Kang Jia, Eudy-Byrne Rena J, Mondick John, Knebel William, Jayadeva Girish, Liesenfeld Karl-Heinz
Metrum Research Group, Tariffville, Connecticut, USA.
Boehringer Ingelheim International GmbH, Ingelheim, Germany.
Br J Clin Pharmacol. 2020 Nov;86(11):2274-2285. doi: 10.1111/bcp.14330. Epub 2020 Jun 11.
Adalimumab-adbm is a monoclonal antibody developed as a biosimilar to adalimumab (Humira, AbbVie Inc.). The key objectives of this study were using a population pharmacokinetic (PPK) approach to assess pharmacokinetic (PK) similarity between adalimumab-adbm and Humira in patients with active rheumatoid arthritis (RA), to quantify the effects of potential covariates on adalimumab PK and to assess the impact of switching treatment from Humira to adalimumab-adbm on PK.
A PPK model was firstly developed using intensive PK data from the phase-1 study in healthy subjects (NCT02045979). PPK models were developed separately for phase-3 base study (NCT02137226) and its extension study (NCT02640612) in patients with active RA.
PPK models were developed for adalimumab from adalimumab-adbm and Humira treatment in healthy subjects and RA patients. Weight and anti-drug antibodies were found to be important predictors of adalimumab clearance. Adalimumab PK was similar between adalimumab-adbm and Humira. The estimated effect of Humira on clearance, relative to the adalimumab-adbm, was 1.02 (i.e., Humira has 0.02 greater clearance). Similarly, the effect of treatment arms (switching) on clearance was estimated to be 1.00 and 0.997 for Humira:Humira:BI and Humira:BI:BI arms, respectively, relative to the BI:BI:BI arm (BI refers to adalimumab-adbm) in the phase-3 extension study.
PK similarity between adalimumab-adbm and Humira in patients with active RA was demonstrated using PPK approach. Adalimumab PK was also similar when switching treatment from Humira to adalimumab-adbm at either week 24 or 48.
阿达木单抗 - adbm是一种开发为阿达木单抗(修美乐,艾伯维公司)生物类似药的单克隆抗体。本研究的主要目标是采用群体药代动力学(PPK)方法评估阿达木单抗 - adbm与修美乐在活动性类风湿关节炎(RA)患者中的药代动力学(PK)相似性,量化潜在协变量对阿达木单抗PK的影响,并评估从修美乐转换为阿达木单抗 - adbm治疗对PK的影响。
首先使用来自健康受试者1期研究(NCT02045979)的密集PK数据建立PPK模型。针对活动性RA患者的3期基础研究(NCT02137226)及其扩展研究(NCT02640612)分别建立PPK模型。
针对健康受试者和RA患者中阿达木单抗 - adbm和修美乐治疗的阿达木单抗建立了PPK模型。发现体重和抗药抗体是阿达木单抗清除率的重要预测因素。阿达木单抗 - adbm与修美乐之间的阿达木单抗PK相似。相对于阿达木单抗 - adbm,修美乐对清除率的估计影响为1.02(即,修美乐的清除率高0.02)。同样,在3期扩展研究中,相对于BI:BI:BI组(BI指阿达木单抗 - adbm),修美乐:修美乐:BI组和修美乐:BI:BI组治疗组(转换)对清除率的影响估计分别为1.00和0.997。
采用PPK方法证明了活动性RA患者中阿达木单抗 - adbm与修美乐之间的PK相似性。在第24周或第48周从修美乐转换为阿达木单抗 - adbm治疗时,阿达木单抗的PK也相似。