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一项评估抗铜绿假单胞菌 PcrV 和 Psl 双特异性人源单克隆抗体 MEDI3902 在健康成年人中安全性、耐受性、药代动力学和药效学的 I 期研究。

Phase 1 study of MEDI3902, an investigational anti-Pseudomonas aeruginosa PcrV and Psl bispecific human monoclonal antibody, in healthy adults.

机构信息

MedImmune, USA.

AstraZeneca, Gaithersburg, MD, USA.

出版信息

Clin Microbiol Infect. 2019 May;25(5):629.e1-629.e6. doi: 10.1016/j.cmi.2018.08.004. Epub 2018 Aug 11.

DOI:10.1016/j.cmi.2018.08.004
PMID:30107283
Abstract

OBJECTIVES

MEDI3902 is a bivalent, bispecific human immunoglobulin G1κ monoclonal antibody that binds to both the Pseudomonas aeruginosa PcrV protein involved in host cell cytotoxicity and the Psl exopolysaccharide involved in P. aeruginosa colonization and tissue adherence. MEDI3902 is being developed for the prevention of nosocomial P. aeruginosa pneumonia in high-risk patients.

METHODS

This phase 1 dose-escalation study (NCT02255760) evaluated the safety, pharmacokinetics, antidrug antibody (ADA) responses and ex vivo anticytotoxicity and opsonophagocytic killing activities of MEDI3902 after a single intravenous infusion in healthy adults aged 18 to 60 years. Fifty-six subjects were randomized in a 3:1 ratio to receive 250, 750, 1500 or 3000 mg of MEDI3902 or placebo and followed for 60 days afterwards.

RESULTS

Treatment-emergent adverse events (TEAEs) were mild or moderate in severity; no serious TEAEs were observed. The most common TEAEs were infusion-related reactions. MEDI3902 exhibited approximately linear pharmacokinetics across the 250, 750 and 1500 mg doses and nonlinear pharmacokinetics between the 1500 and 3000 mg doses. One subject in the 3000 mg group tested positive for ADA on day 61 and had a lower MEDI3902 serum concentration from days 43 to 61 than ADA-negative subjects. Serum anticytotoxicity antibody concentrations and opsonophagocytic killing activity were correlated with MEDI3902 serum concentrations across all doses.

CONCLUSIONS

Phase 1 study results of MEDI3902 in healthy subjects support further evaluation of its safety and efficacy in subjects at risk for P. aeruginosa pneumonia.

摘要

目的

Medi3902 是一种双价、双特异性人免疫球蛋白 G1κ 单克隆抗体,可与铜绿假单胞菌 PcrV 蛋白(参与宿主细胞细胞毒性)和 Psl 胞外多糖(参与铜绿假单胞菌定植和组织黏附)结合。Medi3902 正在开发用于预防高危患者医院获得性铜绿假单胞菌肺炎。

方法

这项 1 期剂量递增研究(NCT02255760)评估了 MEDI3902 在健康成年人中的安全性、药代动力学、抗药物抗体(ADA)反应以及单次静脉输注后的体外细胞毒性抑制和调理吞噬杀伤活性。18 至 60 岁的 56 名受试者按 3:1 的比例随机分配,接受 250、750、1500 或 3000 mg 的 MEDI3902 或安慰剂治疗,并在随后的 60 天内进行随访。

结果

治疗期间出现的不良事件(TEAE)为轻度或中度;未观察到严重的 TEAEs。最常见的 TEAEs 是输注相关反应。MEDI3902 在 250、750 和 1500 mg 剂量范围内呈近似线性药代动力学特征,而在 1500 和 3000 mg 剂量范围内呈非线性药代动力学特征。在 3000 mg 组中,1 名受试者在第 61 天检测出 ADA 阳性,并且 ADA 阴性受试者的 MEDI3902 血清浓度从第 43 天到第 61 天下降。血清细胞毒性抗体浓度和调理吞噬杀伤活性与所有剂量的 MEDI3902 血清浓度相关。

结论

在健康受试者中的 1 期研究结果支持进一步评估 Medi3902 在铜绿假单胞菌肺炎高危患者中的安全性和疗效。

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