Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.
Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of WGKK and AUVA Trauma Centre Meidling, 1st Medical Department Hanusch Hospital, Vienna, Austria.
Clin Pharmacol Ther. 2018 Oct;104(4):655-663. doi: 10.1002/cpt.1111. Epub 2018 Jul 13.
Aberrant activation of the classical complement pathway is the common underlying pathophysiology of orphan diseases such as bullous pemphigoid, antibody-mediated rejection of organ transplants, cold agglutinin disease, and warm autoimmune hemolytic anemia. Therapeutic options for these complement-mediated disorders are limited and sutimlimab, a humanized monoclonal antibody directed against complement factor C1s, may be potentially useful for inhibition of the classical complement pathway. A phase I, first-in-human, double-blind, randomized, placebo-controlled, dose-escalation trial of single and multiple doses of sutimlimab or placebo was conducted in 64 volunteers to evaluate safety, tolerability, pharmacokinetic, and pharmacodynamic profiles. Single and multiple infusions of sutimlimab were well tolerated without any safety concerns. sutimlimab exhibited a steep concentration-effect relationship with a Hill coefficient of 2.4, and an IC of 15.5 μg/mL. This study establishes the foundation for using sutimlimab as a highly selective inhibitor of the classical complement pathway in different diseases.
经典补体途径的异常激活是天疱疮、器官移植抗体介导排斥反应、冷凝集素病和温自身免疫性溶血性贫血等孤儿病的共同潜在病理生理学基础。这些补体介导的疾病的治疗选择有限,而针对补体因子 C1s 的人源化单克隆抗体 sutimlimab 可能对抑制经典补体途径有用。在 64 名志愿者中进行了一项 I 期、首次人体、双盲、随机、安慰剂对照、剂量递增试验,以评估 sutimlimab 或安慰剂的单剂量和多剂量的安全性、耐受性、药代动力学和药效学特征。单剂量和多剂量输注 sutimlimab 耐受性良好,无安全性问题。sutimlimab 表现出陡峭的浓度-效应关系,Hill 系数为 2.4,IC 为 15.5μg/ml。这项研究为在不同疾病中使用 sutimlimab 作为经典补体途径的高度选择性抑制剂奠定了基础。