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多价人免疫球蛋白:一项评估 HAV 阴性健康受试者抗甲型肝炎病毒(HAV)抗体水平、药代动力学和安全性的前瞻性、开放标签研究。

Polyvalent Human Immune Globulin: A Prospective, Open-Label Study Assessing Anti-Hepatitis A Virus (HAV) Antibody Levels, Pharmacokinetics, and Safety in HAV-Seronegative Healthy Subjects.

机构信息

Altasciences/Vince and Associates, Overland Park, KS, USA.

Grifols Bioscience Research Group, Research Triangle Park, NC, USA.

出版信息

Adv Ther. 2020 May;37(5):2373-2389. doi: 10.1007/s12325-020-01327-9. Epub 2020 Apr 16.

Abstract

BACKGROUND

Analytical data suggesting that immunoglobulin given intramuscularly (IGIM) may have reduced protection against hepatitis A virus (HAV) infection led to an update in the recommended IGIM dose (0.2 ml/kg).

METHODS

This prospective, open-label, single-arm clinical study evaluated whether a single 0.2 ml/kg dose of IGIM provided protective levels of anti-HAV antibodies (≥ 10 mIU/ml for up to 60 days) in HAV-seronegative healthy adults.

RESULTS

Of the 28 subjects enrolled and dosed, 26 (93%) completed the study. Mean uncorrected anti-HAV antibody titers peaked at 109 mIU/ml on day 5 and stayed above 10 mIU/ml through day 60 (N = 26). The mean uncorrected anti-HAV antibody titers had a median T of 95.33 h, a mean C of 118 mIU/ml, and a mean observed T of 63.3 days; baseline-corrected titers had a median T of 95.33 h, a mean C of 114 mIU/ml, and a mean observed T of 47.1 days (N = 27). All subjects (28/28) experienced at least 1 treatment-emergent adverse event (TEAE), with a total of 83 TEAEs reported; none was serious, and 96% (80/83) resolved without sequelae. Most (63%) events judged definitely and possibly related to study treatment involved localized pain due to intramuscular injections. There were no serious adverse events and no deaths or discontinuations due to TEAEs.

CONCLUSIONS

A single 0.2 ml/kg dose of IGIM provided protective anti-HAV levels for at least 60 days, with acceptable safety and tolerability profiles in healthy subjects. Uncorrected and baseline-corrected pharmacokinetic findings were similar and consistent with the corresponding sampling points in previous research.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier, NCT03351933.

摘要

背景

分析数据表明,肌内注射免疫球蛋白(IGIM)可能降低甲型肝炎病毒(HAV)感染的保护作用,因此更新了推荐的 IGIM 剂量(0.2ml/kg)。

方法

本前瞻性、开放性、单臂临床研究评估了 HAV 血清阴性的健康成年人单次接受 0.2ml/kg 剂量的 IGIM 是否能产生保护性的抗 HAV 抗体水平(≥10mIU/ml,持续 60 天)。

结果

28 名入组并接受治疗的受试者中,26 名(93%)完成了研究。未经校正的平均抗 HAV 抗体滴度于第 5 天达到峰值 109mIU/ml,并在第 60 天仍保持在 10mIU/ml 以上(N=26)。未经校正的平均抗 HAV 抗体滴度的中位 T 为 95.33 小时,平均 C 为 118mIU/ml,平均观察 T 为 63.3 天;基线校正后的滴度中位 T 为 95.33 小时,平均 C 为 114mIU/ml,平均观察 T 为 47.1 天(N=27)。所有受试者(28/28)均至少发生 1 次治疗后出现的不良事件(TEAE),共报告了 83 次 TEAEs;均非严重事件,96%(80/83)无后遗症消退。大多数(63%)判断为肯定和可能与研究治疗相关的事件涉及肌肉注射引起的局部疼痛。无严重不良事件,也无因 TEAEs 导致的死亡或停药。

结论

单次 0.2ml/kg 剂量的 IGIM 至少提供 60 天的保护性抗 HAV 水平,在健康受试者中具有可接受的安全性和耐受性。未经校正和基线校正的药代动力学发现相似,与之前研究的相应采样点一致。

试验注册

ClinicalTrials.gov 标识符,NCT03351933。

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