Metroplex Clinical Research Center, Dallas, Texas.
Hospital General de Mexico and Universidad Nacional Autónoma de Mexico, Mexico.
Arthritis Care Res (Hoboken). 2018 Nov;70(11):1598-1606. doi: 10.1002/acr.23586.
This extension study provided continued treatment to subjects with active rheumatoid arthritis who had participated for ≥16 weeks in a pharmacokinetic similarity study of PF-05280586 (potential rituximab biosimilar). Objectives were to evaluate overall pharmacokinetics, pharmacodynamics, immunogenicity, safety, and tolerability of PF-05280586 after transition from rituximab reference products to PF-05280586, and follow-up of biomarker and efficacy assessments.
Subjects were offered ≤3 additional courses of treatment of PF-05280586, with or without a single transition from rituximab in Europe (rituximab-EU; MabThera) or the US (rituximab-US; Rituxan) to PF-05280586. Each course comprised 2 intravenous infusions (1,000 mg on days 1 and 15, separated by 24 weeks [± 8 weeks]).
Of 220 subjects in the parent study, 185 were randomized and included in this study. There were no notable differences in drug concentrations between groups or across courses, with little variation in depletion of CD19+ B cells between groups, and no apparent relationship between infusion-related reactions and antidrug antibodies with or without single transition from rituximab reference products to PF-05280586. Long-term safety and tolerability of PF-05280586 was acceptable in all groups for up to 96 weeks, with a low incidence of treatment-emergent adverse events independent of single drug transition. The percentage of subjects with a low disease activity score and disease activity score remission was similar across groups for all time points, and responses were sustained until end of study.
This study demonstrated acceptable safety, tolerability, and immunogenicity, with or without single transition from rituximab reference products to PF-05280586, without increased immunogenicity on single transition.
本扩展研究为参加 PF-05280586(潜在利妥昔单抗生物类似药)药代动力学相似性研究≥16 周的活动性类风湿关节炎受试者提供了持续治疗。目的是评估从利妥昔单抗参比制剂转换为 PF-05280586 后的总体药代动力学、药效学、免疫原性、安全性和耐受性,以及生物标志物和疗效评估的随访。
在欧洲(MabThera,利妥昔单抗-EU)或美国(Rituxan,利妥昔单抗-US)将利妥昔单抗转换为 PF-05280586 后,受试者接受了≤3 个疗程的 PF-05280586 治疗,或不进行利妥昔单抗转换。每个疗程包括 2 次静脉输注(第 1 天和第 15 天输注 1000mg,间隔 24 周[±8 周])。
在母研究的 220 名受试者中,185 名随机入组并纳入本研究。各组之间或各疗程之间药物浓度无显著差异,各组间 CD19+B 细胞耗竭差异较小,且无论是否从利妥昔单抗参比制剂转换为 PF-05280586,输注相关反应与抗药抗体之间均无明显关系。在所有组中,PF-05280586 的长期安全性和耐受性均可接受,最长可达 96 周,各组均有较低的治疗相关不良事件发生率,且与是否从利妥昔单抗参比制剂转换为 PF-05280586 无关。在所有时间点,各组的低疾病活动评分和疾病活动评分缓解的受试者比例相似,直至研究结束时反应仍持续。
本研究表明,无论是否从利妥昔单抗参比制剂转换为 PF-05280586,均具有可接受的安全性、耐受性和免疫原性,且单次转换不会增加免疫原性。