Ionis Pharmaceuticals, Inc., Carlsbad, California, USA.
Clinical Pharmacology & Safety Sciences, Astra Zeneca, Mölndal, Sweden.
Nucleic Acid Ther. 2022 Oct;32(5):369-377. doi: 10.1089/nat.2021.0112. Epub 2022 Sep 29.
Therapeutic oligonucleotides (ONs) have characteristics of both small molecules and biologics. Although safety assessment of ONs largely follows guidelines established for small molecules, the unique characteristics of ONs often require incorporation of concepts from the safety assessment of biologics. The assessment of immunogenicity for ON therapeutics is one area where the approach is distinct from either established small molecule or biologic platforms. Information regarding immunogenicity of ONs is limited, but indicates that administration of ONs can result in antidrug antibody formation. In this study, we summarize the collective experience of the Oligonucleotide Safety Working Group in designing the immunogenicity assessment appropriate for this class of therapeutic, including advice on assay development, clinical monitoring, and evaluation of the impact of immunogenicity on exposure, efficacy, and safety of therapeutic ONs.
治疗性寡核苷酸 (ONs) 兼具小分子和生物制剂的特性。尽管 ONs 的安全性评估主要遵循为小分子制定的指南,但 ONs 的独特特性通常需要纳入生物制剂安全性评估的概念。ON 治疗药物的免疫原性评估是一种与已建立的小分子或生物制剂平台明显不同的方法。关于 ON 免疫原性的信息有限,但表明给予 ON 会导致产生抗药物抗体。在这项研究中,我们总结了寡核苷酸安全工作组在设计适合此类治疗药物的免疫原性评估方面的集体经验,包括关于检测开发、临床监测以及评估免疫原性对治疗性 ON 暴露、疗效和安全性影响的建议。