Biogen, Cambridge, MA 02142, USA.
Biogen, Cambridge, MA 02142, USA.
Med. 2022 Sep 9;3(9):612-621.e3. doi: 10.1016/j.medj.2022.06.006. Epub 2022 Jul 18.
Black/African American participants are underrepresented in clinical trials for multiple sclerosis but can experience a greater burden of disease than other racial groups in the United States. A phase 1, open-label, crossover study that demonstrated bioequivalence of subcutaneous and intramuscular injection of peginterferon β-1a in healthy volunteers enrolled similar proportions of Black and White participants, enabling a post hoc subgroup analysis comparing these groups.
Peginterferon β-1a (125 μg) was administered by subcutaneous or intramuscular injection, followed by a washout period before a second injection using the alternative method. The primary pharmacokinetic and pharmacodynamic endpoints were maximum observed concentration (C) and area under the concentration-time curve from hour 0 to infinity (AUC) of study drug and serum concentration of neop-terin, respectively. Safety and tolerability were included as secondary endpoints.
This analysis included 70 (51.5%) Black and 59 (43.3%) White participants. Peginterferon β-1a C was 29.8% higher in Black than in White participants following subcutaneous administration but was similar following intramuscular administration. Mean AUC was 31.0% and 11.8% greater in Black than in White participants with subcutaneous and intramuscular administration, respectively. Pharmacodynamics and safety signals were similar between groups, although Black participants reported numerically fewer adverse events.
No clinically meaningful differences were identified between Black and White participants related to peginterferon β-1a administration, supporting the approved dose of 125 μg/mL peginterferon β-1a. Future clinical studies should include sufficiently diverse populations to ensure accurate assessments of treatment response.
Funding for medical writing support was provided by Biogen (Cambridge, MA, USA).
在美国,黑种人/非裔美国人参与多发性硬化症临床试验的比例较低,但比其他种族群体的疾病负担更大。一项 1 期、开放性、交叉研究表明,健康志愿者中皮下和肌肉内注射培戈干扰素β-1a 的生物等效性相似,招募了相似比例的黑人和白人参与者,从而能够进行事后亚组分析比较这两个群体。
培戈干扰素β-1a(125μg)通过皮下或肌肉内注射给药,然后在使用替代方法进行第二次注射前进行洗脱期。主要药代动力学和药效学终点分别为研究药物的最大观察浓度(C)和从 0 小时到无穷大的浓度-时间曲线下面积(AUC)以及血清中新蝶呤浓度。安全性和耐受性也被包括为次要终点。
这项分析包括 70 名(51.5%)黑人参与者和 59 名(43.3%)白人参与者。与肌肉内给药相比,黑种人接受皮下给药时,培戈干扰素β-1a 的 C 高出 29.8%,但肌肉内给药时则相似。与皮下和肌肉内给药相比,黑人参与者的平均 AUC 分别高出 31.0%和 11.8%。药效学和安全性信号在两组之间相似,尽管黑人参与者报告的不良事件数量较少。
与培戈干扰素β-1a 的给药相关,黑人和白人参与者之间没有发现具有临床意义的差异,支持批准的 125μg/mL 培戈干扰素β-1a 剂量。未来的临床研究应包括足够多样化的人群,以确保对治疗反应的准确评估。
医学写作支持的经费由 Biogen(马萨诸塞州剑桥,美国)提供。