biological Sciences Division, National Institute for Biological Standards and Control, Medicines and Healthcare Products Regulatory Agency, Potters Bar, United Kingdom
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Desvignes C, Ternant D, Lecomte T, Lièvre A, Ohresser M, Chautard R, Raoul W, Paintaud G. A robust enzyme-linked immunosorbent assay to measure serum ramucirumab concentrations. Bioanalysis 2021; 13:565-574. [PMID: 33769095 DOI: 10.4155/bio-2020-0199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Aim: Ramucirumab, an anti-VEGFR2 monoclonal antibody, has been approved for the treatment of metastatic gastric and colorectal cancer. An assay measuring ramucirumab serum concentrations was needed to investigate its pharmacokinetics and concentration-response relationship. Results: An ELISA was developed and validated according to the international guidelines for ligand-binding assays. Ramucirumab calibration standards ranged from 0.125 to 40 mg/l. Low, middle and high quality controls were spiked at 0.2, 4 and 8 mg/l, respectively. The limits of quantification were established to be 0.125 and 10 mg/l for LLOQ and ULOQ, respectively. No cross-reactivity with anti-VEGF or anti-EGFR was detected. Conclusion: This in-house-developed ELISA is sensitive, accurate, reproducible and suitable for pharmacokinetic studies of ramucirumab.
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Affiliation(s)
- Céline Desvignes
- CHRU de Tours, Plateforme Recherche, Centre Pilote de Suivi Biologique des Traitements par Anticorps (CePiBAc), Tours, France
- Université de Tours, EA4245 Transplantation, Immunologie, Inflammation, Tours, France
| | - David Ternant
- CHRU de Tours, Plateforme Recherche, Centre Pilote de Suivi Biologique des Traitements par Anticorps (CePiBAc), Tours, France
- Université de Tours, EA4245 Transplantation, Immunologie, Inflammation, Tours, France
- CHRU de Tours, Service de Pharmacologie Médicale, Tours, France
| | - Thierry Lecomte
- CHRU de Tours, Service d'Hépato-Gastroentérologie et Oncologie Digestive, Tours, France
- Université de Tours, EA 7501 Groupe Innovation et Ciblage Cellulaire, Tours, France
| | - Astrid Lièvre
- CHU Pontchaillou, Service de Gastroentérologie, Rennes, France
- INSERM U1242, Oncogenesis, Stress & Signaling, Rennes, France
| | - Marc Ohresser
- Université de Tours, EA4245 Transplantation, Immunologie, Inflammation, Tours, France
| | - Romain Chautard
- CHRU de Tours, Service d'Hépato-Gastroentérologie et Oncologie Digestive, Tours, France
| | - William Raoul
- Inserm UMR 1069, Nutrition Croissance et Cancer (N2C), Université de Tours, Tours, France
| | - Gilles Paintaud
- CHRU de Tours, Plateforme Recherche, Centre Pilote de Suivi Biologique des Traitements par Anticorps (CePiBAc), Tours, France
- Université de Tours, EA4245 Transplantation, Immunologie, Inflammation, Tours, France
- CHRU de Tours, Service de Pharmacologie Médicale, Tours, France
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Ducourau E, Rispens T, Samain M, Dernis E, Le Guilchard F, Andras L, Perdriger A, Lespessailles E, Martin A, Cormier G, Armingeat T, Devauchelle-Pensec V, Gervais E, Le Goff B, de Vries A, Piver E, Paintaud G, Desvignes C, Ternant D, Watier H, Goupille P, Mulleman D. Methotrexate effect on immunogenicity and long-term maintenance of adalimumab in axial spondyloarthritis: a multicentric randomised trial. RMD Open 2020; 6:rmdopen-2019-001047. [PMID: 31958280 PMCID: PMC7046954 DOI: 10.1136/rmdopen-2019-001047] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 12/04/2019] [Accepted: 12/06/2019] [Indexed: 12/17/2022] Open
Abstract
Objectives Anti-drug antibodies (ADA) are responsible for decreased adalimumab efficacy in axial spondyloarthritis (SpA). We aimed to evaluate the ability of methotrexate (MTX) to decrease adalimumab immunisation. Methods A total of 110 patients eligible to receive adalimumab 40 mg subcutaneously (s.c.) every other week were randomised (1:1 ratio) to receive, 2 weeks before adalimumab (W-2) and weekly, MTX 10 mg s.c. (MTX+) or not (MTX−). ADA detection and adalimumab serum concentration were assessed at weeks 4 (W4), 8 (W8), 12 (W12) and 26 (W26) after starting adalimumab (W0). The primary outcome was the proportion of patients with ADA at W26. Four years after the study completion, we retrospectively analysed adalimumab maintenance in relation with MTX co-treatment duration. Results We analysed data for 107 patients (MTX+; n=52; MTX-; n=55). ADA were detected at W26 in 39/107 (36.4%) patients: 13/52 (25%) in the MTX+ group and 26/55 (47.3%) in the MTX− group (p=0.03). Adalimumab concentration was significantly higher in the MTX+ than MTX− group at W4, W8, W12 and W26. The two groups did not differ in adverse events or efficacy. In the follow-up study, MTX co-treatment >W26 versus no MTX or ≤W26 was significantly associated with adalimumab long-term maintenance (p=0.04). Conclusion MTX reduces the immunogenicity and ameliorate the pharmacokinetics of adalimumab in axial SpA. A prolonged co-treatment of MTX>W26 seems to increase adalimumab long-term maintenance.
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Affiliation(s)
- Emilie Ducourau
- Department of Rheumatology, University of Tours, EA 7501 GICC, CHRU de Tours, Tours, France.,Department of Rheumatology, CHR d'Orléans, Orléans, France
| | - Theo Rispens
- Landsteiner Laboratory, Sanquin Research, Amsterdam, Netherlands
| | - Marine Samain
- Department of Rheumatology, University of Tours, EA 7501 GICC, CHRU de Tours, Tours, France
| | | | | | - Lucia Andras
- Department of Rheumatology, CH de Blois, Blois, France
| | | | | | - Antoine Martin
- Department of Rheumatology, CH de Saint-Brieuc, Saint-Brieuc, France
| | - Grégoire Cormier
- Department of Rheumatology, CHD Vendée, La Roche-sur-Yon, France
| | - Thomas Armingeat
- Department of Rheumatology, CH de Saint-Nazaire, Saint-Nazaire, France
| | | | | | - Benoit Le Goff
- Department of Rheumatology, CHRU de Nantes, Nantes, France
| | - Annick de Vries
- Biologicals Lab, Sanquin Diagnostic Services, Amsterdam, Netherlands
| | - Eric Piver
- Department of Biochemistry, University of Tours, Inserm U 1259, CHRU de Tours, Tours, France
| | - Gilles Paintaud
- Department of Pharmacology-Toxicology, University of Tours, EA GICC, CHRU de Tours, Tours, France
| | - Céline Desvignes
- Department of Pharmacology-Toxicology, University of Tours, EA GICC, CHRU de Tours, Tours, France
| | - David Ternant
- Department of Pharmacology-Toxicology, University of Tours, EA GICC, CHRU de Tours, Tours, France
| | - Hervé Watier
- Department of Immunology, University of Tours, EA 7501 GICC, CHRU de Tours, Tours, France
| | - Philippe Goupille
- Department of Rheumatology, University of Tours, EA 7501 GICC, CHRU de Tours, Tours, France.,Inserm CIC1415, Tours, France
| | - Denis Mulleman
- Department of Rheumatology, University of Tours, EA 7501 GICC, CHRU de Tours, Tours, France
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Adamson H, Nicholl A, Tiede C, Tang AA, Davidson A, Curd H, Wignall A, Ford R, Nuttall J, McPherson MJ, Johnson M, Tomlinson DC. Affimers as anti-idiotypic affinity reagents for pharmacokinetic analysis of biotherapeutics. Biotechniques 2019; 67:261-269. [DOI: 10.2144/btn-2019-0089] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Therapeutic antibodies are the fastest growing class of drugs in the treatment of cancer, and autoimmune and inflammatory diseases that require the concomitant development of assays to monitor therapeutic antibody levels. Here, we demonstrate that the use of Affimer nonantibody binding proteins provides an advantage over current antibody-based detection systems. For four therapeutic antibodies, we used phage display to isolate highly specific anti-idiotypic Affimer reagents, which selectively bind to the therapeutic antibody idiotype. For each antibody target the calibration curves met US Food and Drug Administration criteria and the dynamic range compared favorably with commercially available reagents. Affimer proteins therefore represent promising anti-idiotypic reagents that are simple to select and manufacture, and that offer the sensitivity, specificity and consistency required for pharmacokinetic assays.
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Affiliation(s)
- Hope Adamson
- School of Molecular & Cellular Biology, Astbury Centre for Structural Molecular Biology, University of Leeds, Leeds, LS2 9JT, UK
| | - Amanda Nicholl
- Avacta Life Sciences, Ash Way, Thorp Arch Estate, Wetherby, LS23 7FA, UK
| | - Christian Tiede
- School of Molecular & Cellular Biology, Astbury Centre for Structural Molecular Biology, University of Leeds, Leeds, LS2 9JT, UK
| | - Anna A Tang
- School of Molecular & Cellular Biology, Astbury Centre for Structural Molecular Biology, University of Leeds, Leeds, LS2 9JT, UK
| | - Alex Davidson
- Avacta Life Sciences, Ash Way, Thorp Arch Estate, Wetherby, LS23 7FA, UK
| | - Helen Curd
- Avacta Life Sciences, Ash Way, Thorp Arch Estate, Wetherby, LS23 7FA, UK
| | - Alex Wignall
- Avacta Life Sciences, Ash Way, Thorp Arch Estate, Wetherby, LS23 7FA, UK
| | - Robert Ford
- Avacta Life Sciences, Ash Way, Thorp Arch Estate, Wetherby, LS23 7FA, UK
| | - James Nuttall
- Avacta Life Sciences, Ash Way, Thorp Arch Estate, Wetherby, LS23 7FA, UK
| | - Michael J McPherson
- School of Molecular & Cellular Biology, Astbury Centre for Structural Molecular Biology, University of Leeds, Leeds, LS2 9JT, UK
| | - Matt Johnson
- Avacta Life Sciences, Ash Way, Thorp Arch Estate, Wetherby, LS23 7FA, UK
| | - Darren C Tomlinson
- School of Molecular & Cellular Biology, Astbury Centre for Structural Molecular Biology, University of Leeds, Leeds, LS2 9JT, UK
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10
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Groell F, Jordan O, Borchard G. In vitro models for immunogenicity prediction of therapeutic proteins. Eur J Pharm Biopharm 2018; 130:128-142. [DOI: 10.1016/j.ejpb.2018.06.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 05/09/2018] [Accepted: 06/08/2018] [Indexed: 12/21/2022]
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11
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Immunoassays for Measuring Serum Concentrations of Monoclonal Antibodies and Anti-biopharmaceutical Antibodies in Patients. Ther Drug Monit 2018; 39:316-321. [PMID: 28570370 DOI: 10.1097/ftd.0000000000000419] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Monoclonal antibodies (mAbs) may be used as biopharmaceuticals to treat various diseases, ranging from oncology to inflammatory and cardiovascular affections. Trustworthy analytical methods are necessary to study their pharmacokinetics, both during their development and in post-marketing studies. Because biopharmaceuticals are macromolecules, ligand-binding assays (both immunoassays and bioassays) are methods of choice to measure their concentrations. Immunoassays are based on the capture of biopharmaceuticals by their target, which may be a circulating or membrane antigen or by an antibody recognizing their structure. Bioassays measure the activity of the biopharmaceutical in a specific in vitro test. A number of techniques have been reported, but their limits of detection and quantification vary widely. Anti-drug antibodies (ADA) against biopharmaceuticals are often formed and sometimes interfere with clinical efficacy. Accurate and reliable detection of ADA is therefore necessary. Binding of ADA is dependent on affinity and avidity, which makes quantification challenging. In this review, we discuss the benefits and limitations of each method to determine mAb levels and carefully compare ADA assays.
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12
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Arnoult C, Brachet G, Cadena Castaneda D, Azzopardi N, Passot C, Desvignes C, Paintaud G, Heuzé-Vourc'h N, Watier H, Gouilleux-Gruart V. Crucial Role for Immune Complexes but Not FcRn in Immunization against Anti-TNF-α Antibodies after a Single Injection in Mice. THE JOURNAL OF IMMUNOLOGY 2017; 199:418-424. [PMID: 28584008 DOI: 10.4049/jimmunol.1601246] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 05/06/2017] [Indexed: 01/08/2023]
Abstract
The immunogenicity of infliximab and adalimumab is a major concern because patients may develop Abs also called antidrug Abs (ADA), directed against these anti-TNF-α Abs after just a few weeks of treatment. These ADAs can lead to a decrease in biologic concentration, which is associated with lower treatment efficacy. Our aim was to study the involvement of immune complexes and neonatal Fc receptor (FcRn) in the emergence of ADAs in the case of anti-TNF-α Abs. Wild type and FcRn knockout mice were injected once with either infliximab or adalimumab, alone or preincubated with TNF-α. Adalimumab cross-reacts with murine TNF-α whereas infliximab is species specific. When injected alone, only adalimumab elicited a humoral response. By preforming immune complexes with TNF-α, an anti-infliximab response was elicited. Surprisingly, both wild type and FcRn knockout mice were able to mount an immune response against anti-TNF-α Abs, suggesting that immune complexes are a major determinant of this immunization.
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Affiliation(s)
- Christophe Arnoult
- Université François Rabelais de Tours, CNRS, UMR 7292, F-37032 Tours, France
| | - Guillaume Brachet
- Université François Rabelais de Tours, CNRS, UMR 7292, F-37032 Tours, France.,Laboratoire d'Immunologie, Centre Hospitalier Régional Universitaire de Tours, F-37032 Tours, France
| | | | - Nicolas Azzopardi
- Université François Rabelais de Tours, CNRS, UMR 7292, F-37032 Tours, France
| | - Christophe Passot
- Université François Rabelais de Tours, CNRS, UMR 7292, F-37032 Tours, France.,Laboratoire de Pharmacologie-Toxicologie, Centre Hospitalier Régional Universitaire de Tours, F-37032 Tours, France; and
| | - Celine Desvignes
- Laboratoire de Pharmacologie-Toxicologie, Centre Hospitalier Régional Universitaire de Tours, F-37032 Tours, France; and
| | - Gilles Paintaud
- Université François Rabelais de Tours, CNRS, UMR 7292, F-37032 Tours, France.,Laboratoire de Pharmacologie-Toxicologie, Centre Hospitalier Régional Universitaire de Tours, F-37032 Tours, France; and
| | - Nathalie Heuzé-Vourc'h
- Université François Rabelais de Tours, Centre d'Etude des Pathologies Respiratoires, INSERM, UMR 1100, F-37032 Tours, France
| | - Hervé Watier
- Université François Rabelais de Tours, CNRS, UMR 7292, F-37032 Tours, France.,Laboratoire d'Immunologie, Centre Hospitalier Régional Universitaire de Tours, F-37032 Tours, France
| | - Valérie Gouilleux-Gruart
- Université François Rabelais de Tours, CNRS, UMR 7292, F-37032 Tours, France; .,Laboratoire d'Immunologie, Centre Hospitalier Régional Universitaire de Tours, F-37032 Tours, France
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Abstract
Monoclonal antibodies (mAbs) and fusion proteins with an Fc portion of immunoglobulin G (IgG) are emblematic of the remarkable expansion of biopharmaceuticals. Despite their biological origin, these products display an interindividual variability in their efficacy and/or side effects, which must be taken into consideration. Biological monitoring allowing for adapted prescription and dose adjustments may lead to therapeutic optimization and limitation of the high costs of these drugs. Herein, we review the biological theranostic of mAbs and Fc fusion proteins, including pre-treatment analyses, monitoring of efficacy, therapeutic drug monitoring, and monitoring of side effects. Supported by concrete evidence, a specific interest is given to individualised therapeutic monitoring that combines intention to treat, biomarkers of efficacy and adaptation of serum concentrations.
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Affiliation(s)
- Benjamin Chaigne
- Université Paris Descartes, Faculté de Médecine, Service de Médecine Interne, Centre de Référence Pour les Vascularites Nécrosantes et la Sclérodermie Systémique, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France; Institut Cochin, INSERM U1016, CNRS UMR 8104, Université Paris Descartes, Paris, France
| | - Hervé Watier
- CHRU de Tours, Laboratoire d'Immunologie, France; Université François-Rabelais de Tours, France; CNRS, UMR 7292, Tours, France.
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Detection of adalimumab and anti-adalimumab antibodies in patients with rheumatoid arthritis: a comprehensive overview of methodology pitfalls and benefits. Immunol Res 2016; 65:172-185. [DOI: 10.1007/s12026-016-8824-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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