Novo Nordisk A/S, Novo Nordisk Park, Maalov, Denmark.
Thromb Res. 2011 Aug;128(2):191-5. doi: 10.1016/j.thromres.2011.02.018. Epub 2011 Mar 22.
Bleeding episodes in haemophilia patients with inhibitors are primarily treated with by-passing agents such as recombinant activated FVII (rFVIIa). Prophylactic treatment with rFVIIa has been shown to significantly reduce the number of bleeding episodes as compared to conventional on-demand haemostatic therapy, and a reduced dosing frequency could present an improved treatment option in inhibitor patients.
A series of glycoPEGylated rFVIIa derivatives (5-40K PEG) has been produced and their effect and pharmocokinetics have been investigated in several animal species.
The glycoPEGylated rFVIIa derivatives exhibit significant prolongation of half-life in mice, dogs and pigs as measured by rFVIIa clot activity. The clearance of rFVIIa, rFVIIa-5K PEG, rFVIIa-10K PEG, rFVIIa-20K PEG and rFVIIa-40K PEG in minipigs were estimated to 59, 27, 22, 8.7 and 3.1 ml/h/kg, respectively. Across species a reduction in clearance as a function of the size of the attached PEG was observed. By allometric scaling, the compiled pharmacokinetics predicts a human half-life for rFVIIa-10K PEG and rFVIIa-40K PEG of approximately 7 and 12h, respectively. The rFVIIa-10K PEG and rFVIIa-40K PEG are efficacious in stopping a bleed in the haemophilia A mouse tail-bleeding model after intravenous administration.
GlycoPEGylation of rFVIIa significantly increases the rFVIIa exposure in three animal models, glycoPEGylated rFVIIa compounds are effective in vivo and thus, represents a potential prophylactic treatment option for patients with inhibitors.
患有抑制剂的血友病患者的出血事件主要通过旁路制剂(如重组激活的 FVII(rFVIIa))进行治疗。与传统按需止血治疗相比,预防性使用 rFVIIa 已被证明可显著减少出血事件的发生次数,而减少给药频率可能为抑制剂患者提供一种改进的治疗选择。
已生产了一系列糖基化 PEG 化 rFVIIa 衍生物(5-40K PEG),并在几种动物物种中研究了它们的效果和药代动力学。
糖基化 rFVIIa 衍生物在小鼠、狗和猪中通过 rFVIIa 凝块活性测量显示出显著延长半衰期。rFVIIa、rFVIIa-5K PEG、rFVIIa-10K PEG、rFVIIa-20K PEG 和 rFVIIa-40K PEG 在迷你猪中的清除率估计分别为 59、27、22、8.7 和 3.1ml/h/kg。在所有物种中,观察到清除率随附着 PEG 大小的减少而降低。通过比例缩放,综合药代动力学预测 rFVIIa-10K PEG 和 rFVIIa-40K PEG 的人体半衰期分别约为 7 和 12 小时。rFVIIa-10K PEG 和 rFVIIa-40K PEG 在静脉给药后可有效阻止血友病 A 小鼠尾巴出血模型中的出血。
rFVIIa 的糖基化显著增加了三种动物模型中的 rFVIIa 暴露量,糖基化 rFVIIa 化合物在体内有效,因此代表了一种潜在的抑制剂患者的预防性治疗选择。