Nucleus Network, Melbourne, Australia.
Br J Clin Pharmacol. 2013 Jan;75(1):118-28. doi: 10.1111/j.1365-2125.2012.04334.x.
IL-13 is implicated as an important mediator of the pathology of asthma. This first clinical study with GSK679586, a novel humanized anti-IL-13 IgG1 monoclonal antibody, evaluated the safety, pharmacokinetics and pharmacodynamics of escalating single and repeat doses of GSK679586.
In this randomized, double-blind study, healthy subjects received single intravenous infusions of GSK679586 (0.005, 0.05, 0.5, 2.5, 10 mg kg(-1)) or placebo and mild intermittent asthmatics received two once monthly intravenous infusions of GSK679586 (2.5, 10, 20 mg kg(-1)) or placebo.
GSK679586 displayed approximately linear pharmacokinetics (based on AUC and C(max)) with limited accumulation upon repeat administration. In mild intermittent asthmatics, treatment with GSK679586 produced an increase in serum total IL-13 concentrations, indicative of GSK679586-IL-13 complex formation. Additionally, mean levels of exhaled nitric oxide (FeNO), a marker of pulmonary inflammation, were reduced relative to baseline at 2.5, 10 and 20 mg kg(-1) doses of GSK679586 at both 2 weeks (19%, 44% and 52% decreases) and 8 weeks (29%, 55% and 42% decreases) after the second infusion. GSK679586 was well tolerated; the incidence of AEs was comparable across all presumed biologically active doses and there were no treatment-related SAEs.
GSK679586 demonstrated dose-dependent pharmacological activity in the lungs of mild intermittent asthmatics. These findings, together with the favourable safety profile and advantageous PK characteristics of a monoclonal antibody (e.g. a long half-life supporting less frequent dosing), warrant further investigation of GSK679586 in a broader asthma patient population.
IL-13 被认为是哮喘病理的重要介质。这是第一项关于 GSK679586(一种新型人源化抗 IL-13 IgG1 单克隆抗体)的临床研究,评估了递增单剂量和重复剂量 GSK679586 的安全性、药代动力学和药效学。
在这项随机、双盲研究中,健康受试者接受了 GSK679586(0.005、0.05、0.5、2.5、10mg/kg)或安慰剂的单次静脉输注,轻度间歇性哮喘患者接受了 GSK679586(2.5、10、20mg/kg)或安慰剂的两次每月一次静脉输注。
GSK679586 显示出近似线性的药代动力学(基于 AUC 和 C(max)),重复给药时积累有限。在轻度间歇性哮喘患者中,GSK679586 治疗导致血清总 IL-13 浓度增加,表明 GSK679586-IL-13 复合物的形成。此外,与基线相比,GSK679586 以 2.5、10 和 20mg/kg 剂量治疗时,呼气一氧化氮(FeNO)的平均水平(肺部炎症的标志物)在第二次输注后 2 周(19%、44%和 52%的降低)和 8 周(29%、55%和 42%的降低)时降低。GSK679586 耐受性良好;在所有假定具有生物活性的剂量下,不良事件的发生率相似,并且没有与治疗相关的严重不良事件。
GSK679586 在轻度间歇性哮喘患者的肺部显示出剂量依赖性的药理活性。这些发现,加上单克隆抗体的有利安全性概况和有利的 PK 特征(例如半衰期长,支持更频繁的给药),进一步证明了 GSK679586 在更广泛的哮喘患者人群中的进一步研究。