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A phase 2 multicenter study of ublituximab, a novel glycoengineered anti-CD20 monoclonal antibody, in patients with relapsing forms of multiple sclerosis
Multiple Sclerosis Journal ( IF 5.8 ) Pub Date : 2020-04-30 , DOI: 10.1177/1352458520918375
Edward Fox 1 , Amy E Lovett-Racke 2 , Matthew Gormley 2 , Yue Liu 2 , Maria Petracca 3 , Sirio Cocozza 4 , Richard Shubin 5 , Sibyl Wray 6 , Michael S Weiss 7 , Jenna A Bosco 7 , Sean A Power 7 , Koby Mok 7 , Matilde Inglese 8
Affiliation  

BACKGROUND Ublituximab, a novel monoclonal antibody (mAb) targeting a unique epitope on the CD20 antigen, is glycoengineered for enhanced B-cell targeting through antibody-dependent cellular cytotoxicity (ADCC). Greater ADCC may allow lower doses and shorter infusion times versus other anti-CD20 mAbs. OBJECTIVE The objective was to determine optimal dose, infusion time, and activity of ublituximab in relapsing multiple sclerosis. METHODS This is a phase 2, placebo-controlled study. Patients received three ublituximab infusions (150 mg over 1-4 hours on day 1 and 450-600 mg over 1-3 hours on day 15 and week 24) in six dosing cohorts. The primary endpoint was B-cell depletion. RESULTS In all cohorts (N = 48), median B-cell depletion was >99% by week 4, maintained at weeks 24 and 48. Most common adverse events (AEs) were infusion-related reactions (all grade 1-2), with no apparent increased incidence at shorter infusion times. There were no AE-related discontinuations. At weeks 24 and 48, no T1 gadolinium-enhancing lesions (p = 0.003) and a 10.6% decrease in T2 lesion volume (p = 0.002) were detected. The annualized relapse rate was 0.07; 93% remained relapse free on study. Overall, 74% of patients had no evidence of disease activity (NEDA). CONCLUSION Ublituximab was safely infused as rapid as 1 hour, producing robust B-cell depletion and profound reductions in magnetic resonance imaging (MRI) activity and relapses.

中文翻译:

ublituximab(一种新型糖基工程抗 CD20 单克隆抗体)在复发型多发性硬化症患者中的 2 期多中心研究

背景 Ublituximab 是一种新型单克隆抗体 (mAb),靶向 CD20 抗原上的独特表位,经过糖工程改造以通过抗体依赖性细胞毒性 (ADCC) 增强 B 细胞靶向。与其他抗 CD20 mAb 相比,更大的 ADCC 可能允许更低的剂量和更短的输注时间。目的 目的是确定 ublituximab 在复发性多发性硬化症中的最佳剂量、输注时间和活性。方法 这是一项 2 期安慰剂对照研究。患者在六个给药队列中接受了 3 次 ublituximab 输注(第 1 天 1-4 小时内 150 毫克,第 15 天和第 24 周内 1-3 小时内 450-600 毫克)。主要终点是 B 细胞耗竭。结果 在所有队列 (N = 48) 中,第 4 周 B 细胞耗竭的中位数 >99%,并在第 24 周和第 48 周保持不变。最常见的不良事件 (AE) 是输液相关反应(均为 1-2 级),在较短的输液时间内发生率没有明显增加。没有与 AE 相关的停药。在第 24 周和第 48 周,未检测到 T1 钆增强病变(p = 0.003),T2 病变体积减少 10.6%(p = 0.002)。年化复发率为0.07;93% 在研究中保持无复发。总体而言,74% 的患者没有疾病活动的证据(NEDA)。结论 Ublituximab 安全输注最快 1 小时,产生强大的 B 细胞耗竭和磁共振成像 (MRI) 活动和复发的显着减少。检测到 T2 病灶体积减少 6% (p = 0.002)。年化复发率为0.07;93% 在研究中保持无复发。总体而言,74% 的患者没有疾病活动的证据(NEDA)。结论 Ublituximab 安全输注最快 1 小时,产生强大的 B 细胞耗竭和磁共振成像 (MRI) 活动和复发的显着减少。检测到 T2 病灶体积减少 6% (p = 0.002)。年化复发率为0.07;93% 在研究中保持无复发。总体而言,74% 的患者没有疾病活动的证据(NEDA)。结论 Ublituximab 安全输注最快 1 小时,产生强大的 B 细胞耗竭和磁共振成像 (MRI) 活动和复发的显着减少。
更新日期:2020-04-30
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