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A randomized, double-blind, placebo-controlled phase 1 study of multiple ascending doses of subcutaneous M1095, an anti–interleukin 17A/F nanobody, in moderate-to-severe psoriasis - 21/06/19

Doi : 10.1016/j.jaad.2019.03.056 
Danka Svecova, MD, PhD a, Martin W. Lubell, MD b, Florence Casset-Semanaz, MSc b, Harald Mackenzie, MBChB b, Roland Grenningloh, PhD b, , James G. Krueger, MD c
a Faculty of Medicine of Comenius University, Bratislava, Slovakia 
b EMD Serono Research and Development Institute, Billerica, Massachusetts 
c Rockefeller University, New York, New York 

Correspondence to: Roland Grenningloh, PhD, EMD Serono Research and Development Institute, 45A Middlesex Turnpike, Billerica 01821, MA.EMD Serono Research and Development Institute45A Middlesex TurnpikeBillericaMA01821

Abstract

Background

Interleukin 17 is involved in the pathogenesis of psoriasis, a chronic debilitating disease.

Objectives

To evaluate the safety/tolerability, immunogenicity, pharmacokinetics/pharmacodynamics, and efficacy of M1095, an anti–interleukin 17A/F nanobody, in moderate-to-severe plaque psoriasis.

Methods

This multicenter, double-blind, placebo-controlled dose escalation phase 1 study randomized 44 patients 4:1 to treatment with subcutaneous M1095 (30, 60, 120, or 240 mg) or placebo biweekly for 6 weeks, in 4 ascending dose cohorts.

Results

The most frequent treatment-emergent adverse events with M1095 were pruritus (n = 4) and headache (n = 3); 2 patients withdrew owing to adverse events (injection site reaction and elevated liver enzyme levels). The terminal half-life of M1095 was 11 to 12 days. The area under the curve/maximum concentration was dose proportional. Of 10 M1095-treated patients positive for antidrug antibodies, 5 showed treatment-emergent antidrug antibody responses. There was no effect on M1095 exposure. Marked decreases in psoriasis inflammatory markers were observed with M1095. By day 85, 100% and 56% of patients receiving M1095, 240 mg, achieved psoriasis area and severity index 90 and 100, respectively. Improvements in static Physician's Global Assessment and affected body surface area were also seen.

Limitations

Interpretation of efficacy data is limited by the small sample size.

Conclusion

Multiple subcutaneous doses of M1095 showed a favorable safety profile with dose-dependent improvements in psoriasis.

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Key words : ALX-0761, interleukin 17, M1095, nanobody, phase 1, psoriasis

Abbreviations used : ADA, AE, BSA, IL, PASI, sPGA, TEAE


Mappa


 Funding sources: This study was sponsored by Merck KGaA, Darmstadt, Germany.
 Disclosure: Dr Lubell and Mr Mackenzie were employees of EMD Serono, US (a business of Merck KGaA, Darmstadt, Germany) at the time of the study. Ms Casset-Semanaz and Dr Grenningloh are employees of EMD Serono, US (a business of Merck KGaA, Darmstadt, Germany). Ms Svecova declares no conflicts of interest. Dr Krueger's institution (Rockefeller University) received a research grant to fund part of this study, and he has been a consultant to Amgen, Lilly, Novartis, and UCB related to the development of interleukin 17–targeted therapeutics.
 The data in this manuscript were presented as a poster at the American Association of Dermatology annual meeting, Orlando, FL, March 3-7, 2017.
 Reprints not available from the authors.


© 2019  American Academy of Dermatology, Inc.. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 81 - N° 1

P. 196-203 - luglio 2019 Ritorno al numero
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