Concizumab restores thrombin generation potential in patients with haemophilia: Pharmacokinetic/pharmacodynamic modelling results of concizumab phase 1/1b data
PBN-AR
Instytucja
Instytut Hematologii i Transfuzjologii
Informacje podstawowe
Główny język publikacji
angielski
Czasopismo
Haemophilia
ISSN
1351-8216
EISSN
1365-2516
Wydawca
WILEY-BLACKWELL
DOI
URL
Rok publikacji
2019
Numer zeszytu
1
Strony od-do
60-66
Numer tomu
25
Identyfikator DOI
Liczba arkuszy
Autorzy
(liczba autorów: 8)
Pozostali autorzy
+ 7
Streszczenia
Język
angielski
Treść
Introduction: Concizumab enhances thrombin generation (TG) potential in haemo ‐philia patients by inhibiting tissue factor pathway inhibitor (TFPI). In EXPLORER3 (phase 1b), a dose‐dependent pharmacokinetic/pharmacodynamic (PK/PD) relation‐ship was confirmed between concizumab dose, free TFPI and TG potential.Aim: Determine the association between concizumab exposure, PD markers (free TFPI; peak TG) and bleeding episodes to establish the minimum concizumab concen‐tration for achieving sufficient efficacy.Methods: Free TFPI predictions were generated using an estimated concizumab‐free TFPI exposure‐response (Emax) model based on concizumab phase 1/1b data for which simultaneously collected concizumab and free TFPI samples were available. Concizumab concentration at the time of a bleed was predicted using a PK model, based on available data for concizumab doses >50 μg/kg to ≤9 mg/kg. Peak TG vs concizumab concentration analyses and an Emax model were constructed based on EXPLORER3 observations.Results: The Emax model showed a tight PK/PD relationship between concizumab exposure and free TFPI; free TFPI decreased with increasing concizumab concentra‐tion. A strong correlation between concizumab concentration and peak TG was ob ‐served; concizumab >100 ng/mL re‐established TG potential to within the normal reference range. Estimated EC50 values for the identified concizumab‐free TFPI and concizumab‐TG potential models were very similar, supporting free TFPI as an impor ‐tant biomarker. A correlation between bleeding episode frequency and concizumab concentration was indicated; patients with a concizumab concentration >100 ng/mL experienced less frequent bleeding. The PK model predicted that once‐daily dosing would minimize within‐patient concizumab PK variability.Conclusion: Concizumab phase 2 trials will target an exposure ≥100 ng/mL, with a once‐daily regimen
Cechy publikacji
original article
artykuł oryginalny
Inne
System-identifier
PX-5c2e0cfbd5deeffd294e42ad
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