纳塔利祖马布6周剂量的药理动力学和药理动力学与持续4周剂量的复发性复发性硬化症的药理动力学和药理动力学
John F Foley1, Gilles Defer1, Lana Zhovtis Ryerson1
1From the Rocky Mountain MS Clinic (J.F.F.), Salt Lake City, UT; Department of Neurology (G.D.), Centre Hospitalier Universitaire de Caen, France; Hackensack Meridian Medical Group - Neurology (L.Z.R.), Jersey Shore University Medical Center, Neptune City, NJ; Mellen MS Center (J.A.C.), Neurological Institute, Cleveland Clinic, OH; Montréal Neurological Institute (D.L.A.), McGill University; NeuroRx Research (D.L.A.), Montréal, Quebec, Canada; Department of Neuroscience (H.B.), Central Clinical School, Monash University, Melbourne, Victoria, Australia; University of Alabama at Birmingham (G.R.C.), School of Public Health; Blizard Institute (G.G.), Barts and The London School of Medicine and Dentistry; Queen Mary University of London (G.G.), United Kingdom; Department of Neurology (J.K.), Amsterdam University Medical Centers, Vrije Universiteit, Netherlands; Department of Neurology with Institute of Translational Neurology (H.W.), University of Münster, Germany; Biogen (K.L., L.D., M.T., K.F., J.S., T.L.), Cambridge, MA; and Ashfield MedComms (H.E.), Middletown, CT.
与标准Q4W剂量相比,纳塔利祖马布用于复发性复发性多发性硬化症 (RRMS) 的延长间隔剂量 (Q6W) 降低了药物水平和α4-整合素和. 在临床实践中,这些标志物可能无法一致预测疾病活动.
科学领域:
- 神经免疫学 神经免疫学
- 药理学 药理学是指药理学的学科.
- 临床治疗学 临床治疗学
背景情况:
- 纳塔利祖马布有效治疗复发性复发性多发性硬化症 (RRMS).
- 纳塔利祖马布的使用与渐进的多焦点白血脑病 (PML) 风险有关.
- 延长间隔剂量 (Q6W) 可以降低PML风险,同时保持疗效.
研究的目的:
- 在3b期NOVA试验中报告Q6W与Q4W纳塔利祖马布剂量的药理动力学 (PK) 和药理动力学 (PD).
- 为了比较 natalizumab 血清度,α4-整合素和和 sVCAM-1 水平在 Q6W 和 Q4W 剂量方案之间.
主要方法:
- 在Q4W纳塔利祖马布治疗中稳定的RRMS参与者被随机分配到Q4W或Q6W剂量72周.
- 探索性结局包括最低血清纳塔利祖马布度,α4-整合素和sVCAM-1水平.
- 混合效应模型分析了治疗差异;患者级数据检查了复发或放射性活性.
主要成果:
- Q6W的剂量导致纳塔利祖马布的平均最低水平降低了60% - 70% (10-21 μg/mL) 与Q4W (33-38 μg/mL) 相比.
- 与Q4W (≥77.9%) 相比,Q6W (≥65.5%) 的平均α4-整合素和率较低.
- 可溶性血管细胞粘附分子-1 (sVCAM-1) 水平在Q6W时增加,但在Q4W时保持稳定.
结论:
- 与Q4W相比,Q6W纳塔利祖马布剂量显著降低了平均药物谷水平和α4-整合素和.
- 无论是纳塔利祖马布度还是α4-整合素和都不能在患者水平上一致预测病变或复发活动.
- 在临床实践中,对纳塔利祖马布和α4-整合素和度的测量应谨慎解释.
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