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在接受和不接受阿托伐他汀治疗的高胆固醇血症患者中单次和多次给予 bococizumab(一种人源化 IgG2Δa 单克隆抗体,与前蛋白转化酶枯草溶菌素/糜蛋白酶 9 结合)的效果:四项 I 期研究的结果。

The effects of single- and multiple-dose administration of bococizumab (RN316/PF-04950615), a humanized IgG2Δa monoclonal antibody binding proprotein convertase subtilisin/kexin type 9, in hypercholesterolemic subjects treated with and without atorvastatin: Results from four phase I studies.

机构信息

Pfizer Inc., South San Francisco and San Diego, CA, USA.

Mirati Therapeutics Inc., San Diego, CA, USA.

出版信息

Cardiovasc Ther. 2018 Feb;36(1). doi: 10.1111/1755-5922.12309. Epub 2017 Nov 23.


DOI:10.1111/1755-5922.12309
PMID:29078037
Abstract

AIMS: Three single-dose and one multiple-dose phase I studies were conducted in subjects with primary hypercholesterolemia to evaluate the safety, tolerability, pharmacokinetics, and pharmacodynamics of bococizumab, a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor. METHODS: The dosing schedules for hypercholesterolemic subjects randomized in the four phase I studies were (1) ascending, single, intravenous (IV) bococizumab (0.3, 1, 3, 6, 12, or 18 mg/kg), or placebo (N = 48; baseline low-density lipoprotein cholesterol [LDL-C] ≥130 mg/dL); (2) single, IV bococizumab (0.5 or 4 mg/kg; no placebo) added to ongoing atorvastatin 40 mg/day (N = 24); (3) single, fixed, subcutaneous (SC) bococizumab (100 or 200 mg), or IV bococizumab (200 mg; no placebo; N = 49; baseline LDL-C ≥130 mg/dL); and (4) weekly IV bococizumab (0.25, 0.5, 1, or 1.5 mg/kg) or placebo for 4 weeks (N = 67; baseline LDL-C ≥130 mg/dL). RESULTS: Bococizumab pharmacokinetics were well characterized following single IV or SC doses and following multiple IV doses. Exposure to single-dose bococizumab increased slightly greater than dose-proportionally and clearance decreased with increasing dose. In the single-dose studies, maximal mean percent reductions from baseline in LDL-C ranged from 43% (0.3 mg/kg) to 84% (18 mg/kg) in bococizumab-treated subjects, compared with 2% for placebo. For the multiple-dose study, maximal reductions in LDL-C ranged from 55% (0.25 mg/kg) to 66% (1 mg/kg) in bococizumab-treated subjects, compared with 9% for placebo. In all studies, adverse events were infrequent, transient, and not dose-related. CONCLUSIONS: Bococizumab was generally safe and well tolerated. Bococizumab lowered LDL-C levels substantially in all four studies.

摘要

目的:四项 I 期研究招募了原发性高胆固醇血症患者,旨在评估 bococizumab(一种前蛋白转化酶枯草溶菌素/克那霉 9(PCSK9)抑制剂)单次和多次给药的安全性、耐受性、药代动力学和药效学。

方法:四项 I 期研究中,高胆固醇血症受试者的给药方案如下:(1)单次递增静脉内(IV) bococizumab(0.3、1、3、6、12 或 18mg/kg)或安慰剂(n=48;基线低密度脂蛋白胆固醇[LDL-C]≥130mg/dL);(2)在阿托伐他汀 40mg/天的基础上加用单次 IV bococizumab(0.5 或 4mg/kg;无安慰剂)(n=24);(3)单次固定皮下(SC) bococizumab(100 或 200mg)或 IV bococizumab(200mg;无安慰剂;n=49;基线 LDL-C≥130mg/dL);(4)每周 IV bococizumab(0.25、0.5、1 或 1.5mg/kg)或安慰剂 4 周(n=67;基线 LDL-C≥130mg/dL)。

结果:单次 IV 或 SC 剂量及多次 IV 剂量后,bococizumab 的药代动力学特征良好。单次给药 bococizumab 的暴露量呈剂量依赖性增加,清除率随剂量增加而降低。在单次给药研究中,与安慰剂组相比,接受 bococizumab 治疗的受试者的 LDL-C 基线平均最大百分比降幅范围为 43%(0.3mg/kg)至 84%(18mg/kg);在多次给药研究中,接受 bococizumab 治疗的受试者的 LDL-C 最大降幅范围为 55%(0.25mg/kg)至 66%(1mg/kg),而安慰剂组的降幅为 9%。在所有研究中,不良事件均不常见、短暂且与剂量无关。

结论:bococizumab 通常安全且耐受良好。四项研究中,bococizumab 均显著降低 LDL-C 水平。

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Cardiovasc Ther. 2017-11-23

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[3]
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