Mavrilimumab, a human monoclonal antibody targeting GM-CSF receptor-α, in subjects with rheumatoid arthritis: a randomised, double-blind, placebo-controlled, phase I, first-in-human study.

Abstract

OBJECTIVE:

To evaluate the safety, tolerability, pharmacokinetic and pharmacodynamic profiles of mavrilimumab, a human monoclonal antibody targeting the granulocyte-macrophage colony-stimulating factor receptor-α, in subjects with rheumatoid arthritis (RA).

METHODS:

A randomised, double-blind, placebo-controlled, dose-escalating phase I study in subjects with RA who received stable methotrexate treatment for ≥3 months before enrolment.

SUBJECTS:

received single intravenous escalating doses of mavrilimumab (0.01-10.0 mg/kg) or placebo.

RESULTS:

32 subjects were enrolled in this study (1 unblinded subject at 0.01 mg/kg and another at 0.03 mg/kg were followed by five sequential double-blinded cohorts, n=6 each, treated with 0.1, 0.3, 1.0, 3.0 and 10.0 mg/kg, respectively). Adverse events were mild or moderate and were reported with similar frequency across all treatment cohorts. One subject (10.0 mg/kg) experienced moderate face and neck urticaria during infusion that resolved with symptomatic treatment. Systemic clearance of mavrilimumab approached that of endogenous IgG at doses >1.0 mg/kg; pharmacodynamic activity was confirmed in the 1.0 and 3.0 mg/kg cohorts by suppression of suppressor of cytokine signalling 3 mRNA transcripts. In exploratory analyses, reductions of acute phase reactants were observed in subjects with elevated C-reactive protein (>5 mg/l) and erythrocyte sedimentation rate (≥20.0 mm/h) at baseline. No significant change in Disease Activity Score 28-joint assessment (DAS28) was seen in any of the cohorts. In mavrilimumab-treated subjects (n=15) with baseline DAS28 >3.2, mean disease activity (DAS28) was significantly reduced at 4 weeks.

CONCLUSION:

In this first-in-human study, mavrilimumab showed preliminary evidence of pharmacodynamic activity. Importantly, the safety and pharmacokinetic profiles of mavrilimumab support further clinical studies in RA.

TRIAL REGISTRATION NUMBER:

NCT00771420.

• Authors: Gerd R Burmester, Eugen Feist, Matthew A Sleeman, Bing Wang, Barbara White, Fabio Magrini
• Journal: Annals of the rheumatic diseases (Ann Rheum Dis) Vol. 70 Issue 9 Pg. 1542-9 (Sep 2011) ISSN: 1468-2060 [Electronic] England
• PMID: 21613310 (Publication Type: Clinical Trial, Phase I, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Humanized
• Antirheumatic Agents
• RNA, Messenger
• Receptors, Granulocyte-Macrophage Colony-Stimulating Factor
• SOCS3 protein, human
• Suppressor of Cytokine Signaling 3 Protein
• Suppressor of Cytokine Signaling Proteins
• mavrilimumab

Topics

• Adolescent
• Adult
• Aged
• Antibodies, Monoclonal (administration & dosage, adverse effects, blood, therapeutic use)
• Antibodies, Monoclonal, Humanized
• Antirheumatic Agents (administration & dosage, adverse effects, blood, therapeutic use)
• Arthritis, Rheumatoid (blood, drug therapy)
• Dose-Response Relationship, Drug
• Double-Blind Method
• Gene Expression Regulation (drug effects)
• Humans
• Injections, Intravenous
• Middle Aged
• RNA, Messenger (genetics)
• Receptors, Granulocyte-Macrophage Colony-Stimulating Factor (antagonists & inhibitors)
• Severity of Illness Index
• Suppressor of Cytokine Signaling 3 Protein
• Suppressor of Cytokine Signaling Proteins (biosynthesis, genetics)
• Treatment Outcome
• Young Adult