Department of Clinical Pharmacology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China.
Jiangsu Hengrui Pharmaceuticals, Co., Ltd, Shanghai, China.
Alzheimers Res Ther. 2024 Oct 10;16(1):218. doi: 10.1186/s13195-024-01584-8.
SHR-1707 is a novel humanized anti-Aβ IgG1 monoclonal antibody that binds to Aβ fibrils and monomers to block the formation of Aβ plaques or to promote the microglial phagocytosis of Aβ. Preclinical studies showed that SHR-1707 reduced brain Aβ deposition in 5xFAD transgenic mice. Herein, we conducted two phase 1 studies to evaluate the safety, tolerability, pharmacokinetics (PK) and pharmacodynamics (PD) of a single intravenous dose of SHR-1707 in healthy adult subjects.
Two randomized, double-blind, single-ascending-dose, phase 1 studies were conducted in China (Study CHN) and Australia (Study AUS). Study CHN consisted of 2 parts. In Part 1, eligible healthy young adults (18-45 years) were sequentially randomized 8:2 to receive SHR-1707 (five cohorts: 2, 6, 20, 40, and 60 mg/kg) or placebo in each cohort; in Part 2, elderly subjects (55-80 years) were randomized 8:4 to receive SHR-1707 (20 mg/kg) or placebo. A similar design was used in Study AUS, but with only healthy young adults enrolled across three dosing cohorts (2, 20, and 60 mg/kg).
Sixty-two (part 1/2, n = 50/12; age range, 18-42/55-63 years) and 30 subjects (age range, 18-42 years) received SHR-1707 or placebo in Study CHN and Study AUS, respectively. In Study CHN, all treatment-related adverse events (TRAEs) were mild, with the most common being transient laboratory abnormalities. In Study AUS, TRAEs were mostly mild (1 moderate event each with SHR-1707/placebo); the most common TRAEs with SHR-1707 were dysgeusia and fatigue (8.3% each). In both studies, the exposure of SHR-1707 increased in a slightly greater than dose-proportional manner over the dose range of 2-60 mg/kg in young adults; there was a dose-dependent increase in plasma Aβ42 concentration following SHR-1707 administration compared with the placebo group. The safety and PK and PD profiles of SHR-1707 in the elderly subjects were consistent with the younger counterpart at the same dose level. No ethnic difference in safety, PK and PD of SHR-1707 was observed.
A single intravenous dose of SHR-1707 at 2-60 mg/kg was safe and well tolerated in healthy young adult and elderly subjects. The PK and PD profiles are supportive for further clinical development.
NCT04973189 (retrospectively registered on Jul.21, 2021) and NCT04745104 (registered on Feb.6, 2021) on clinicaltrials.gov.
SHR-1707 是一种新型人源化抗 Aβ IgG1 单克隆抗体,能够与 Aβ 纤维和单体结合,从而阻止 Aβ 斑块的形成或促进小胶质细胞对 Aβ 的吞噬。临床前研究表明,SHR-1707 可减少 5xFAD 转基因小鼠大脑中的 Aβ 沉积。在此,我们进行了两项 I 期研究,以评估健康成年受试者单次静脉注射 SHR-1707 的安全性、耐受性、药代动力学(PK)和药效学(PD)。
在中国(研究 CHN)和澳大利亚(研究 AUS)进行了两项随机、双盲、单次递增剂量的 I 期研究。研究 CHN 分为两部分。在第 1 部分中,符合条件的健康年轻成年人(18-45 岁)按 8:2 的比例连续随机接受 SHR-1707(五个队列:2、6、20、40 和 60mg/kg)或安慰剂治疗;在第 2 部分中,老年受试者(55-80 岁)按 8:4 的比例随机接受 SHR-1707(20mg/kg)或安慰剂治疗。研究 AUS 采用类似的设计,但仅在三个剂量队列(2、20 和 60mg/kg)中招募健康年轻成年人。
62 名(第 1/2 部分,n=50/12;年龄范围,18-42/55-63 岁)和 30 名(年龄范围,18-42 岁)受试者分别在研究 CHN 和研究 AUS 中接受了 SHR-1707 或安慰剂治疗。在研究 CHN 中,所有与治疗相关的不良事件(TRAEs)均为轻度,最常见的是短暂的实验室异常。在研究 AUS 中,TRAEs 大多为轻度(SHR-1707/安慰剂各 1 例中度事件);SHR-1707 最常见的 TRAEs 为味觉障碍和疲劳(各 8.3%)。在两项研究中,年轻成年人在 2-60mg/kg 剂量范围内,SHR-1707 的暴露量以略微大于剂量比例的方式增加;与安慰剂组相比,SHR-1707 给药后血浆 Aβ42 浓度呈剂量依赖性增加。老年受试者中 SHR-1707 的安全性、PK 和 PD 特征与相同剂量水平的年轻受试者一致。在 SHR-1707 的安全性、PK 和 PD 方面,未观察到种族差异。
在健康年轻成年和老年受试者中,单次静脉注射 SHR-1707 的剂量为 2-60mg/kg 是安全且耐受良好的。PK 和 PD 特征支持进一步的临床开发。
NCT04973189(2021 年 7 月 21 日回顾性注册)和 NCT04745104(2021 年 2 月 6 日注册),均在 clinicaltrials.gov 上。