Alpine Immune Sciences, a Vertex Company, Seattle, Washington, USA.
Nucleus Network (NN), Melbourne, Victoria, Australia.
Clin Transl Sci. 2024 Nov;17(11):e70055. doi: 10.1111/cts.70055.
Therapeutic agents targeting the tumor necrosis factor (TNF) superfamily cytokines B-cell activating factor (BAFF, BLyS) and/or A PRoliferation Inducing Ligand (APRIL) have demonstrated clinical effectiveness in multiple autoimmune diseases, such as systemic lupus erythematosus, lupus nephritis, and immunoglobulin A nephropathy (IgAN). However, their clinical utility can often be limited by incomplete and/or prolonged times to clinical response and inconvenient dosing regimens, which may be improved by more potent dual inhibition of both cytokines. Povetacicept (ALPN-303; TACI vTD-Fc) is a crystallizable fragment (Fc) fusion protein of an engineered transmembrane activator and CAML interactor (TACI) domain which mediates more potent inhibitory activity than wild-type TACI-Fc or BAFF- or APRIL-specific antibodies and demonstrates superior pharmacokinetic and pharmacodynamic activity in multiple preclinical disease models. In this first-in-human study in healthy adults, povetacicept was well-tolerated as single ascending doses of up to 960 mg administered intravenously or subcutaneously. Dose-dependent pharmacokinetics were observed. Coverage of BAFF and APRIL was observed for 2-3 weeks and ≥4 weeks after doses of 80 mg and ≥240 mg, respectively. Maximal pharmacodynamic effects were observed at dose levels ≥80 mg for a single dose, associated with on-target reductions in antibody-secreting cells as well as in all circulating immunoglobulin isotypes, including the IgAN disease-related biomarker galactose-deficient-immunoglobulin A1 (Gd-IgA1), and were superior to results reported for wild-type TACI-Fc. These data strongly support further development of povetacicept for the treatment of B-cell-mediated automimmune diseases.
靶向肿瘤坏死因子(TNF)超家族细胞因子 B 细胞激活因子(BAFF、BLyS)和/或增殖诱导配体(APRIL)的治疗药物已在多种自身免疫性疾病中显示出临床疗效,如系统性红斑狼疮、狼疮性肾炎和免疫球蛋白 A 肾病(IgAN)。然而,它们的临床应用常常受到不完全和/或延长的临床反应时间以及不方便的给药方案的限制,通过更有效地双重抑制这两种细胞因子可能会得到改善。Povetacicept(ALPN-303;TACI vTD-Fc)是一种可结晶片段(Fc)融合蛋白,由工程跨膜激活物和 CAML 相互作用物(TACI)结构域组成,与野生型 TACI-Fc 或 BAFF 或 APRIL 特异性抗体相比,具有更强的抑制活性,并在多种临床前疾病模型中表现出优越的药代动力学和药效学活性。在这项健康成年人的首次人体研究中,静脉内或皮下给予高达 960mg 的单次递增剂量,povetacicept 耐受性良好。观察到剂量依赖性药代动力学。在 80mg 和≥240mg 剂量后,分别观察到 2-3 周和≥4 周的 BAFF 和 APRIL 覆盖。单次剂量≥80mg 时观察到最大药效学效应,与靶标减少抗体分泌细胞以及所有循环免疫球蛋白同种型相关,包括 IgAN 疾病相关生物标志物半乳糖缺乏免疫球蛋白 A1(Gd-IgA1),并且优于野生型 TACI-Fc 的报道结果。这些数据强烈支持进一步开发 povetacicept 用于治疗 B 细胞介导的自身免疫性疾病。