P W Collins1, J Møss, K Knobe, A Groth, T Colberg, E Watson. 1. Arthur Bloom Haemophilia Centre, School of Medicine, Cardiff University, Cardiff, UK Clinical Pharmacology Biopharm, Novo Nordisk A/S, Søborg, Denmark Centre for Thrombosis and Haemostasis, Lund University, Malmö, Sweden Quantitative Clinical Pharmacology, Novo Nordisk A/S, Søborg Medical and Science, Haemophilia, Novo Nordisk A/S, Søborg DMPK and Bioanalysis, Novo Nordisk A/S, Måløv, Denmark.
Abstract
BACKGROUND: nonacog beta pegol (N9-GP) is a glycoPEGylated recombinant factor IX (rFIX) molecule with a prolonged half-life. OBJECTIVES: To provide information on potential dose regimens for N9-GP for phase 3 pivotal and surgery trials. METHODS: A population pharmacokinetic model was developed from single-dose data derived from the first human-dose trial with N9-GP in hemophilia B patients, and was used to extrapolate to steady-state conditions for different N9-GP dose regimens for prophylaxis. The model was also used to compare prophylaxis using N9-GP with standard prophylactic regimens using rFIX or plasma-derived (pd) FIX (40 IU kg(-1) every third day). Plasma activity following dosing with N9-GP, rFIX and pdFIX for surgery and on-demand treatment of bleeds was also simulated. RESULTS: A linear two-compartmental model best described the pharmacokinetic profiles of N9-GP, rFIX and pdFIX. A prophylactic regimen of 10 U kg(-1) N9-GP once weekly predicted mean peak and trough levels of 18 and 4.2 U dL(-1) , while 40 U kg(-1) once weekly predicted values of 72 and 17 U dL(-1) , respectively. Standard prophylactic regimens with rFIX and pdFIX predicted mean peak and trough levels of 34 and 3.9 IU dL(-1) for rFIX, and mean values of 43 and 2.1 IU dL(-1) for pdFIX. Additional simulations predicted significantly reduced dosing frequency and factor concentrate consumption for N9-GP vs. rFIX and pdFIX for surgery and the treatment of bleeds. CONCLUSIONS: N9-GP may allow prophylaxis, surgical dosing regimens and on-demand treatment of bleeding episodes with less frequent injections and lower factor concentrate consumption; this possibility is being investigated in prospective clinical trials.
BACKGROUND: nonacog beta pegol (N9-GP) is a glycoPEGylated recombinant factor IX (rFIX) molecule with a prolonged half-life. OBJECTIVES: To provide information on potential dose regimens for N9-GP for phase 3 pivotal and surgery trials. METHODS: A population pharmacokinetic model was developed from single-dose data derived from the first human-dose trial with N9-GP in hemophilia Bpatients, and was used to extrapolate to steady-state conditions for different N9-GP dose regimens for prophylaxis. The model was also used to compare prophylaxis using N9-GP with standard prophylactic regimens using rFIX or plasma-derived (pd) FIX (40 IU kg(-1) every third day). Plasma activity following dosing with N9-GP, rFIX and pdFIX for surgery and on-demand treatment of bleeds was also simulated. RESULTS: A linear two-compartmental model best described the pharmacokinetic profiles of N9-GP, rFIX and pdFIX. A prophylactic regimen of 10 U kg(-1) N9-GP once weekly predicted mean peak and trough levels of 18 and 4.2 U dL(-1) , while 40 U kg(-1) once weekly predicted values of 72 and 17 U dL(-1) , respectively. Standard prophylactic regimens with rFIX and pdFIX predicted mean peak and trough levels of 34 and 3.9 IU dL(-1) for rFIX, and mean values of 43 and 2.1 IU dL(-1) for pdFIX. Additional simulations predicted significantly reduced dosing frequency and factor concentrate consumption for N9-GP vs. rFIX and pdFIX for surgery and the treatment of bleeds. CONCLUSIONS: N9-GP may allow prophylaxis, surgical dosing regimens and on-demand treatment of bleeding episodes with less frequent injections and lower factor concentrate consumption; this possibility is being investigated in prospective clinical trials.
Authors: Peter W Collins; Guy Young; Karin Knobe; Faraizah Abdul Karim; Pantep Angchaisuksiri; Claus Banner; Türkiz Gürsel; Johnny Mahlangu; Tadashi Matsushita; Eveline P Mauser-Bunschoten; Johannes Oldenburg; Christopher E Walsh; Claude Negrier Journal: Blood Date: 2014-09-26 Impact factor: 22.113
Authors: Tim Preijers; Laura Bukkems; Max van Spengler; Frank Leebeek; Marjon Cnossen; Ron Mathôt Journal: Eur J Clin Pharmacol Date: 2021-02-24 Impact factor: 2.953