Middle Level IM-MS and CIU Experiments for Improved Therapeutic Immunoglobulin Subclass Fingerprinting ACS Paragon Plus Environment Analytical Chemistry T

Total Page:16

File Type:pdf, Size:1020Kb

Middle Level IM-MS and CIU Experiments for Improved Therapeutic Immunoglobulin Subclass Fingerprinting ACS Paragon Plus Environment Analytical Chemistry T Middle level IM-MS and CIU experiments for improved therapeutic immunoglobulin subclass fingerprinting ACS Paragon Plus Environment Analytical Chemistry T. Botzanowski, O. Hernandez-Alba, M. Malissard, E. Wagner-Rousset, E. Desligniere, O. Colas, F. Haeuw J., A. Beck, S. Cianferani To cite this version: T. Botzanowski, O. Hernandez-Alba, M. Malissard, E. Wagner-Rousset, E. Desligniere, et al.. Middle level IM-MS and CIU experiments for improved therapeutic immunoglobulin subclass fingerprinting ACS Paragon Plus Environment Analytical Chemistry. Analytical Chemistry, American Chemical Society, 2020, 92 (13), pp.8827-8835. 10.1021/acs.analchem.0c00293. hal-02960844 HAL Id: hal-02960844 https://hal.archives-ouvertes.fr/hal-02960844 Submitted on 8 Oct 2020 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. Analytical Chemistry This document is confidential and is proprietary to the American Chemical Society and its authors. Do not copy or disclose without written permission. If you have received this item in error, notify the sender and delete all copies. Middle level IM-MS and CIU experiments for improved therapeutic immunoglobulin subclass fingerprinting Journal: Analytical Chemistry Manuscript ID ac-2020-00293w.R2 Manuscript Type: Article Date Submitted by the n/a Author: Complete List of Authors: Botzanowski, Thomas; IPHC Hernandez-Alba, Oscar; IPHC, Laboratoire de Spectrométrie de Masse Bio-Organique (LSMBO) Malissard, Martine; Centre d'Immunologie Pierre Fabre Wagner-Rousset, Elsa; Centre d'Immunologie Pierre Fabre, Physici- Chemistry Deslignière, Evolène; IPHC, Laboratoire de Spectrométrie de Masse Bio- Organique (LSMBO) Colas, Olivier; Centre d'Immunologie Pierre Fabre Haeuw, Jean-François; Centre d'Immunologie Pierre Fabre, Physico- Chemistry Beck, Alain; Centre d'Immunologie Pierre Fabre, Physico-Chemistry Cianférani, Sarah; IPHC, Laboratoire de Spectrométrie de Masse Bio- Organique (LSMBO) ACS Paragon Plus Environment Page 1 of 16 Analytical Chemistry 1 2 3 4 5 6 7 Middle level IM-MS and CIU experiments for improved therapeutic 8 immunoglobulin subclass fingerprinting 9 10 Thomas Botzanowski1¶, Oscar Hernandez-Alba1¶, Martine Malisssard2, Elsa Wagner-Rousset2, Evolène 11 Deslignière1, Olivier Colas2, Jean-François Haeuw2, Alain Beck2, Sarah Cianférani1* 12 13 1 Laboratoire de Spectrométrie de Masse BioOrganique, Université de Strasbourg, CNRS, IPHC UMR 7178, 67000 14 Strasbourg, France. 15 2 IRPF - Centre d’Immunologie Pierre-Fabre (CIPF), 74160 Saint-Julien-en-Genevois, France. 16 17 *Corresponding author: Sarah Cianférani. Email: [email protected] 18 ABSTRACT: Most of the current FDA and EMA approved therapeutic monoclonal antibodies (mAbs) are based on humanized or 19 human IgG1, 2 or 4 subclasses and engineered variants. On the structural side, these subclasses are characterized by specific inter- 20 chains disulfide bridge connections. Different analytical techniques have been reported to assess intact IgGs subclasses, with recently 21 special interest in native ion mobility (IM) and collision induced unfolding (CIU) mass spectrometry (MS). However, these two 22 techniques exhibit significant limitations to differentiate mAb subclasses at the intact level. In the present work, we aimed at developing a unique IM-MS-based approach for the characterization of mAb subclasses at the middle level. Upon IdeS-digestion, the 23 unfolding patterns of the F(ab’)2 and Fc domains were simultaneously analyzed in a single run to provide deeper structural insights 24 of the mAb scaffold. The unfolding patterns associated with the F(ab’) domains are completely different in terms of unfolding 25 2 energies and number of transitions. Thereby, F(ab’)2 regions are the diagnostic domain to provide specific unfolding signatures to 26 differentiate IgG subclasses and provide more confident subclass categorization than CIU on intact mAbs. In addition, the potential 27 of middle-level CIU was evaluated through the characterization of eculizumab, a hybrid therapeutic IgG2/4 mAb. The unfolding 28 signatures of both domains allowed to corroborate, within a single run, the hybrid nature of eculizumab as well as specific subclass 29 domain assignments to the F(ab’)2 and Fc regions. Altogether, our results confirm the suitability of middle-level CIU of F(ab’)2 30 domains for subclass categorization of canonical and more complex new generation engineered antibodies and related products. 31 32 33 INTRODUCTION disulfide bond, while the two heavy-chains can be linked either 34 During the last 20 years, monoclonal antibody (mAb) by two (for IgG1 and IgG4) or four (for IgG2) disulfide bonds 35 3 development and engineering have significantly evolved due to located in the hinge region of the antibody . In addition, mAbs 36 their therapeutic efficiency against many diseases such as global structure is also maintained with 12 intra-chain disulfide 37 cancer, and autoimmune diseases1. More than 80 antibody- bridges that connect two cysteines that belong to the same 38 based products are currently approved by regulatory agencies domain. The inter-chain disulfide bridges network, which is 39 (FDA and EMA), while ~600 others are in clinical studies, characteristic of each individual subclass, has an impact on 40 including more than 60 in phase III clinical trials2. different mAb properties (structure, stability, surface hydrophobicity, isoelectric point, etc.)4 and modulate their 41 Among the different post-translational modifications (PTMs) higher-order structure5-8. Thereby, mAbs from different 42 that can occur within the primary sequence of mAbs, subclasses will differ in their secondary immune functions9-10. glycosylation and inter-chain disulfide linkages strongly 43 In terms of mAb developability, there is a continuous interest contribute to the stabilization of the tertiary structure of these 44 for improvement of new analytical techniques to characterize proteins. Indeed, therapeutic mAbs can be classified into four 45 the impact of the different inter-chain disulfide patterns on subclasses (IgG1, IgG2, IgG3, and IgG4) with different inter- 46 therapeutic mAb structures and structure-function relationships. 47 and intra-chain disulfide connectivities. While human IgG3 subclass is usually not considered for therapeutic mAbs Ion mobility coupled to mass spectrometry (IM-MS), and its 48 engineering and production due to its limited potential collision induced unfolding (CIU) variant, have been used to 11-14 49 associated to its shorter half-life1, human IgG1, IgG2, and IgG4 characterize the structure and dynamics of proteins and 15-16 50 mAb subclasses represent the main classes of mAb-based protein complexes in the gas-phase. During the last 5 years, 51 therapeutics. One of the main structural differences between the CIU has been increasingly used in structural biology to 52 three therapeutic subclasses (IgG1, IgG2, and IgG4) is the characterize a wide range of biological systems and has 53 number (four for IgG1 and IgG4 and six for IgG2) and the integrated the analytical portfolio of international regulatory 17 54 connectivities of inter-chain disulfide bridges3 (Figure 1). The agencies . Although the CIU approach still remains as a 55 heavy and light chains of all subclasses are linked by one laborious and time-consuming process, significant efforts have 56 1 57 58 59 60 ACS Paragon Plus Environment Analytical Chemistry Page 2 of 16 been made to improve data acquisition18 and interpretation19-20. N-deglycosylated during 30 min at 37 °C with IgGZERO 1 CIU experiments allowed to circumvent in some cases the (Genovis). In the case of middle-level analysis, the 2 limitations associated to IM resolution to separate and deglycosylated mAbs were degraded with IdeS enzyme 3 differentiate mAbs with very similar global structure. Thereby, (immunoglobulin-degrading enzyme of Streptococcus 4 CIU afforded structural insights that led to the differentiation of pyogenes, FabRICATOR, Genovis). A 1 µg/unit ratio was used 20, 22 5 human non-therapeutic mAb subclasses , ADCs’ to achieve an efficient digestion and subsequently, the mixture 23-24 6 characterization , and stabilized vs wild-type therapeutic was incubated during 60 min at 37°C. After deglycosylation IgG4 mAbs among others25. More particularly, the group of and/or IdeS digestion, therapeutic mAbs were then desalted 7 Ruotolo reported that glycan moieties contribute to the against 100 mM ammonium acetate at pH 7.0 prior to native 8 stabilization of the mAb scaffold in the gas-phase, thus MS analysis, using about six to eight cycles of centrifugal 9 glycosylated mAbs require around 15% more energy to undergo concentrator (Vivaspin, 30 kDa cutoff, Sartorious, Göttingen, 10 unfolding compared to their non-glycosylated counterparts22. Germany). The concentration of each individual solution after 11 The same study also highlighted the role of inter-chain disulfide desalting process was measured by UV absorbance using a 12 linkage in mAb gas-phase stability, the latter being proposed as nanodrop spectrophotometer
Recommended publications
  • Exploring the Association Between Monoclonal Antibodies and Depression and Suicidal Ideation and Behavior: a Vigibase Study
    Drug Safety https://doi.org/10.1007/s40264-018-00789-9 ORIGINAL RESEARCH ARTICLE Exploring the Association between Monoclonal Antibodies and Depression and Suicidal Ideation and Behavior: A VigiBase Study Lotte A. Minnema1,2 · Thijs J. Giezen2,3 · Patrick C. Souverein1 · Toine C. G. Egberts1,4 · Hubert G. M. Leufkens1 · Helga Gardarsdottir1,4,5 © The Author(s) 2019 Abstract Introduction Several monoclonal antibodies (mAbs) have been linked to neuropsychiatric adverse efects in patients, includ- ing depression and suicidal ideation and behavior. Objective The aim of this study was to quantify and characterize spontaneously reported adverse drug reactions (ADRs) of depression and suicidal ideation and behavior related to mAb users, and to explore a possible association with their mecha- nism of action. Methods We included mAb ADRs that were reported in VigiBase, and identifed those related to depression and suicidal ideation and behavior. Reporting odds ratios (RORs) were estimated for each mAb (bevacizumab as the reference) and according to their infuence on the immune system (not directly targeting [reference], stimulating, or suppressing). Those suppressing the immune system were further divided into their intended indication (auto-immune diseases, cancer). Results Overall, 2,924,319 ADRs for 44 mAbs were included; 9455 ADRs were related to depression and 1770 were related to suicidal ideation and behavior. The association was strongest for natalizumab and belimumab, both for depression (ROR 5.7, 95% confdence interval [CI] 5.0–6.4; and ROR 5.1, 95% CI 4.2–6.2) and suicidal ideation and behavior (ROR 12.0, 95% CI 7.9–18.3; and ROR 20.2, 95% CI 12.4–33.0).
    [Show full text]
  • SPECIALTY MEDICATION ADMINISTRATION – SITE of CARE REVIEW GUIDELINES Policy Number: PHARMACY 276.15 T2 Effective Date: September 1, 2017
    UnitedHealthcare® Oxford Clinical Policy SPECIALTY MEDICATION ADMINISTRATION – SITE OF CARE REVIEW GUIDELINES Policy Number: PHARMACY 276.15 T2 Effective Date: September 1, 2017 Table of Contents Page Related Policies INSTRUCTIONS FOR USE .......................................... 1 Actemra® (Tocilizumab) Injection for Intravenous CONDITIONS OF COVERAGE ...................................... 1 Infusion BENEFIT CONSIDERATIONS ...................................... 2 Entyvio® (Vedolizumab) COVERAGE RATIONALE ............................................. 2 Exondys 51™ (Eteplirsen) DEFINITIONS .......................................................... 3 Home Health Care DESCRIPTION OF SERVICES ...................................... 3 Infliximab (Remicade®, Inflectra™, Renflexis™) CLINICAL EVIDENCE ................................................. 3 ® REFERENCES ........................................................... 4 Orencia (Abatacept) Injection for Intravenous POLICY HISTORY/REVISION INFORMATION ................. 5 Infusion Radicava™ (Edaravone) Simponi Aria® (Golimumab) Injection for Intravenous Infusion Soliris® (Eculizumab) INSTRUCTIONS FOR USE This Clinical Policy provides assistance in interpreting Oxford benefit plans. Unless otherwise stated, Oxford policies do not apply to Medicare Advantage members. Oxford reserves the right, in its sole discretion, to modify its policies as necessary. This Clinical Policy is provided for informational purposes. It does not constitute medical advice. The term Oxford includes Oxford
    [Show full text]
  • New Biological Therapies: Introduction to the Basis of the Risk of Infection
    New biological therapies: introduction to the basis of the risk of infection Mario FERNÁNDEZ RUIZ, MD, PhD Unit of Infectious Diseases Hospital Universitario “12 de Octubre”, Madrid ESCMIDInstituto de Investigación eLibraryHospital “12 de Octubre” (i+12) © by author Transparency Declaration Over the last 24 months I have received honoraria for talks on behalf of • Astellas Pharma • Gillead Sciences • Roche • Sanofi • Qiagen Infections and biologicals: a real concern? (two-hour symposium): New biological therapies: introduction to the ESCMIDbasis of the risk of infection eLibrary © by author Paul Ehrlich (1854-1915) • “side-chain” theory (1897) • receptor-ligand concept (1900) • “magic bullet” theory • foundation for specific chemotherapy (1906) • Nobel Prize in Physiology and Medicine (1908) (together with Metchnikoff) Infections and biologicals: a real concern? (two-hour symposium): New biological therapies: introduction to the ESCMIDbasis of the risk of infection eLibrary © by author 1981: B-1 antibody (tositumomab) anti-CD20 monoclonal antibody 1997: FDA approval of rituximab for the treatment of relapsed or refractory CD20-positive NHL 2001: FDA approval of imatinib for the treatment of chronic myelogenous leukemia Infections and biologicals: a real concern? (two-hour symposium): New biological therapies: introduction to the ESCMIDbasis of the risk of infection eLibrary © by author Functional classification of targeted (biological) agents • Agents targeting soluble immune effector molecules • Agents targeting cell surface receptors
    [Show full text]
  • International Consensus Guidance for Management of Myasthenia Gravis 2020 Update
    VIEWS & REVIEWS OPEN ACCESS LEVEL OF RECOMMENDATION International Consensus Guidance for Management of Myasthenia Gravis 2020 Update Pushpa Narayanaswami, MBBS, DM, Donald B. Sanders, MD, Gil Wolfe, MD, Michael Benatar, MD, Correspondence Gabriel Cea, MD, Amelia Evoli, MD, Nils Erik Gilhus, MD, Isabel Illa, MD, Nancy L. Kuntz, MD, Janice Massey, MD, Dr. Narayanaswami Arthur Melms, MD, Hiroyuki Murai, MD, Michael Nicolle, MD, Jacqueline Palace, MD, David Richman, MD, and pnarayan@ Jan Verschuuren, MD bidmc.harvard.edu Neurology® 2021;96:114-122. doi:10.1212/WNL.0000000000011124 Abstract Objective To update the 2016 formal consensus-based guidance for the management of myasthenia gravis (MG) based on the latest evidence in the literature. Methods In October 2013, the Myasthenia Gravis Foundation of America appointed a Task Force to develop treatment guidance for MG, and a panel of 15 international experts was convened. The RAND/UCLA appropriateness method was used to develop consensus recommendations pertaining to 7 treatment topics. In February 2019, the international panel was reconvened with the addition of one member to represent South America. All previous recommendations were reviewed for currency, and new consensus recommendations were developed on topics that required inclusion or updates based on the recent literature. Up to 3 rounds of anonymous e-mail votes were used to reach consensus, with modifications to recommendations between rounds based on the panel input. A simple majority vote (80% of panel members voting “yes”) was used to approve minor changes in grammar and syntax to improve clarity. Results The previous recommendations for thymectomy were updated. New recommendations were developed for the use of rituximab, eculizumab, and methotrexate as well as for the following topics: early immunosuppression in ocular MG and MG associated with immune checkpoint inhibitor treatment.
    [Show full text]
  • Neuromyelitis Optica Spectrum Disorder
    © Copyright 2012 Oregon State University. All Rights Reserved Drug Use Research & Management Program Oregon State University, 500 Summer Street NE, E35 Salem, Oregon 97301-1079 Phone 503-947-5220 | Fax 503-947-2596 Drug Class Review with New Drug Evaluation: Biologics for Autoimmune Disorders-Neuromyelitis Optica Spectrum Disorder Date of Review: April 2021 Date of Last Review: n/a Dates of Literature Search: 1/1/1996 – 1/20/2021 Generic Name: Brand Name (Manufacturer): Eculizumab Soliris® (Alexion Pharmaceuticals) Inebilizumab-cdon Uplizna™ (Viela Bio) Satralizumab-mwge Enspryng™ (Genentech/Roche) Dossiers Received: Yes Current Status of PDL Class: See Appendix 1. Purpose for Class Update: To define place in therapy for 3 immunosuppressive agents, eculizumab, inebilizumab-cdon, and satralizumab-mwge, recently approved by the Food and Drug Administration (FDA) for the treatment adults with neuromyelitis optica spectrum disorder (NMOSD). Research Questions: 1. What is the effectiveness of eculizumab, inebilizumab, and satralizumab in reducing time to relapse in adult patients with NMOSD who are anti-aquaporin-4 (AQP4) antibody positive? 2. What are the harms of eculizumab, inebilizumab-cdon and satralizumab in adults with NMOSD? 3. Is there comparative evidence that eculizumab, inebilizumab, and satralizumab differ in efficacy or harms for management of NMOSD? 4. Are there certain sub-populations (based on age, gender, ethnicity, comorbidities, disease duration or severity) in which eculizumab, inebilizumab, or satralizumab may be beneficial
    [Show full text]
  • Submission of Eculizumab for NMOSD to PBAC Meeting November 2020
    PBAC Secretariat MDP 952 Department of Health and Ageing GPO Box 9848 Canberra ACT 2601 7 October 2020 Re: Submission of eculizumab for NMOSD to PBAC meeting November 2020 This is a joint submission to the Pharmaceutical Benefits Advisory Committee (PBAC) in relation to eculizumab (Soliris) for neuromyelitis optica spectrum disorder (NMOSD) from MS Research Australia, the Centre for Community-Driven Research and MS Australia. • MS Research Australia is the largest national not-for-profit organisation dedicated to funding MS discoveries and coordinating MS research in Australia. • The Centre for Community-Driven Research is a non-profit organisation with expertise in gathering patient experience and expectations data. • MS Australia is the national voice for people with multiple sclerosis. MS Australia works in advocacy and communications and collaborates with their stakeholders to benefit thousands of people affected by MS across the country. MS Research Australia and MS Australia are writing to support the inclusion of eculizumab on the Pharmaceutical Benefits Scheme (PBS) for people with NMOSD. The Centre for Community-Driven Research is keen to inform the PBAC about the experience of people with NMOSD and their expectations of new treatments. The NMOSD community in Australia is not represented by a national peak body and as NMOSD and MS have some similarities, we are proud to advocate on behalf of those living with NMOSD. One area we are all particularly passionate about is the provision of affordable and accessible treatments that can improve the lives of people with NMOSD. About NMOSD NMOSD is a recently defined inflammatory disorder of the central nervous system (CNS) that was previously either misdiagnosed as MS or identified as Devic’s disease.
    [Show full text]
  • Cimzia (Certolizumab Pegol) AHM
    Cimzia (Certolizumab Pegol) AHM Clinical Indications • Cimzia (Certolizumab Pegol) is considered medically necessary for adult members 18 years of age or older with moderately-to-severely active disease when ALL of the following conditions are met o Moderately-to-severely active Crohn's disease as manifested by 1 or more of the following . Diarrhea . Abdominal pain . Bleeding . Weight loss . Perianal disease . Internal fistulae . Intestinal obstruction . Megacolon . Extra-intestinal manifestations: arthritis or spondylitis o Crohn's disease has remained active despite treatment with 1 or more of the following . Corticosteroids . 6-mercaptopurine/azathioprine • Certollizumab pegol (see note) is considered medically necessary for persons with active psoriatic arthritis who meet criteria in Psoriasis and Psoriatic Arthritis: Biological Therapies. • Cimzia, (Certolizumab Pegol), alone or in combination with methotrexate (MTX), is considered medically necessary for the treatment of adult members 18 years of age or older with moderately-to-severely active rheumatoid arthritis (RA). • Cimzia (Certolizumab pegol is considered medically necessary for reducing signs and symptoms of members with active ankylosing spondylitis who have an inadequate response to 2 or more NSAIDs. • Cimzia (Certolizumab Pegol) is considered investigational for all other indications (e.g.,ocular inflammation/uveitis; not an all-inclusive list) because its effectiveness for indications other than the ones listed above has not been established. Notes • There are several brands of targeted immune modulators on the market. There is a lack of reliable evidence that any one brand of targeted immune modulator is superior to other brands for medically necessary indications. Enbrel (etanercept), Humira (adalimumab), Remicade (infliximab), Simponi (golimumab), Simponi Aria (golimumab intravneous), and Stelara (ustekinumab) brands of targeted immune modulators ("least cost brands of targeted immune modulators") are less costly to the plan.
    [Show full text]
  • Soliris (Eculizumab) NON HEMATOLOGY POLICY Intravenous Department: PHA
    Policy Title: Soliris (eculizumab) NON HEMATOLOGY POLICY Intravenous Department: PHA Effective Date: 01/01/2020 Review Date: 09/18/2019, 12/20/2019, 1/22/2020, 12/2020, 5/27/2021 Revision Date: 09/18/2019, 1/22/2020, 12/2020 Purpose: To support safe, effective and appropriate use of Soliris (eculizumab). Scope: Medicaid, Commercial, Medicare-Medicaid Plan (MMP) Policy Statement: Soliris (eculizumab) is covered under the Medical Benefit when used within the following guidelines. Use outside of these guidelines may result in non-payment unless approved under an exception process. For Hematology indications, please refer to the NHPRI Soliris Hematology Policy Procedure: Coverage of Soliris (eculizumab) will be reviewed prospectively via the prior authorization process based on criteria below. Initial Criteria: MMP members who have previously received this medication within the past 365 days are not subject to Step Therapy Requirements. Neuromyelitis optica spectrum disorder (NMOSD) Submission of medical records (e.g., chart notes, laboratory values, etc.) to support the diagnosis of neuromyelitis optica spectrum disorder (NMOSD) by a neurologist confirming all of the following: Past medical history of one of the following: . Optic neuritis . Acute myelitis . Area postrema syndrome: episode of otherwise unexplained hiccups or nausea and vomiting . Acute brainstem syndrome . Symptomatic narcolepsy or acute diencephalic clinical syndrome with NMOSD- typical diencephalic MRI lesions . Symptomatic cerebral syndrome with NMOSD-typical brain
    [Show full text]
  • Ocrelizumab And
    Ocrelizumab and PML As of May 2019, there have been 7 confirmed cases of carry-over PMLa in MS patients treated with Prescribing information* ocrelizumab, out of more than 100,000 patients treated globally (clinical trials and post-marketing experience); no unconfoundedb cases have been reported: Progressive Multifocal Leukoencephalopathy (PML) is an opportunistic viral infection of the brain caused by the Report Date Case Description John Cunningham (JC) virus that typically only occurs in Case was from a compassionate-use program in a JCV+ patient who switched to ocrelizumab after 36 infusions of natalizumab. patients who are immunocompromised, and that usually May 2017 Assessment of the case resulted in it being reported to regulators as related to natalizumab and not ocrelizumab.3 leads to death or severe disability. The patient had increasingly worsening neurological symptoms and MRI changes prior to discontinuing treatment with Although no cases of PML were identified in fingolimod in December 2017. The patient started treatment with ocrelizumab in March/April 2018. In April 2018, MRI changes, April 2018 ocrelizumab clinical trials, a risk of PML cannot be worsening clinical presentation and JCV DNA in the CSF confirmed the diagnosis of PML. The case was reported to regulators ruled out since JC virus infection resulting in PML as a carry-over PML from fingolimod as assessed by the physician.4 has been observed in patients treated with anti-CD20 A JCV+ patient was previously treated with natalizumab for 7 years. Due to MRI changes and worsening clinical symptoms, antibodies and other MS therapies and associated with April 2018 natalizumab was discontinued in February 2018.
    [Show full text]
  • Ipilimumab for the Treatment of Metastatic Melanoma Hansoo Kim*, Samantha Comey, Karl Hausler and Greg Cook
    Kim et al. Journal of Pharmaceutical Policy and Practice (2018) 11:4 DOI 10.1186/s40545-018-0131-4 RESEARCH Open Access A real world example of coverage with evidence development in Australia - ipilimumab for the treatment of metastatic melanoma Hansoo Kim*, Samantha Comey, Karl Hausler and Greg Cook Abstract Background: Australian Government subsidisation of ipilimumab for the treatment of patients with metastatic melanoma was conditional on the sponsor entering a ‘managed entry scheme’ to assess the 2-year overall survival rate in metastatic melanoma patients who received ipilimumab in the first year of Pharmaceutical Benefits Scheme listing. Methods: All unresectable stage IIIc / IV metastatic melanoma patients treated with at least one dose of ipilimumab therapy in Australia from the PBS listing date to a time point 12 months later (i.e. from 1-Aug-2013 to 31-Jul-2014) were invited to participate. Overall survival at 2 years post treatment initiation was measured, with Cox regression analysis used to examine the relationship between survival and patient baseline characteristics. Results: The evaluable population (910 patients) was on average 63.3 years old, male (70.1%) and treated in a public hospital (64.4%) in an urban area (76.5%). The majority of patients were treatment naïve (63.3%), did not have brain metastases (71.1%), and were classified as ECOG performance status 0 or 1 (90.4%). The 2 year overall survival rate was conservatively calculated to be at least 23.9% and potentially as high as 34.2%. A significant difference in overall survival at 2 years was demonstrated across the categories of ECOG performance status (p < 0.0001), M-status (p = 0.0005) and treatment status (p = 0.0114).
    [Show full text]
  • Biosim™ Natalizumab (Tysabri®) (Human) ELISA
    FOR RESEARCH USE ONLY! ™ BioSim Natalizumab (Tysabri®) (Human) ELISA Kit 07/20 (Catalog # E4856-100, 96 assays, Store at 4°C) I. Introduction: Natalizumab is a humanized IgG4k monoclonal antibody produced in murine myeloma cells. Natalizumab contains human framework regions and the complementarity-determining regions of a murine antibody that binds to a4-integrin. Natalizumab is used to treat multiple sclerosis-MS. It is thought to help by preventing patient’s immune system from attacking the nerves in the brain and spinal cord. Natalizumab is also used to treat a bowel condition called Crohn's disease (CD). BioSim™ Natalizumab ELISA kit has been developed for specific quantification of Natalizumab concentration in human serum or plasma with high sensitivity and reproducibility. Natalizumab ELISA kit is based on the sandwich ELISA principle. Standards and samples (serum or plasma) are added in the microtiter plate coated with the reactant for Natalizumab. After incubation, the wells are washed. The HRP conjugated probe is added and binds to Natalizumab captured by the reactant on the surface of the wells. Following incubation wells are washed and the bound enzymatic activity is detected by addition of TMB chromogen substrate. Finally, the reaction is terminated with an acidic stop solution. The color developed is proportional to the amount of Natalizumab in the sample or standard. Results of samples can be determined directly using the standard curve. II. Application: This ELISA kit is used for in vitro quantitative determination of Natalizumab Detection Range: 30 - 1000 ng/ml Sensitivity: 3 ng/ml Assay Precision: Intra-Assay: CV < 30%; Inter-Assay: CV < 30% (CV (%) = SD/mean X 100) Recovery rate: <100±30% with normal human serum samples with known concentrations Cross Reactivity: Except for Natalizumab, there is no cross reaction with other therapeutic antibodies and native serum immunoglobins.
    [Show full text]
  • WO 2016/176089 Al 3 November 2016 (03.11.2016) P O P C T
    (12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (10) International Publication Number (43) International Publication Date WO 2016/176089 Al 3 November 2016 (03.11.2016) P O P C T (51) International Patent Classification: BZ, CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM, A01N 43/00 (2006.01) A61K 31/33 (2006.01) DO, DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, HN, HR, HU, ID, IL, IN, IR, IS, JP, KE, KG, KN, KP, KR, (21) International Application Number: KZ, LA, LC, LK, LR, LS, LU, LY, MA, MD, ME, MG, PCT/US2016/028383 MK, MN, MW, MX, MY, MZ, NA, NG, NI, NO, NZ, OM, (22) International Filing Date: PA, PE, PG, PH, PL, PT, QA, RO, RS, RU, RW, SA, SC, 20 April 2016 (20.04.2016) SD, SE, SG, SK, SL, SM, ST, SV, SY, TH, TJ, TM, TN, TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, ZW. (25) Filing Language: English (84) Designated States (unless otherwise indicated, for every (26) Publication Language: English kind of regional protection available): ARIPO (BW, GH, (30) Priority Data: GM, KE, LR, LS, MW, MZ, NA, RW, SD, SL, ST, SZ, 62/154,426 29 April 2015 (29.04.2015) US TZ, UG, ZM, ZW), Eurasian (AM, AZ, BY, KG, KZ, RU, TJ, TM), European (AL, AT, BE, BG, CH, CY, CZ, DE, (71) Applicant: KARDIATONOS, INC. [US/US]; 4909 DK, EE, ES, FI, FR, GB, GR, HR, HU, IE, IS, IT, LT, LU, Lapeer Road, Metamora, Michigan 48455 (US).
    [Show full text]