Monoclonal antibodies (mAbs) and fusion proteins directed towards soluble targets make an important contribution to the treatment of disease. The purpose of this review was to correlate the clinical and preclinical data on the 14 currently approved mAbs and fusion proteins targeted to soluble targets. The principal sources used to gather data were: the peer reviewed Literature; European Medicines Agency 'Scientific Discussions' and United States Food and Drug Administration 'Pharmacology/Toxicology Reviews' and package inserts (United States Prescribing Information). Data on the following approved biopharmaceuticals were included: adalimumab, anakinra, bevacizumab, canakinumab, certolizumab pegol, denosumab, eculizumab, etanercept, golimumab, infliximab, omalizumab, ranibizumab, rilonacept and ustekinumab. Some related biopharmaceuticals in late-stage development were also included for comparison. Good concordance with human pharmacodynamics was found for both non-human primates (NHPs) receiving the human biopharmaceutical and mice receiving rodent homologues (surrogates). In contrast, there was limited concordance for human adverse effects in genetically deficient mice, mice receiving surrogates or NHPs receiving the human pharmaceutical. In summary, the results of this survey show that although both mice and NHPs have good predictive value for human pharmacodynamics, neither species have good predictive value for human adverse effects. No evidence that NHPs have superior predictive value was found.
AbbreviationsCFR, Code of Federal Regulations; DTH, delayed-type hypersensitivity; EMA, European Medicines Agency; FDA, Food and Drug Administration; GLP, good laboratory practices; ICH, International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use; mAb, monoclonal antibody; NHP, non-human primate; OECD, Organisation for Economic Co-operation and Development; RANK-L, receptor activator of NF-kB ligand; TDAR, T-cell-dependent antibody response; USPI, United States Prescribing Information
IntroductionThe non-clinical safety evaluation of medicinal products intended for human use is generally tested in two mammalian species, a rodent and a non-rodent [International Conference on Harmonization (ICH) guideline M3 (R2) (2009), for small-molecular-weight pharmaceuticals and ICH S6 (R1) (1997, Addendum 2011), for large-molecule biopharmaceuticals]. The purpose of these studies is to identify potential target organs for toxicity and to establish a dose at which no adverse effects are observed. A comparison between the maximum tolerated dose and the no observed adverse effect level provides the safety margin for the product. Toxicities may be characterized as 'on-target', that is, directly related to the pharmacology of the product, or may be considered 'offtarget', that is, not directly related to the pharmacology BJP British Journal of Pharmacology DOI:10.1111DOI:10. /j.1476DOI:10. -5381.2011 806 British Journal of Pharmacology (2012) Guengerich, 2011). Examples of 'of...