Use of quantitative pharmacology in the development of HAE1, a high-affinity anti-IgE monoclonal antibody

AAPS J. 2008 Jun;10(2):425-30. doi: 10.1208/s12248-008-9045-4. Epub 2008 Aug 7.

Abstract

HAE1, a high-affinity anti-IgE monoclonal antibody, is discussed here as a case study in the use of quantitative pharmacology in the development of a second-generation molecule. In vitro, preclinical, and clinical data from the first-generation molecule, omalizumab, were heavily leveraged in the HAE1 program. A preliminary mechanism-based pharmacokinetic/pharmacodynamic (PK/PD) model for HAE1 was developed using an existing model for omalizumab, together with in vitro binding data for HAE1 and omalizumab. When phase I data were available, the model was refined by simultaneously modeling PK/PD data from omalizumab studies with the available HAE1 phase I data. The HAE1 clinical program was based on knowledge of the quantitative relationship between a pharmacodynamic biomarker, suppression of free IgE, and clinical response (e.g., lower exacerbation rates) obtained in pivotal studies with omalizumab. A clinical trial simulation platform was developed to predict free IgE levels and clinical responses following attainment of a target free IgE level (</=10 IU/ml). The simulation platform enabled selection of four doses for the phase II dose-ranging trial by two independent methods: dose-response non-linear fitting and linear mixed modeling. Agreement between the two methods provided confidence in the doses selected. Modeling and simulation played a large role in supporting acceleration of the HAE1 program by enabling data-driven decision-making, often based on confirmation of projections and/or learning from incoming new data.

Publication types

  • Review

MeSH terms

  • Antibodies, Anti-Idiotypic
  • Antibodies, Monoclonal* / immunology
  • Antibodies, Monoclonal* / pharmacology
  • Antibodies, Monoclonal* / therapeutic use
  • Antibodies, Monoclonal, Humanized
  • Antibody Affinity / immunology*
  • Asthma / drug therapy
  • Cell Line
  • Drug Design*
  • Humans
  • Immunoglobulin E / immunology*
  • Omalizumab
  • Receptors, IgE / immunology

Substances

  • Antibodies, Anti-Idiotypic
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Receptors, IgE
  • Omalizumab
  • Immunoglobulin E