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A recombinant human ADAMTS-13: first-in-human study evaluating pharmacokinetics, safety and tolerability in cTTP patients

Marie Scully, Paul Knöbl, Karim Kentouche, Lawrence Rice, Jerzy Windyga, Reinhard Schneppenheim, Johanna A. Kremer Hovinga, Michiko Kajiwara, Yoshihiro Fujimura, Caterina Maggiore, Jennifer Doralt, Christopher Hibbard, Leah Martell and Bruce Ewenstein

Key points

  • In this first-in-human, phase 1 study, recombinant ADAMTS-13 was safe, non-immunogenic and well tolerated in patients with congenital TTP.

  • Recombinant ADAMTS-13 demonstrated a PK profile comparable to plasma infusion studies, and showed evidence of pharmacodynamic activity.

Abstract

Safety, tolerability and pharmacokinetics of recombinant ADAMTS-13 (rADAMTS-13; BAX 930; SHP655) were investigated in 15 patients diagnosed with severe congenital ADAMTS-13 deficiency (plasma ADAMTS-13 activity < 6%) in a prospective phase 1, first-in-human, multicenter dose escalation study. BAX 930 was well tolerated, no serious adverse events occurred, and no anti-ADAMTS-13 antibodies were observed. Following single dose administration of BAX 930 at 5, 20, or 40 U/kg body weight to adolescents and adults, there was approximate dose proportionality with respect to Cmax and AUC. Dose related increases of individual ADAMTS-13:Ag and activity were observed and reached a maximum within 1 hour. With escalating BAX 930 doses administered, a dose-dependent persistence of ADAMTS-13 mediated VWF cleavage products and reduced VWF multimeric size were observed. This study demonstrated that pharmacokinetic parameters of BAX 930 were comparable to those estimated in previous plasma infusion studies and provided evidence of pharmacodynamic activity. The study was registered on www.clinicaltrials.gov under the number NCT02216084.

  • Submitted June 1, 2017.
  • Accepted August 7, 2017.