Population Pharmacokinetics and Exposure‐Response Modeling Analyses of Ustekinumab in Adults With Moderately to Severely Active Ulcerative Colitis

Journal of Clinical Pharmacology - Tập 60 Số 7 - Trang 889-902 - 2020
Yan Xu1, Chuanpu Hu1, Yang Chen1, Xin Miao1, Omoniyi J. Adedokun1, Zhenhua Xu1, Amarnath Sharma1, Honghui Zhou1
1Clinical Pharmacology and Pharmacometrics Janssen Research & Development, LLC, Spring House Pennsylvania USA

Tóm tắt

AbstractTo characterize the pharmacokinetics (PK) and exposure‐response (E‐R) relationship of ustekinumab, an anti‐interleukin‐12/interleukin‐23 (IL‐12/IL‐23) human monoclonal antibody, in the treatment of moderately to severely active ulcerative colitis (UC), population PK and E‐R modeling analyses were conducted based on the data from the pivotal phase 3 induction and maintenance studies in UC patients. The observed serum concentration‐time data of ustekinumab were adequately described by a 2‐compartment linear PK model with first‐order absorption and first‐order elimination. Body weight, baseline serum albumin, sex, and antibodies to ustekinumab were the covariates to influence ustekinumab PK, but the magnitudes of the effects of these covariates were not considered clinically relevant, and dose adjustment was not warranted. Positive E‐R relationships were demonstrated between ustekinumab exposure metrics and clinical endpoints (including clinical response, clinical remission, and endoscopic healing based on Mayo score) at induction week 8 and maintenance week 44, consistent with the effectiveness of ustekinumab in the induction and maintenance treatment of patients with UC. E‐R modeling results suggest that ustekinumab ∼6 mg/kg intravenous induction and 90‐mg subcutaneous every‐8‐week maintenance dose would produce greater efficacy than the 130 mg intravenous induction and the 90‐mg subcutaneous every‐12‐week maintenance regimen, respectively. Our work provides a comprehensive evaluation of ustekinumab PK and E‐R in a modeling framework to support ustekinumab dose recommendations in patients with UC.

Từ khóa


Tài liệu tham khảo

10.1016/S0140-6736(16)32126-2

10.1093/ibd/izy327

10.3748/wjg.v24.i32.3567

10.1093/gastro/gou087

Stelara® (Ustekinumab) United States Package Insert. 2018. Janssen Biotech Inc. Horsham Pennsuylvania.https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/125261s147lbl.pdf. Accessed January 19 2019.

10.1056/NEJMoa1900750

10.1185/030079907X182112

10.1016/j.clpt.2003.11.034

10.1177/0091270008329556

10.5414/CPP48830

10.1007/s10928-017-9529-x

10.1177/0091270009343695

10.1007/s40265-014-0242-4

10.1053/j.gastro.2018.01.043

10.1056/NEJM198712243172603

10.1002/jcph.393

10.1002/jcph.1101

10.1002/jcph.1063

10.1177/0091270008318670

10.1002/pst.403

10.2165/11535960-000000000-00000

10.1038/psp.2013.14

10.1080/19466315.2018.1560361

10.1046/j.1365-2664.2001.00604.x

10.2165/11531280-000000000-00000

10.1038/clpt.2011.328

10.1111/apt.13243

Entyvio® (Vedolizumab) United States Package Insert. 2018. Takeda Pharmaceuticals Deerfield Illinois.https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/125476s022lbl.pdf. Accessed January 9 2019.

Humira® (Adalimumab) United States Package Insert. AbbVie Inc. North Chicago Illinois.https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/125057s406lbl.pdf. Accessed January 9 2019.

10.1053/j.gastro.2014.08.035

10.1136/gutjnl-2012-304094