Pfaff Samuel J, O'Reilly Terry, Zhang Yan, Olsen Walter, Kuchenbecker Kristopher
Silver Creek Pharmaceuticals, Inc., South San Francisco, California, USA.
Clin Pharmacol Drug Dev. 2025 Jan;14(1):65-78. doi: 10.1002/cpdd.1486. Epub 2024 Dec 8.
Apoptosis is a major driver of cell loss and infarct expansion in ischemic injuries such as acute ischemic stroke (AIS) and acute myocardial infarction (AMI). Insulin-like growth factor-1 (IGF-1) can mitigate cell death and potentiate recovery following acute ischemic injury, but short half-life and nonspecificity limit its therapeutic potential. Scp776 is an IGF-1 fusion protein designed to target damaged tissue and promote apoptosis escape and is in clinical development as an acute therapy for AIS and AMI. Two phase 1 placebo-controlled studies in healthy volunteers evaluated safety, tolerability, pharmacokinetic profile, and pharmacodynamics under single (1, 2, or 4 mg/kg) or multiple (6, 6.2, or 7.25 mg/kg total doses) dosing regimens. In addition, a blood glucose management plan was developed and implemented to mitigate hypoglycemia that may develop following scp776 injection. Scp776 was well tolerated in healthy volunteers (n = 51) without serious adverse events. Exposure increased in a near dose-proportional manner with a mean half-life across all doses of 8 hours. Adaptive dextrose infusions maintained normal blood glucose levels with occasional mild hypoglycemic events. These results informed scp776 dose selection and the design of blood glucose monitoring protocols for phase 2 studies.
细胞凋亡是急性缺血性中风(AIS)和急性心肌梗死(AMI)等缺血性损伤中细胞丢失和梗死扩展的主要驱动因素。胰岛素样生长因子-1(IGF-1)可减轻急性缺血性损伤后的细胞死亡并增强恢复能力,但半衰期短和非特异性限制了其治疗潜力。Scp776是一种IGF-1融合蛋白,旨在靶向受损组织并促进细胞凋亡逃逸,目前正作为AIS和AMI的急性治疗药物进行临床开发。两项针对健康志愿者的1期安慰剂对照研究评估了单剂量(1、2或4mg/kg)或多剂量(总剂量6、6.2或7.25mg/kg)给药方案下的安全性、耐受性、药代动力学特征和药效学。此外,还制定并实施了血糖管理计划,以减轻scp776注射后可能出现的低血糖。Scp776在健康志愿者(n = 51)中耐受性良好,无严重不良事件。暴露量以接近剂量比例的方式增加,所有剂量的平均半衰期为8小时。适应性葡萄糖输注维持了正常血糖水平,偶尔出现轻度低血糖事件。这些结果为scp776的剂量选择和2期研究的血糖监测方案设计提供了依据。