Biologics in Asthma
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Pharmacologic Considerations in the Disposition of Antibodies and Antibody-Drug Conjugates in Preclinical Models and in Patients
antibodies Review Pharmacologic Considerations in the Disposition of Antibodies and Antibody-Drug Conjugates in Preclinical Models and in Patients Andrew T. Lucas 1,2,3,*, Ryan Robinson 3, Allison N. Schorzman 2, Joseph A. Piscitelli 1, Juan F. Razo 1 and William C. Zamboni 1,2,3 1 University of North Carolina (UNC), Eshelman School of Pharmacy, Chapel Hill, NC 27599, USA; [email protected] (J.A.P.); [email protected] (J.F.R.); [email protected] (W.C.Z.) 2 Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; [email protected] 3 Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; [email protected] * Correspondence: [email protected]; Tel.: +1-919-966-5242; Fax: +1-919-966-5863 Received: 30 November 2018; Accepted: 22 December 2018; Published: 1 January 2019 Abstract: The rapid advancement in the development of therapeutic proteins, including monoclonal antibodies (mAbs) and antibody-drug conjugates (ADCs), has created a novel mechanism to selectively deliver highly potent cytotoxic agents in the treatment of cancer. These agents provide numerous benefits compared to traditional small molecule drugs, though their clinical use still requires optimization. The pharmacology of mAbs/ADCs is complex and because ADCs are comprised of multiple components, individual agent characteristics and patient variables can affect their disposition. To further improve the clinical use and rational development of these agents, it is imperative to comprehend the complex mechanisms employed by antibody-based agents in traversing numerous biological barriers and how agent/patient factors affect tumor delivery, toxicities, efficacy, and ultimately, biodistribution. -
Kyntheum, INN-Brodalumab
ANNEX I SUMMARY OF PRODUCT CHARACTERISTICS 1 This medicinal product is subject to additional monitoring. This will allow quick identification of new safety information. Healthcare professionals are asked to report any suspected adverse reactions. See section 4.8 for how to report adverse reactions. 1. NAME OF THE MEDICINAL PRODUCT Kyntheum 210 mg solution for injection in pre-filled syringe 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each pre-filled syringe contains 210 mg brodalumab in 1.5 ml solution. 1 ml solution contains 140 mg brodalumab. Brodalumab is a recombinant human monoclonal antibody produced in Chinese Hamster Ovary (CHO) cells. For the full list of excipients, see section 6.1. 3. PHARMACEUTICAL FORM Solution for injection (injection) The solution is clear to slightly opalescent, colourless to slightly yellow and free from particles. 4. CLINICAL PARTICULARS 4.1 Therapeutic indications Kyntheum is indicated for the treatment of moderate to severe plaque psoriasis in adult patients who are candidates for systemic therapy. 4.2 Posology and method of administration Kyntheum is intended for use under the guidance and supervision of a physician experienced in the diagnosis and treatment of psoriasis. Posology The recommended dose is 210 mg administered by subcutaneous injection at weeks 0, 1, and 2 followed by 210 mg every 2 weeks. Consideration should be given to discontinuing treatment in patients who have shown no response after 12-16 weeks of treatment. Some patients with initial partial response may subsequently improve with continued treatment beyond 16 weeks. Special populations Elderly (aged 65 years and over) No dose adjustment is recommended in elderly patients (see section 5.2). -
Genentech Tocilizumab Letter of Authority June 24 2021
June 24, 2021 Hoffmann-La Roche, Ltd. C/O Genentech, Inc. Attention: Dhushy Thambipillai Regulatory Project Management 1 DNA Way, Bldg 45-1 South San Francisco, CA 94080 RE: Emergency Use Authorization 099 Dear Ms. Thambipillai: This letter is in response to Genentech, Inc.’s (Genentech) request that the Food and Drug Administration (FDA) issue an Emergency Use Authorization (EUA) for the emergency use of Actemra1 (tocilizumab) for the treatment of coronavirus disease 2019 (COVID-19) in certain hospitalized patients, as described in the Scope of Authorization (Section II) of this letter, pursuant to Section 564 of the Federal Food, Drug, and Cosmetic Act (the Act) (21 U.S.C. §360bbb-3). On February 4, 2020, pursuant to Section 564(b)(1)(C) of the Act, the Secretary of the Department of Health and Human Services (HHS) determined that there is a public health emergency that has a significant potential to affect national security or the health and security of United States citizens living abroad, and that involves the virus that causes coronavirus disease 2019 (COVID-19).2 On the basis of such determination, the Secretary of HHS on March 27, 2020, declared that circumstances exist justifying the authorization of emergency use of drugs and biological products during the COVID-19 pandemic, pursuant to Section 564 of the Act (21 3 U.S.C. 360bbb-3), subject to terms of any authorization issued under that section. Actemra is a recombinant humanized monoclonal antibody that selectively binds to both soluble and membrane-bound human IL-6 receptors (sIL-6R and mIL-6R) and subsequently inhibits IL- 6-mediated signaling through these receptors. -
Revised 6/29/2020 GEORGIA MEDICAID FEE-FOR-SERVICE
GEORGIA MEDICAID FEE-FOR-SERVICE BIOLOGIC IMMUNOMODULATORS PA SUMMARY Preferred Non-Preferred Arcalyst (rilonacept) Actemra subcutaneous (tocilizumab) Benlysta subcutaneous (belimumab) Cimzia (certolizumab) Enbrel (etanercept) Cosentyx (secukinumab) Humira (adalimumab) Dupixent (dupilumab) Ilaris (canakinumab) Fasenra Pen (benralizumab autoinjector)Kevzara Xeljanz (tofacitinib) (sarilumab) Xeljanz XR (tofacitinib extended-release) Kineret (anakinra) Nucala Pen (mepolizumab autoinjector) Olumiant (baricitinib) Orencia subcutaneous (abatacept) Otezla (apremilast) Rinvoq (upadacitinib) Siliq (brodalumab) Simponi (golimumab) Stelara (ustekinumab) Skyrizi (risankizumab) Taltz (ixekizumab) Tremfya (guselkumab) The drug names above include all available oral or subcutaneous formulations under the same primary name. LENGTH OF AUTHORIZATION: Varies NOTES: ▪ All preferred and non-preferred products require prior authorization. Intravenous (IV) formulations of the biologic immunomodulators are not covered under Pharmacy Services. ▪ The criteria details below are for the outpatient pharmacy program. If a medication is being administered in a physician’s office or clinic, then the medication must be billed through the DCH physician services program and not the outpatient pharmacy program. Information regarding the physician services program is located at www.mmis.georgia.gov. PA CRITERIA: Actemra Subcutaneous ❖ Approvable for members 2 years of age or older with a diagnosis of moderately to severely active polyarticular juvenile idiopathic arthritis -
Review Anti-Cytokine Biologic Treatment Beyond Anti-TNF in Behçet's Disease
Review Anti-cytokine biologic treatment beyond anti-TNF in Behçet’s disease A. Arida, P.P. Sfikakis First Department of Propedeutic Internal ABSTRACT and thrombotic complications (1-3). Medicine Laikon Hospital, Athens, Unmet therapeutic needs in Behçet’s Treatment varies according to type and University Medical School, Greece. disease have drawn recent attention to severity of disease manifestations. Cor- Aikaterini Arida, MD biological agents targeting cytokines ticosteroids, interferon-alpha and con- Petros P. Sfikakis, MD other than TNF. The anti-IL-17 anti- ventional immunosuppressive drugs, Please address correspondence to: body secukinumab and the anti-IL-2 such as azathioprine, cyclosporine-A, Petros P. Sfikakis, MD, receptor antibody daclizumab were not cyclophosphamide and methotrexate, First Department of Propedeutic superior to placebo for ocular Behçet’s and Internal Medicine, are used either alone or in combination Laikon Hospital, in randomised controlled trials, com- for vital organ involvement. During the Athens University Medical School, prising 118 and 17 patients, respec- last decade there has been increased use Ag Thoma, 17, tively. The anti-IL-1 agents anakinra of anti-TNF monoclonal antibodies in GR-11527 Athens, Greece. and canakinumab and the anti-IL-6 patients with BD who were refractory E-mail: [email protected] agent tocilizumab were given to iso- to conventional treatment or developed Received on June 7, 2014; accepted in lated refractory disease patients, who life-threatening complications (4, 5). revised form on September 17, 2014. were either anti-TNF naïve (n=9) or Anti-TNF treatment has been shown to Clin Exp Rheumatol 2014; 32 (Suppl. 84): experienced (n=18). -
Tocilizumab in Hospitalised Adults with Covid-19
This document has been approved for use at [ ] USE OF TOCILIZUMAB IN HOSPITALISED ADULTS WITH COVID-19 INFORMATION FOR PATIENTS, FAMILIES AND CARERS This information leaflet contains important information about the medicine called tocilizumab when used in the treatment of COVID-19. WHAT IS THE POTENTIAL BENEFIT OF It is important you provide your formal consent TOCILIZUMAB FOR COVID-19? before receiving tocilizumab. You can always change your mind about treatment with Tocilizumab belongs to a group of medicines called tocilizumab and withdraw consent at any time. monoclonal antibodies. Monoclonal antibodies are proteins, which specifically recognise and bind to unique proteins in the body to modify the way the WHAT SHOULD THE DOCTOR KNOW immune system works. Tocilizumab has effects on BEFORE TOCILIZUMAB IS USED IN the immune system that may be useful in helping COVID-19? to reduce the effects of severe COVID-19. The doctor should know about: Tocilizumab has been approved in Australia to treat any other conditions including HIV or AIDs, some immune conditions such as arthritis, cytokine tuberculosis, diverticulitis, stomach ulcers, release syndrome and giant cell arteritis. The brand diabetes, cancer, heart problems, raised name is Actemra®. blood pressure or any nerve disease such as Recent clinical trials studying the effectiveness of neuropathy tocilizumab in COVID-19 have been analysed by previous allergic reactions to any medicine Australia’s National COVID-19 Clinical Evidence all medicines including over-the-counter and Taskforce. The Taskforce makes recommendations complementary medicines e.g. vitamins, about when tocilizumab is most likely to be minerals, herbal or naturopathic medicines effective in the treatment of COVID-19. -
Fasenra, INN-Benralizumab
ANNEX I SUMMARY OF PRODUCT CHARACTERISTICS 1 This medicinal product is subject to additional monitoring. This will allow quick identification of new safety information. Healthcare professionals are asked to report any suspected adverse reactions. See section 4.8 for how to report adverse reactions. 1. NAME OF THE MEDICINAL PRODUCT Fasenra 30 mg solution for injection in pre-filled syringe Fasenra 30 mg solution for injection in pre-filled pen 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Pre-filled syringe Each pre-filled syringe contains 30 mg benralizumab* in 1 mL. Pre-filled pen Each pre-filled pen contains 30 mg benralizumab* in 1 mL. *Benralizumab is a humanised monoclonal antibody produced in Chinese hamster ovary (CHO) cells by recombinant DNA technology. For the full list of excipients, see section 6.1. 3. PHARMACEUTICAL FORM Solution for injection in pre-filled syringe (injection) Solution for injection in pre-filled pen (injection) (Fasenra Pen) Clear to opalescent, colourless to yellow solution and may contain translucent or white to off-white particles. 4. CLINICAL PARTICULARS 4.1 Therapeutic indications Fasenra is indicated as an add-on maintenance treatment in adult patients with severe eosinophilic asthma inadequately controlled despite high-dose inhaled corticosteroids plus long-acting β-agonists (see section 5.1). 4.2 Posology and method of administration Fasenra treatment should be initiated by a physician experienced in the diagnosis and treatment of severe asthma. After proper training in the subcutaneous injection technique and education about signs and symptoms of hypersensitivity reactions (see section 4.4), patients with no known history of anaphylaxis or their caregivers may administer Fasenra if their physician determines that it is appropriate, with medical follow-up as necessary. -
Challenges and Approaches for the Development of Safer Immunomodulatory Biologics
REVIEWS Challenges and approaches for the development of safer immunomodulatory biologics Jean G. Sathish1*, Swaminathan Sethu1*, Marie-Christine Bielsky2, Lolke de Haan3, Neil S. French1, Karthik Govindappa1, James Green4, Christopher E. M. Griffiths5, Stephen Holgate6, David Jones2, Ian Kimber7, Jonathan Moggs8, Dean J. Naisbitt1, Munir Pirmohamed1, Gabriele Reichmann9, Jennifer Sims10, Meena Subramanyam11, Marque D. Todd12, Jan Willem Van Der Laan13, Richard J. Weaver14 and B. Kevin Park1 Abstract | Immunomodulatory biologics, which render their therapeutic effects by modulating or harnessing immune responses, have proven their therapeutic utility in several complex conditions including cancer and autoimmune diseases. However, unwanted adverse reactions — including serious infections, malignancy, cytokine release syndrome, anaphylaxis and hypersensitivity as well as immunogenicity — pose a challenge to the development of new (and safer) immunomodulatory biologics. In this article, we assess the safety issues associated with immunomodulatory biologics and discuss the current approaches for predicting and mitigating adverse reactions associated with their use. We also outline how these approaches can inform the development of safer immunomodulatory biologics. Immunomodulatory Biologics currently represent more than 30% of licensed The high specificity of the interactions of immu- biologics pharmaceutical products and have expanded the thera- nomodulatory biologics with their relevant immune Biotechnology-derived peutic options available -
BIOLOGIC THERAPIES ASTHMA DYKEWICZ F BW.Pdf
11/30/2011 Biologic Asthma Therapies and Individualized Medicine Disclosures Advisory boards Mark S. Dykewicz, MD Merck (advisor, honorarium) Director, Allergy & Immunology Shire (advisor, honorarium) Fellowship Program Director Wake Forest University School of Medicine Editorial boards Winston-Salem, North Carolina USA Allergy & Asthma Proceedings American Journal of Rhinology & Allergy Clinical Reviews in Allergy & Immunology Journal of Angioedema Learning Objective Biological therapies May fill unmet needs, potentially in To better understand the use of biologic subpopulations or phenotypes of patients with modifiers in individualized asthma more severe asthma. treatment. May provide insight into mechanisms of asthma Sheharyar, Durrani, Busse. Biological Therapy for Asthma. ACCP PCCSU Article | 03.15.11 Omalizumab (Anti-IgE) Biologics with action against IgE (omalizumab) Biologic mechanism: Mab against IgE; decreases IgE Cytokines levels; results in down-regulation of IgE receptor IL-4 and/or IL-13 Patient subsets: persistent asthma selected for IL-5 specific IgE to perennial allergen, total serum IgE in Chemokine Receptors specified range CCR3 Benefits: 8 trials (n=3429) Rodrigo. Chest 2011 139:28 CXCR2 decreases in exacerbations, dose of inhaled and oral Transcription Factors corticosteroids, hospitalizations PPARs (peroxisome proliferator-activated receptors) improvement in QOL when used as add-on Rx Prostaglandin Receptors no improvement in lung function. CRTH2 6 1 11/30/2011 IL-4 Modifiers IL-13 Altrakincept Solubilized IL-4 Failed to show efficacy in large phase Pleiotropic cytokine of Th2 cells, promotes IgE receptor fragment, 3 trial. production neutralizes IL-4 Adcock et al (2008) May contribute to key features of asthma Pascolizumab Monoclonal Ab Phase 2 study of pascolizumab IL-13 production inhibited by inhaled glucocorticoids against IL- 4 discontinued because of inefficacy. -
Biological Therapies for Atopic Dermatitis: an Update (Review)
EXPERIMENTAL AND THERAPEUTIC MEDICINE 17: 1061-1067, 2019 Biological therapies for atopic dermatitis: An update (Review) DIANA DELEANU1-3 and IRENA NEDELEA1,2 1Allergology and Immunology Discipline, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400058 Cluj-Napoca; Departments of 2Allergy and 3Internal Medicine, ‘Professor Doctor Octavian Fodor’ Regional Institute of Gastroenterology and Hepatology, 400162 Cluj-Napoca, Romania Received July 6, 2018; Accepted August 22, 2018 DOI: 10.3892/etm.2018.6989 Abstract. Severe atopic dermatitis, which affects both adults in low-income countries (3). Furthermore, the past decades and children, is a debilitating disorder with a significant decline brought a 2-3-fold increase in prevalence in industrialized of patients' quality of life. Although aetiopathogenic factors countries (3). Generally AD onset is in early childhood, as are currently a topic of study and interpretation, the main one of the first steps of the ‘atopic march’, which describes the features of atopic eczema are skin barrier disturbance and natural history of atopic manifestations, and it is character- immune dysregulation. Severe refractory disease that fails to ized by xerotic skin and acute flare-ups of intensely pruritic improve with conventional therapy may benefit from biologic eczematous lesions (4). Recent studies recognize a predilection therapy. Progress in understanding immunopathology of atopic of AD for persistence in adulthood, with a lifetime prevalence dermatitis have allowed identification of therapeutic molecular accounting for 34.1% (5). Early onset, allergic rhinitis and targets in the field of biological therapy. We reviewed the hand eczema in childhood are high-risk factors for persistent different biological treatments with a focus on novel targeted AD (5). -
Astra Makes Quiet Progress with Respiratory Pipeline
June 18, 2014 Astra makes quiet progress with respiratory pipeline Jonathan Gardner In defending AstraZeneca against acquisition by Pfizer its executives pointed to oncology candidates such as the checkpoint inhibitor Medi4736 and lung cancer project AZD9291 as assets not fully valued by the American pursuer. Less well appreciated is Astra's portfolio of clinical-stage respiratory programmes, one of which appears to be the only project of its class to be tested in the clinic. Given Astra's relative position in each therapy area, one might think that respiratory disease would draw more attention, even though oncology remains the hottest area of drug development. A focus on novel classes and severe disease – demonstrated by a licensing deal last week for an inhalable interferon for asthma – could allow Astra to expand even as growth in respiratory therapies flattens through the rest of the decade. Ordinary and unusual Astra executives themselves have made less of the respiratory disease pipeline, forecasting sales that are in line with consensus figures even as they pumped up the group’s collective R&D (Don’t blame Soriot, he’s just doing his job, May 7, 2014). In some respects, it is somewhat ordinary: the phase III pipeline features some candidates in well-established classes like long-acting beta-2 agonists (LABAs) in the form of assets brought on board with the acquisition of Pearl Therapeutics (Astra’s Soriot finds hidden value in private assets, June 10, 2013). James Ward-Lilley, the UK group’s vice-president of respiratory, inflammation and autoimmune disease, acknowledged that the respiratory group had not received the attention of the investor community in part because the potential payoff of a clinical gamble is not valued as highly. -
Classification Decisions Taken by the Harmonized System Committee from the 47Th to 60Th Sessions (2011
CLASSIFICATION DECISIONS TAKEN BY THE HARMONIZED SYSTEM COMMITTEE FROM THE 47TH TO 60TH SESSIONS (2011 - 2018) WORLD CUSTOMS ORGANIZATION Rue du Marché 30 B-1210 Brussels Belgium November 2011 Copyright © 2011 World Customs Organization. All rights reserved. Requests and inquiries concerning translation, reproduction and adaptation rights should be addressed to [email protected]. D/2011/0448/25 The following list contains the classification decisions (other than those subject to a reservation) taken by the Harmonized System Committee ( 47th Session – March 2011) on specific products, together with their related Harmonized System code numbers and, in certain cases, the classification rationale. Advice Parties seeking to import or export merchandise covered by a decision are advised to verify the implementation of the decision by the importing or exporting country, as the case may be. HS codes Classification No Product description Classification considered rationale 1. Preparation, in the form of a powder, consisting of 92 % sugar, 6 % 2106.90 GRIs 1 and 6 black currant powder, anticaking agent, citric acid and black currant flavouring, put up for retail sale in 32-gram sachets, intended to be consumed as a beverage after mixing with hot water. 2. Vanutide cridificar (INN List 100). 3002.20 3. Certain INN products. Chapters 28, 29 (See “INN List 101” at the end of this publication.) and 30 4. Certain INN products. Chapters 13, 29 (See “INN List 102” at the end of this publication.) and 30 5. Certain INN products. Chapters 28, 29, (See “INN List 103” at the end of this publication.) 30, 35 and 39 6. Re-classification of INN products.