Giovannoni G, Barbarash O, Casset-Semanaz F, King J, Metz L, Pardo G, Simsarian J, Sørensen P S, Stubinski B
Institute of Cell and Molecular Science, Barts and the London School of Medicine and Dentistry, London, UK.
Mult Scler. 2009 Feb;15(2):219-28. doi: 10.1177/1352458508097299. Epub 2008 Aug 28.
A new formulation of subcutaneous (s.c.) interferon-beta-1a has been developed (Rebif New Formulation, RNF), produced without fetal bovine serum and without human serum albumin as an excipient, with the aim of improving injection tolerability, and reducing immunogenicity.
This article reports 96-week analyses of a Phase IIIb, open-label study of the safety and immunogenicity of RNF compared with historical (EVIDENCE study) and recent (REGARD study) data on the original formulation.
Patients with relapsing multiple sclerosis (McDonald criteria) and an Expanded Disability Status Scale score < 6.0 received RNF, 44 microg s.c. three times weekly.
The proportion of neutralizing antibody-positive (NAb+) patients (serum NAb status >or=20 neutralizing units/mL) at week 96 (last observation carried forward; primary endpoint) was 17.4% (exact 95% confidence interval [CI]: 13.0-22.5), compared with 21.4% (95% CI: 17.2-26.2) in the EVIDENCE study, and 27.3% (95% CI: 22.8-32.1) in the REGARD study. The proportion of patients NAb+ at any time during the 96 weeks was 18.9% (95% CI: 14.4-24.2), compared with 27.1% (95% CI: 22.4-32.2) and 33.7% (95% CI: 28.9-38.7), respectively. Most pre-specified categories of adverse events were reported by patients in the RNF study at a similar or lower proportion than in the EVIDENCE and REGARD studies. Injection-site reactions were experienced by fewer patients than in the EVIDENCE and REGARD studies.
RNF has improved overall immunogenicity and safety profiles compared with the original formulation.
已研发出一种皮下注射用干扰素β-1a的新剂型(Rebif新剂型,RNF),其生产过程中未使用胎牛血清且未使用人血清白蛋白作为辅料,旨在提高注射耐受性并降低免疫原性。
本文报告了一项IIIb期开放标签研究的96周分析结果,该研究比较了RNF与原剂型的历史数据(EVIDENCE研究)和近期数据(REGARD研究)的安全性和免疫原性。
复发型多发性硬化症(符合McDonald标准)且扩展残疾状态量表评分<6.0的患者接受RNF治疗,皮下注射44微克,每周三次。
在第96周(末次观察结转;主要终点)时,中和抗体阳性(NAb+)患者(血清NAb状态≥20中和单位/毫升)的比例为17.4%(精确95%置信区间[CI]:13.0 - 22.5),而在EVIDENCE研究中为21.4%(95% CI:17.2 - 26.2),在REGARD研究中为27.3%(95% CI:22.8 - 32.1)。在96周内任何时间NAb+患者的比例为18.9%(95% CI:14.4 - 24.2),而在EVIDENCE研究和REGARD研究中分别为27.1%(95% CI:22.4 - 32.2)和33.7%(95% CI:28.9 - 38.7)。RNF研究中患者报告的大多数预先指定的不良事件类别比例与EVIDENCE研究和REGARD研究相似或更低。与EVIDENCE研究和REGARD研究相比,经历注射部位反应的患者更少。
与原剂型相比,RNF改善了总体免疫原性和安全性。