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Thiboutot DM, Craft N, Rissmann R, Gatlik E, Souquières M, Jones J, Loesche C. Anti-IL-17A blockade did not significantly reduce inflammatory lesions in a placebo-controlled pilot study in adult patients with moderate to severe acne. J DERMATOL TREAT 2023; 34:2138691. [PMID: 36305633 DOI: 10.1080/09546634.2022.2138691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND CJM112 is a potent anti-IL-17A monoclonal antibody, whose clinical efficacy in psoriasis was recently documented. This study aimed to assess the effect of IL-17A blockade, using CJM112, in patients with moderate to severe acne. METHODS A randomized, placebo-controlled, double-blind, parallel-group, proof-of-concept study was conducted on patients with moderate to severe acne. Patients received CJM112 300 mg, 75 mg, or placebo subcutaneously during Treatment Period 1 (0-12 weeks). Patients receiving placebo were re-randomized to receive CJM112 300 mg or 75 mg during Treatment Period 2 (12-24 weeks). The primary endpoint was the number of inflammatory facial lesions at Week 12. RESULTS As the futility criterion was met during the interim analysis, only 52/75 (69.3%) patients were recruited. In total, 48/52 (92.3%) and 26/41 (63.4%) completed Treatment Periods 1 and 2, respectively. All groups exhibited a reduction in facial inflammatory lesions, with no difference observed between CJM112 and placebo (CJM112 300 mg 27.6 ± 20.7; CJM112 75 mg 30.4 ± 34.8; placebo 23.6 ± 13.6; primary endpoint). Additionally, no differences were observed between groups in other secondary and exploratory endpoints at Week 12. CONCLUSIONS Anti-IL-17A therapy was not significantly different compared to the placebo in reducing inflammatory lesions in patients with moderate to severe acne.
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Affiliation(s)
- Diane M Thiboutot
- Department of Dermatology, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Noah Craft
- Department of Dermatology, Good Dermatology, Torrance, CA, USA.,Department of Dermatology, People Science, Venice, CA, USA
| | - Robert Rissmann
- Department of Dermatology, Centre for Human Drug Research, Leiden, The Netherlands.,Department of Biotherapeutics, Leiden Academic Center for Drug Research, Leiden University, Leiden, The Netherlands
| | - Ewa Gatlik
- Novartis Institute for Biomedical Research, Basel, Switzerland
| | - Malika Souquières
- Novartis Institute for Biomedical Research, Basel, Switzerland.,Priothera SAS, Saint-Louis, France
| | - Julie Jones
- Biostatistical Sciences and Pharmacometrics, Novartis Pharma AG, Basel, Switzerland
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2
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Zhang C, Yan K, Diao Q, Guo Q, Jin H, Yang S, Chen X, Lei T, Wu J, Yu H, Zheng M, Gao X, Sinclair R, Zhu Y, Xu Q, Xu J. A Multi-Center, Randomized, Double-blinded, Placebo-controlled, Dose-ranging Study Evaluating Efficacy and Safety of Vunakizumab in Patients with Moderate-to-Severe Plaque Psoriasis. J Am Acad Dermatol 2022; 87:95-102. [PMID: 35026342 DOI: 10.1016/j.jaad.2022.01.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 12/28/2021] [Accepted: 01/05/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Vunakizumab (SHR-1314) is a novel interleukin-17A monoclonal antibody that has shown preliminary efficacy and tolerability in phase I trials. OBJECTIVE To evaluate the efficacy and safety of vunakizumab in moderate-to-severe plaque psoriasis. METHODS In this 36-week, multi-center, double-blinded, phase II study (NCT03463187), 187 eligible patients with moderate-to-severe plaque psoriasis were randomized 1:1:1:1:1 to receive vunakizumab (40, 80, 160, or 240 mg) or placebo subcutaneously every four weeks until week 12 (2 more drug administrations for the vunakizumab groups on week 16/20). The primary endpoint was at least 75% improvement in the psoriasis area and severity index (PASI 75) at week 12. RESULTS At week 12, there were significantly greater proportions of PASI 75 responders in all vunakizumab groups compared to placebo (40, 80, 160, 240 mg: 56.8%, 65.8%, 81.6%, 86.5% vs 5.4%; all P < .001); the proportions of patients achieving physician's global assessment response of 0 or 1 were also higher with vunakizumab (45.9%, 47.4%, 60.5%, 73.0% vs 8.1%). No unexpected adverse effects were observed. LIMITATIONS The study was relatively short in duration and included no active control. CONCLUSION Vunakizumab showed promising efficacy for moderate-to-severe plaque psoriasis, with good tolerability, warranting further investigation in larger and longer-term studies.
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Affiliation(s)
| | - Kexiang Yan
- Huashan Hospital Affiliated to Fudan University, Shanghai, China
| | - Qingchun Diao
- Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Qing Guo
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hongzhong Jin
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Sen Yang
- The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xiang Chen
- Xiangya Hospital, Central South University, Changsha, China
| | - Tiechi Lei
- Renmin Hospital of Wuhan University, Hubei General Hospital, Wuhan, China
| | - Jianhua Wu
- Changhai Hospital of Shanghai, Shanghai, China
| | - Hong Yu
- Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Min Zheng
- The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xinghua Gao
- The 1(st) Hospital of China Medical University, Shenyang, China
| | | | - Yi Zhu
- Jiangsu Hengrui Pharmaceuticals Co., Ltd, Shanghai, China
| | - Qian Xu
- Jiangsu Hengrui Pharmaceuticals Co., Ltd, Shanghai, China
| | - Jinhua Xu
- Huashan Hospital Affiliated to Fudan University, Shanghai, China.
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Morelli M, Galluzzo M, Madonna S, Scarponi C, Scaglione GL, Galluccio T, Andreani M, Pallotta S, Girolomoni G, Bianchi L, Talamonti M, Albanesi C. HLA-Cw6 and other HLA-C alleles, as well as MICB-DT, DDX58, and TYK2 genetic variants associate with optimal response to anti-IL-17A treatment in patients with psoriasis. Expert Opin Biol Ther 2021; 21:259-270. [PMID: 33297781 DOI: 10.1080/14712598.2021.1862082] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 12/07/2020] [Indexed: 01/12/2023]
Abstract
Objective: Our pharmacogenomic study evaluated the influence of the presence/absence of genetic variants of psoriasis-risk loci on the clinical response to secukinumab. Differences in the single-nucleotide polymorphism (SNP) pattern characterizing HLA-Cw6+ or HLA-Cw6- patient subpopulations, showing high or low responses to secukinumab, were also analyzed. Methods: 417 SNPs were analyzed by Next-Generation Sequencing technology, in a cohort of 62 psoriatic patients and undergone secukinumab treatment. Univariate regression analysis was employed to examine the association between SNP and clinical response to secukinumab. Multivariate analysis was also performed to assess multivariate differences in SNP pattern of HLA-Cw6+ or HLA-Cw6- patients showing high or low responses to secukinumab. Results: Eight SNPs in HLA-C and upstream region (rs13207315, rs6900444, rs12189871, rs12191877, rs4406273, and rs10484554), including HLA-Cw6 classical allele (rs1131118), and three in MICB-DT (rs9267325), DDX58 (rs34085293) and TYK2 (rs2304255) genes, associating with excellent response to secukinumab were identified. Importantly, rs34085293 or rs2304255 SNP status defined a subgroup of super-responder patients. We also found that HLA-Cw6+ and HLA-Cw6- patients carried out specific patterns of SNPs associating with different responses to secukinumab. Conclusion: Assessment of HLA-Cw6, together with other allelic variants of genes, could be helpful to define patients which better benefit from anti-IL-17 therapy. Abbreviations: PASI: Psoriasis Area and Severity Index; SNP: Single-Nucleotide Polymorphism Rs: Reference SNP; PASI75: 75% reduction in Psoriasis Area and Severity Index; PASI90: 90% reduction in Psoriasis Area and Severity Index; PASI100: 100% reduction in Psoriasis Area and Severity Index; NGS: Next-Generation Sequencing; OR: Odds Ratio; CAP: Canonical Analysis of Principal coordinates; BMI: Body Mass Index; LD: Linkage Disequilibrium.
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Affiliation(s)
- Martina Morelli
- Laboratory of Experimental Immunology, IDI-IRCCS , Rome, Italy
- Section of Dermatology, Department of Medicine, University of Verona , Verona, Italy
| | - Marco Galluzzo
- Department of Experimental Medicine, University of Rome "Tor Vergata" , Rome, Italy
| | | | | | | | - Tiziana Galluccio
- Department of Oncohematology and Cell and Gene Therapy, IRCCS Bambin Gesù Pediatric Hospital, Laboratory of Immunogenetics and Transplant , Rome, Italy
| | - Marco Andreani
- Department of Oncohematology and Cell and Gene Therapy, IRCCS Bambin Gesù Pediatric Hospital, Laboratory of Immunogenetics and Transplant , Rome, Italy
| | | | - Giampiero Girolomoni
- Section of Dermatology, Department of Medicine, University of Verona , Verona, Italy
| | - Luca Bianchi
- Department of Systems Medicine, University of Rome "Tor Vergata" , Rome, Italy
| | - Marina Talamonti
- Department of Systems Medicine, University of Rome "Tor Vergata" , Rome, Italy
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Adams R, Maroof A, Baker T, Lawson ADG, Oliver R, Paveley R, Rapecki S, Shaw S, Vajjah P, West S, Griffiths M. Bimekizumab, a Novel Humanized IgG1 Antibody That Neutralizes Both IL-17A and IL-17F. Front Immunol 2020; 11:1894. [PMID: 32973785 PMCID: PMC7473305 DOI: 10.3389/fimmu.2020.01894] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 07/14/2020] [Indexed: 11/13/2022] Open
Abstract
Interleukin (IL)-17A is a key driver of inflammation and the principal target of anti-IL-17 therapeutic monoclonal antibodies. IL-17A, and its structurally similar family member IL-17F, have been shown to be functionally dysregulated in certain human immune-mediated inflammatory diseases such as psoriasis, psoriatic arthritis, and axial spondyloarthritis. Given the overlapping biology of these two cytokines, we postulated that dual neutralization of IL-17A and IL-17F may provide a greater depth of clinical response in IL-17-mediated diseases than IL-17A inhibition alone. We identified 496.g1, a humanized antibody with strong affinity for IL-17A but poor affinity for IL-17F. Affinity maturation of 496.g1 to 496.g3 greatly enhanced the affinity of the Fab fragment for IL-17F while retaining strong binding to IL-17A. As an IgG1, the affinity for IL-17A and IL-17F was 3.2 pM and 23 pM, respectively. Comparison of 496.g3 IgG1 with the commercially available anti-IL-17A monoclonal antibodies ixekizumab and secukinumab, by surface plasmon resonance and in a human in vitro IL-17A functional assay, showed that 496.g3 and ixekizumab display equivalent affinity for IL-17A, and that both antibodies are markedly more potent than secukinumab. In contrast to ixekizumab and secukinumab, 496.g3 exhibited the unique feature of also being able to neutralize the biological activity of IL-17F. Therefore, antibody 496.g3 was selected for clinical development for its ability to neutralize the biologic function of both IL-17A and IL-17F and was renamed bimekizumab (formerly UCB4940). Early clinical data in patients with psoriasis, in those with psoriatic arthritis, and from the Phase 2 studies in psoriasis, psoriatic arthritis, and ankylosing spondylitis, are encouraging and support the targeted approach of dual neutralization of IL-17A and IL-17F. Taken together, these findings provide the rationale for the continued clinical evaluation of bimekizumab in patients with immune-mediated inflammatory diseases.
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Affiliation(s)
- Ralph Adams
- Discovery Science, New Modality Therapeutics, UCB Pharma, Slough, United Kingdom
| | - Asher Maroof
- Immuno-Bone Therapeutic Area, Immunology Research, UCB Pharma, Slough, United Kingdom
| | - Terry Baker
- Discovery Science, New Modality Therapeutics, UCB Pharma, Slough, United Kingdom
| | | | - Ruth Oliver
- Development Science, QP/DMPK, UCB Pharma, Slough, United Kingdom
| | - Ross Paveley
- Immuno-Bone Therapeutic Area, Immuno-Bone Discovery, UCB Pharma, Slough, United Kingdom
| | - Steve Rapecki
- Discovery Science, New Modality Therapeutics, UCB Pharma, Slough, United Kingdom
| | - Stevan Shaw
- Immuno-Bone Therapeutic Area, Immunology Research, UCB Pharma, Slough, United Kingdom
| | - Pavan Vajjah
- Development Science, QP/DMPK, UCB Pharma, Slough, United Kingdom
| | - Shauna West
- Immuno-Bone Therapeutic Area, Immuno-Bone Discovery, UCB Pharma, Slough, United Kingdom
| | - Meryn Griffiths
- Translational Medicine, TM Immuno-Bone, UCB Pharma, Slough, United Kingdom
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5
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Liu L, Lu J, Allan BW, Tang Y, Tetreault J, Chow CK, Barmettler B, Nelson J, Bina H, Huang L, Wroblewski VJ, Kikly K. Generation and characterization of ixekizumab, a humanized monoclonal antibody that neutralizes interleukin-17A. J Inflamm Res 2016; 9:39-50. [PMID: 27143947 PMCID: PMC4846058 DOI: 10.2147/jir.s100940] [Citation(s) in RCA: 123] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Interleukin (IL)-17A exists as a homodimer (A/A) or as a heterodimer (A/F) with IL-17F. IL-17A is expressed by a subset of T-cells, called Th17 cells, at inflammatory sites. Most cell types can respond to the local production of IL-17A because of the near ubiquitous expression of IL-17A receptors, IL-17RA and IL-17RC. IL-17A stimulates the release of cytokines and chemokines designed to recruit and activate both neutrophils and memory T-cells to the site of injury or inflammation and maintain a proinflammatory state. IL-17A-producing pathogenic T-cells contribute to the pathogenesis of autoimmune diseases, including psoriasis, psoriatic arthritis, rheumatoid arthritis, and ankylosing spondylitis. This study describes the generation and characterization of ixekizumab, a humanized IgG4 variant IL-17A-neutralizing antibody. Ixekizumab binds human and cynomolgus monkey IL-17A with high affinity and binds rabbit IL-17A weakly but does not bind to rodent IL-17A or other IL-17 family members. Ixekizumab effectively inhibits the interaction between IL-17A and its receptor in binding assays and potently blocks IL-17A-induced GRO or KC secretion in cell-based assays. In an in vivo mouse pharmcodynamic model, ixekizumab blocks human IL-17A-induced mouse KC secretion. These data provide a comprehensive preclinical characterization of ixekizumab, for which the efficacy and safety have been demonstrated in human clinical trials in psoriasis and psoriatic arthritis.
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Affiliation(s)
- Ling Liu
- Biotechnology Discovery Research, Indianapolis, IN, USA
| | - Jirong Lu
- Biotechnology Discovery Research, Indianapolis, IN, USA
| | - Barrett W Allan
- Applied Molecular Evolution, Lilly Biotechnology Center, San Diego, CA, USA
| | - Ying Tang
- Applied Molecular Evolution, Lilly Biotechnology Center, San Diego, CA, USA
| | | | - Chi-Kin Chow
- Biotechnology Discovery Research, Indianapolis, IN, USA
| | - Barbra Barmettler
- Applied Molecular Evolution, Lilly Biotechnology Center, San Diego, CA, USA
| | - James Nelson
- Applied Molecular Evolution, Lilly Biotechnology Center, San Diego, CA, USA
| | - Holly Bina
- Biotechnology Discovery Research, Indianapolis, IN, USA
| | - Lihua Huang
- Bioproduct Research and Development, Indianapolis, IN, USA
| | - Victor J Wroblewski
- Drug Disposition, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA
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