Safety, Tolerability, and Pharmacokinetics of MEDI8897, the Respiratory Syncytial Virus Prefusion F-Targeting Monoclonal Antibody with an Extended Half-Life, in Healthy Adults

M Pamela Griffin, Anis A Khan, Mark T Esser, Kathryn Jensen, Therese Takas, Martin K Kankam, Tonya Villafana, Filip Dubovsky, M Pamela Griffin, Anis A Khan, Mark T Esser, Kathryn Jensen, Therese Takas, Martin K Kankam, Tonya Villafana, Filip Dubovsky

Abstract

Prevention of respiratory syncytial virus (RSV) illness in infants is a major public health priority, but there is no approved vaccine. Palivizumab is a monoclonal antibody that provides RSV prophylaxis but requires 5 monthly injections and is approved only for infants who experience the greatest morbidity and mortality from RSV. Thus, there remains a significant unmet medical need for prevention of RSV disease in healthy infants. MEDI8897 is a recombinant human RSV monoclonal antibody with a modified Fc region that extends its half-life and is being developed as RSV prophylaxis for all infants. In this phase 1, first-in-human, placebo-controlled study, 136 healthy adults were randomized to receive a single dose of MEDI8897 (n = 102) or placebo (n = 34) in 1 of 5 cohorts (300, 1,000, or 3,000 mg intravenously or 100 or 300 mg intramuscularly [i.m.]) and were monitored for 360 days. The mean half-life of MEDI8897 was 85 to 117 days across dose groups, and bioavailability after 300-mg i.m. dose administration was 77%. Time to maximum concentration following i.m. dosing was 5 to 9 days. Antidrug antibody (ADA) responses were detected in a similar proportion of placebo (15.2%) and MEDI8897 (13.7%) recipients. The safety profile of MEDI8897 was similar to that of the placebo. These results support clinical studies of the i.m. administration of a single dose of MEDI8897 in the target population of infants to provide protection for the duration of the RSV season. (This study has been registered at ClinicalTrials.gov under identifier NCT02114268.).

Keywords: MEDI8897; RSV; healthy adults; infants; lower respiratory tract infections; pharmacokinetics; respiratory syncytial virus.

Copyright © 2017 Griffin et al.

Figures

FIG 1
FIG 1
Subject disposition.
FIG 2
FIG 2
Mean serum MEDI8897 concentrations after a single i.v. or i.m. dose. Data have been jittered. Error bars represent the standard deviations.
FIG 3
FIG 3
Anti-RSV neutralizing antibody titers after a single i.v. or i.m. dose of MEDI8897 or placebo. Data points represent the mean anti-RSV A2 neutralizing antibody titers on a log2 scale. Data have been jittered. Error bars represent the standard deviations. Ab, antibody.

References

    1. Brandt CD, Kim HW, Arrobio JO, Jeffries BC, Wood SC, Chanock RM, Parrott RH. 1973. Epidemiology of respiratory syncytial virus infection in Washington, DC 3. Composite analysis of eleven consecutive yearly epidemics. Am J Epidemiol 98:355–364.
    1. Glezen P, Denny FW. 1973. Epidemiology of acute lower respiratory disease in children. N Engl J Med 288:498–505. doi:10.1056/NEJM197303082881005.
    1. Hall CB, Weinberg GA, Iwane MK, Blumkin AK, Edwards KM, Staat MA, Auinger P, Griffin MR, Poehling KA, Erdman D, Grijalva CG, Zhu Y, Szilagyi P. 2009. The burden of respiratory syncytial virus infection in young children. N Engl J Med 360:588–598. doi:10.1056/NEJMoa0804877.
    1. Hall CB. 2012. The burgeoning burden of respiratory syncytial virus among children. Infect Disord Drug Targets 12:92–97. doi:10.2174/187152612800100099.
    1. Nair H, Nokes DJ, Gessner BD, Dherani M, Madhi SA, Singleton RJ, O'Brien KL, Roca A, Wright PF, Bruce N, Chandran A, Theodoratou E, Sutanto A, Sedyaningsih ER, Ngama M, Munywoki PK, Kartasasmita C, Simoes EA, Rudan I, Weber MW, Campbell H. 2010. Global burden of acute lower respiratory infections due to respiratory syncytial virus in young children: a systematic review and meta-analysis. Lancet 375:1545–1555. doi:10.1016/S0140-6736(10)60206-1.
    1. Shay DK, Holman RC, Newman RD, Liu LL, Stout JW, Anderson LJ. 1999. Bronchiolitis-associated hospitalizations among US children, 1980-1996. JAMA 282:1440–1446. doi:10.1001/jama.282.15.1440.
    1. Stockman LJ, Curns AT, Anderson LJ, Fischer-Langley G. 2012. Respiratory syncytial virus-associated hospitalizations among infants and young children in the United States, 1997-2006. Pediatr Infect Dis J 31:5–9. doi:10.1097/INF.0b013e31822e68e6.
    1. Greenough A, Cox S, Alexander J, Lenney W, Turnbull F, Burgess S, Chetcuti PA, Shaw NJ, Woods A, Boorman J, Coles S, Turner J. 2001. Health care utilisation of infants with chronic lung disease, related to hospitalisation for RSV infection. Arch Dis Child 85:463–468. doi:10.1136/adc.85.6.463.
    1. Meissner HC. 2003. Selected populations at increased risk from respiratory syncytial virus infection. Pediatr Infect Dis J 22:S40–S45. doi:10.1097/01.inf.0000053884.21238.13.
    1. Parrott RH, Kim HW, Arrobio JO, Hodes DS, Murphy BR, Brandt CD, Camargo E, Chanock RM. 1973. Epidemiology of respiratory syncytial virus infection in Washington, DC II. Infection and disease with respect to age, immunologic status, race and sex. Am J Epidemiol 98:289–300.
    1. Kim HW, Canchola JG, Brandt CD, Pyles G, Chanock RM, Jensen K, Parrott RH. 1969. Respiratory syncytial virus disease in infants despite prior administration of antigenic inactivated vaccine. Am J Epidemiol 89:422–434.
    1. American Academy of Pediatrics. 2014. Updated guidance for palivizumab prophylaxis among infants and young children at increased risk of hospitalization for respiratory syncytial virus infection. Pediatrics 134:415–420. doi:10.1542/peds.2014-1665.
    1. McLellan JS, Chen M, Leung S, Graepel KW, Du X, Yang Y, Zhou T, Baxa U, Yasuda E, Beaumont T, Kumar A, Modjarrad K, Zheng Z, Zhao M, Xia N, Kwong PD, Graham BS. 2013. Structure of RSV fusion glycoprotein trimer bound to a prefusion-specific neutralizing antibody. Science 340:1113–1117. doi:10.1126/science.1234914.
    1. Kwakkenbos MJ, Diehl SA, Yasuda E, Bakker AQ, van Geelen CM, Lukens MV, van Bleek GM, Widjojoatmodjo MN, Bogers WM, Mei H, Radbruch A, Scheeren FA, Spits H, Beaumont T. 2010. Generation of stable monoclonal antibody-producing B cell receptor-positive human memory B cells by genetic programming. Nat Med 16:123–128. doi:10.1038/nm.2071.
    1. Dall'Acqua WF, Kiener PA, Wu H. 2006. Properties of human IgG1s engineered for enhanced binding to the neonatal Fc receptor (FcRn). J Biol Chem 281:23514–23524. doi:10.1074/jbc.M604292200.
    1. Robbie GJ, Criste R, Dall'Acqua WF, Jensen K, Patel NK, Losonsky GA, Griffin MP. 2013. A novel investigational Fc-modified humanized monoclonal antibody, motavizumab-YTE, has an extended half-life in healthy adults. Antimicrob Agents Chemother 57:6147–6153. doi:10.1128/AAC.01285-13.
    1. Robbie GJ, Zhao L, Mondick J, Losonsky G, Roskos LK. 2012. Population pharmacokinetics of palivizumab, a humanized anti-respiratory syncytial virus monoclonal antibody, in adults and children. Antimicrob Agents Chemother 56:4927–4936. doi:10.1128/AAC.06446-11.
    1. MedImmune LLC. 2014. Synagis (palivizumab) injections, for intramuscular use. Full prescribing information. MedImmune LLC, Gaithersburg, MD.
    1. Glezen WP, Paredes A, Allison JE, Taber LH, Frank AL. 1981. Risk of respiratory syncytial virus infection for infants from low-income families in relationship to age, sex, ethnic group, and maternal antibody level. J Pediatr 98:708–715. doi:10.1016/S0022-3476(81)80829-3.
    1. Groothuis JR, Simoes EA, Levin MJ, Hall CB, Long CE, Rodriguez WJ, Arrobio J, Meissner HC, Fulton DR, Welliver RC, Tristam DA, Siber GR, Prince GA, van Raden M, Hemming VG, Respiratory Syncytial Virus Immune Globulin Study Group. 1993. Prophylactic administration of respiratory syncytial virus immune globulin to high-risk infants and young children. N Engl J Med 329:1524–1530. doi:10.1056/NEJM199311183292102.
    1. PREVENT Study Group. 1997. Reduction of respiratory syncytial virus hospitalization among premature infants and infants with bronchopulmonary dysplasia using respiratory syncytial virus immune globulin prophylaxis. Pediatrics 99:93–99. doi:10.1542/peds.99.1.93.
    1. The IMpact-RSV Study Group. 1998. Palivizumab, a humanized respiratory syncytial virus monoclonal antibody, reduces hospitalization from respiratory syncytial virus infection in high-risk infants. Pediatrics 102:531–537.
    1. Ogilvie MM, Vathenen AS, Radford M, Codd J, Key S. 1981. Maternal antibody and respiratory syncytial virus infection in infancy. J Med Virol 7:263–271. doi:10.1002/jmv.1890070403.
    1. Falloon J, Ji F, Curtis C, Bart S, Sheldon E, Krieger D, Dubovsky F, Lambert S, Takas T, Villafana T, Esser MT. 2016. A phase 1a, first-in-human, randomized study of a respiratory syncytial virus F protein vaccine with and without a toll-like receptor-4 agonist and stable emulsion adjuvant. Vaccine 34:2847–2854. doi:10.1016/j.vaccine.2016.04.002.
    1. Patton K, Aslam S, Shambaugh C, Lin R, Heeke D, Frantz C, Zuo F, Esser MT, Paliard X, Lambert SL. 2015. Enhanced immunogenicity of a respiratory syncytial virus (RSV) F subunit vaccine formulated with the adjuvant GLA-SE in cynomolgus macaques. Vaccine 33:4472–4478. doi:10.1016/j.vaccine.2015.07.025.

Source: PubMed

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