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CNTO 6785 治疗慢性阻塞性肺疾病的随机、安慰剂对照 2 期临床试验。

A Randomized, Placebo-Controlled Phase 2 Trial of CNTO 6785 in Chronic Obstructive Pulmonary Disease.

机构信息

a IKF Pneumologie Frankfurt , Institut für Klinische Forschung Pneumologie, Clinical Research Centre Respiratory Diseases , Frankfurt , Germany.

b Clinexpert Medical Center , Budapest , Hungary.

出版信息

COPD. 2017 Oct;14(5):476-483. doi: 10.1080/15412555.2017.1335697. Epub 2017 Jul 28.

DOI:10.1080/15412555.2017.1335697
PMID:28753067
Abstract

Interleukin (IL)-17A may be an underlying factor in the pathophysiology of chronic obstructive pulmonary disease (COPD). Anti-IL-17 monoclonal antibodies have been used successfully in treating several immune-mediated inflammatory diseases. This phase 2, randomized, placebo-controlled, double-blind, parallel-group, proof-of-concept study is the first clinical study evaluating the efficacy and safety of the anti-IL-17A monoclonal antibody CNTO 6785 in patients with symptomatic moderate-to-severe COPD. Patients were treated with CNTO 6785 (n = 93) or placebo (n = 94) intravenously at Weeks 0, 2, and 4 (induction), then Weeks 8 and 12, and followed till Week 24. The primary efficacy endpoint was the change from baseline in pre-bronchodilator percent-predicted forced expiratory volume in 1 second at Week 16. Samples were collected at all visits for pharmacokinetic (PK) evaluation, and standard safety assessments were performed. The mean difference in the primary efficacy endpoint between CNTO 6785 and placebo was not statistically significant (-0.49%; p = 0.599). No other efficacy endpoints demonstrated clinically or statistically significant differences with CNTO 6785 compared with placebo. CNTO 6785 was generally well tolerated; no major safety signals were detected. The most frequently reported treatment-emergent adverse events were infections and infestations; however, no notable differences were observed between CNTO 6785 and placebo in terms of rates of infections. PK results suggested that the steady state of serum CNTO 6785 concentration was reached within 16 weeks. These results suggest that IL-17A is unlikely to be a dominant driver in the pathology of, or a viable therapeutic target for, COPD. ClinicalTrials.gov Identifier: NCT01966549; EudraCT Identifier: 2012-003607-36.

摘要

白细胞介素 (IL)-17A 可能是慢性阻塞性肺疾病 (COPD) 病理生理学的一个潜在因素。抗 IL-17 单克隆抗体已成功用于治疗多种免疫介导的炎症性疾病。这项 2 期、随机、安慰剂对照、双盲、平行组、概念验证研究是第一项评估抗 IL-17A 单克隆抗体 CNTO 6785 在有症状的中重度 COPD 患者中的疗效和安全性的临床研究。患者在第 0、2 和 4 周(诱导期)、第 8 和 12 周以及第 24 周时静脉注射 CNTO 6785(n = 93)或安慰剂(n = 94)。主要疗效终点是第 16 周时支气管扩张剂前用力呼气量占预计值的百分比的变化。所有就诊时均采集样本进行药代动力学 (PK) 评估,并进行标准安全性评估。CNTO 6785 与安慰剂在主要疗效终点的平均差异无统计学意义 (-0.49%;p = 0.599)。与安慰剂相比,其他疗效终点没有显示出临床或统计学上的显著差异。CNTO 6785 总体耐受性良好;未发现主要安全性信号。报告的最常见治疗后不良事件是感染和寄生虫感染;然而,CNTO 6785 与安慰剂在感染率方面没有明显差异。PK 结果表明,血清 CNTO 6785 浓度的稳态在 16 周内达到。这些结果表明,IL-17A 不太可能是 COPD 病理生理学中的主要驱动因素,也不是一个可行的治疗靶点。临床试验.gov 标识符:NCT01966549;EudraCT 标识符:2012-003607-36。

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