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目标信息和临床前药代动力学/药效学模型在预测骨质疏松症 Dickkopf-1 抗体临床剂量中的应用。

The application of target information and preclinical pharmacokinetic/pharmacodynamic modeling in predicting clinical doses of a Dickkopf-1 antibody for osteoporosis.

机构信息

Department of Pharmacokinetics, Dynamics, and Metabolism, Pfizer Inc., Eastern Point Road, Groton, CT 06340, USA.

出版信息

J Pharmacol Exp Ther. 2010 Apr;333(1):2-13. doi: 10.1124/jpet.109.164129. Epub 2010 Jan 20.

Abstract

PF-04840082 is a humanized prototype anti-Dickkopf-1 (Dkk-1) immunoglobulin isotype G(2) (IgG(2)) antibody for the treatment of osteoporosis. In vitro, PF-04840082 binds to human, monkey, rat, and mouse Dkk-1 with high affinity. After administration of PF-04840082 to rat and monkey, free Dkk-1 concentrations decreased rapidly and returned to baseline in a dose-dependent manner. In rat and monkey, PF-04840082 exhibited nonlinear pharmacokinetics (PK) and a target-mediated drug disposition (TMDD) model was used to characterize PF-04840082 versus Dkk-1 concentration response relationship. PK/pharmacodynamic (PK/PD) modeling enabled estimation of antibody non-target-mediated elimination, Dkk-1 turnover, complex formation, and complex elimination. The TMDD model was translated to human to predict efficacious dose and minimum anticipated biological effect level (MABEL) by incorporating information on typical IgG(2) human PK, antibody-target association/dissociation rates, Dkk-1 expression, and turnover rates. The PK/PD approach to MABEL was compared with the standard "no adverse effect level" (NOAEL) approach to calculating clinical starting doses and a pharmacological equilibrium method. The NOAEL method gave estimates of dose that were too high to ensure safety of clinical trials. The pharmacological equilibrium approach calculated receptor occupancy (RO) based on equilibrium dissociation constant alone and did not take into account rate of turnover of the target or antibody-target complex kinetics and, as a result, it likely produced a substantial overprediction of RO at a given dose. It was concluded that the calculation of MABEL according to the TMDD model was the most appropriate means for ensuring safety and efficacy in clinical studies.

摘要

PF-04840082 是一种针对 Dickkopf-1(Dkk-1)的人源化原型抗体制剂,属于 IgG2 同种型,拟用于治疗骨质疏松症。体外研究显示,PF-04840082 与人、猴、大鼠和小鼠 Dkk-1 具有高亲和力。在大鼠和猴中,PF-04840082 表现出非线性药代动力学(PK),并采用靶向介导的药物处置(TMDD)模型来描述 PF-04840082 与 Dkk-1 浓度反应关系。采用 PK/药效动力学(PK/PD)模型估算了抗体非靶向介导的消除、Dkk-1 转化、复合物形成和复合物消除。TMDD 模型经转化后可用于预测有效剂量和最小预期生物学效应水平(MABEL),具体方法是结合典型 IgG2 人 PK 信息、抗体-靶标结合/解离率、Dkk-1 表达和转化率。采用 TMDD 模型估算 MABEL 的方法与标准“无不良效应水平(NOAEL)”计算临床起始剂量的方法和药理学平衡方法进行了比较。NOAEL 方法估算的剂量过高,无法确保临床试验的安全性。药理学平衡方法仅基于平衡解离常数计算受体占有率(RO),并未考虑靶标或抗体-靶标复合物的转化速率,因此,在给定剂量下,RO 很可能被大幅高估。研究结论认为,根据 TMDD 模型估算 MABEL 是确保临床试验安全性和疗效的最合适方法。

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