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Pharmacokinetics and Pharmacodynamics of Subcutaneous Sarilumab and Intravenous Tocilizumab Following Single‐Dose Administration in Patients With Active Rheumatoid Arthritis on Stable Methotrexate
We assessed pharmacokinetics (PK), pharmacodynamics (PD), and PK/PD relationships of interleukin‐6 (IL‐6), soluble IL‐6 receptor, and C‐reactive protein (CRP) in serum, and absolute neutrophil count (ANC) in blood following single doses of subcutaneous sarilumab versus intravenous tocilizumab (NCT02...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7754484/ https://www.ncbi.nlm.nih.gov/pubmed/32726514 http://dx.doi.org/10.1002/jcph.1703 |
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author | Paccaly, Anne J. Kovalenko, Pavel Parrino, Janie Boyapati, Anita Xu, Christine van Hoogstraten, Hubert Ishii, Tomonori Davis, John D. DiCioccio, A. Thomas |
author_facet | Paccaly, Anne J. Kovalenko, Pavel Parrino, Janie Boyapati, Anita Xu, Christine van Hoogstraten, Hubert Ishii, Tomonori Davis, John D. DiCioccio, A. Thomas |
author_sort | Paccaly, Anne J. |
collection | PubMed |
description | We assessed pharmacokinetics (PK), pharmacodynamics (PD), and PK/PD relationships of interleukin‐6 (IL‐6), soluble IL‐6 receptor, and C‐reactive protein (CRP) in serum, and absolute neutrophil count (ANC) in blood following single doses of subcutaneous sarilumab versus intravenous tocilizumab (NCT02097524) from patients with rheumatoid arthritis (RA) who are inadequate responders to methotrexate (MTX) and on a stable dose of MTX. Patients with RA randomized (1:1:1:1) to single‐dose sarilumab (150 or 200 mg subcutaneously) or tocilizumab (4 or 8 mg/kg intravenously) were included (n = 101), and PK, PD, and PK/PD relationships and safety were assessed over 6 weeks postdose. PK profiles for both drugs are described by parallel linear and nonlinear target‐mediated clearance pathways. PD markers showed similar onset of effect during the first week postdose, regardless of dose or route of administration. CRP and ANC decreased, with median postdose nadirs at 7‐15 days for CRP and 3‐5 days for ANC. Both drugs at low and high doses achieved the same nadir for ANC and a similar return toward baseline within 2 weeks postdose, suggesting a saturation of effect. Safety profiles of sarilumab and tocilizumab were generally similar. In conclusion, despite differences in PK, the onset of the decrease in CRP (efficacy) and ANC (safety) after a single dose were similar for subcutaneous sarilumab and intravenous tocilizumab. PD effects and safety were consistent with previous studies. |
format | Online Article Text |
id | pubmed-7754484 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-77544842020-12-28 Pharmacokinetics and Pharmacodynamics of Subcutaneous Sarilumab and Intravenous Tocilizumab Following Single‐Dose Administration in Patients With Active Rheumatoid Arthritis on Stable Methotrexate Paccaly, Anne J. Kovalenko, Pavel Parrino, Janie Boyapati, Anita Xu, Christine van Hoogstraten, Hubert Ishii, Tomonori Davis, John D. DiCioccio, A. Thomas J Clin Pharmacol Pharmacokinetics/Pharmacodynamics We assessed pharmacokinetics (PK), pharmacodynamics (PD), and PK/PD relationships of interleukin‐6 (IL‐6), soluble IL‐6 receptor, and C‐reactive protein (CRP) in serum, and absolute neutrophil count (ANC) in blood following single doses of subcutaneous sarilumab versus intravenous tocilizumab (NCT02097524) from patients with rheumatoid arthritis (RA) who are inadequate responders to methotrexate (MTX) and on a stable dose of MTX. Patients with RA randomized (1:1:1:1) to single‐dose sarilumab (150 or 200 mg subcutaneously) or tocilizumab (4 or 8 mg/kg intravenously) were included (n = 101), and PK, PD, and PK/PD relationships and safety were assessed over 6 weeks postdose. PK profiles for both drugs are described by parallel linear and nonlinear target‐mediated clearance pathways. PD markers showed similar onset of effect during the first week postdose, regardless of dose or route of administration. CRP and ANC decreased, with median postdose nadirs at 7‐15 days for CRP and 3‐5 days for ANC. Both drugs at low and high doses achieved the same nadir for ANC and a similar return toward baseline within 2 weeks postdose, suggesting a saturation of effect. Safety profiles of sarilumab and tocilizumab were generally similar. In conclusion, despite differences in PK, the onset of the decrease in CRP (efficacy) and ANC (safety) after a single dose were similar for subcutaneous sarilumab and intravenous tocilizumab. PD effects and safety were consistent with previous studies. John Wiley and Sons Inc. 2020-07-29 2021-01 /pmc/articles/PMC7754484/ /pubmed/32726514 http://dx.doi.org/10.1002/jcph.1703 Text en © 2020 Regeneron Pharmaceuticals, Inc. The Journal of Clinical Pharmacology published by Wiley Periodicals LLC on behalf of American College of Clinical Pharmacology This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Pharmacokinetics/Pharmacodynamics Paccaly, Anne J. Kovalenko, Pavel Parrino, Janie Boyapati, Anita Xu, Christine van Hoogstraten, Hubert Ishii, Tomonori Davis, John D. DiCioccio, A. Thomas Pharmacokinetics and Pharmacodynamics of Subcutaneous Sarilumab and Intravenous Tocilizumab Following Single‐Dose Administration in Patients With Active Rheumatoid Arthritis on Stable Methotrexate |
title | Pharmacokinetics and Pharmacodynamics of Subcutaneous Sarilumab and Intravenous Tocilizumab Following Single‐Dose Administration in Patients With Active Rheumatoid Arthritis on Stable Methotrexate |
title_full | Pharmacokinetics and Pharmacodynamics of Subcutaneous Sarilumab and Intravenous Tocilizumab Following Single‐Dose Administration in Patients With Active Rheumatoid Arthritis on Stable Methotrexate |
title_fullStr | Pharmacokinetics and Pharmacodynamics of Subcutaneous Sarilumab and Intravenous Tocilizumab Following Single‐Dose Administration in Patients With Active Rheumatoid Arthritis on Stable Methotrexate |
title_full_unstemmed | Pharmacokinetics and Pharmacodynamics of Subcutaneous Sarilumab and Intravenous Tocilizumab Following Single‐Dose Administration in Patients With Active Rheumatoid Arthritis on Stable Methotrexate |
title_short | Pharmacokinetics and Pharmacodynamics of Subcutaneous Sarilumab and Intravenous Tocilizumab Following Single‐Dose Administration in Patients With Active Rheumatoid Arthritis on Stable Methotrexate |
title_sort | pharmacokinetics and pharmacodynamics of subcutaneous sarilumab and intravenous tocilizumab following single‐dose administration in patients with active rheumatoid arthritis on stable methotrexate |
topic | Pharmacokinetics/Pharmacodynamics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7754484/ https://www.ncbi.nlm.nih.gov/pubmed/32726514 http://dx.doi.org/10.1002/jcph.1703 |
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