JP2021527062A - ANCA関連血管炎に対するc5aアンタゴニストの投薬及び効果 - Google Patents
ANCA関連血管炎に対するc5aアンタゴニストの投薬及び効果 Download PDFInfo
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Abstract
Description
本出願は、2018年6月7日出願の米国仮出願第62/682,013号の35U.S.C.§119条(e)に基づく利益を主張する出願である。その全体は参照により本明細書に援用される。
該当なし
該当なし
本開示は、特に、それを必要とするヒトにおいてANCA関連血管炎(AAV)を治療する方法に関するものであり、この方法は、以下に示す構造:
本開示は、アバコパンが、治療を受けている個人において血漿補体因子のレベルに影響を与えることなく、AAVを急速に改善するという驚くべき予期せぬ知見を示す。したがって、アバコパンを投与された個体は、Bb、C3a又はC5aのような血漿補体因子のレベルに有意な変化を経験せず、有利には、膜侵襲複合体の集合又は上流補体活性は影響を受けない。
特に断らない限り、本明細書中で使用される全ての技術用語及び科学用語は、本発明が属する当業者によって一般的に理解されるものと同じ意味を有する。さらに、本明細書に記載される方法又は材料と類似又は同等の任意の方法又は材料を、本発明の実施において使用することができる。本発明の目的のために、以下の用語が定義される。
治療方法
本明細書に提供されるいくつかの態様では、それを必要とするヒトにおいてANCA関連血管炎を治療する方法であって、治療的に有効な量のアバコパン:
アバコパンは、典型的には薬学的担体又は希釈剤を含有する組成物として投与することができる。
実施形態1:治療的に有効な量のアバコパン:
実施例:ANCA関連血管炎(AAV)における血漿補体レベルに対する選択的C5aRアンタゴニストアバコパンの効果
方法
CLEAR試験(Jayne DRWら、JASN 2017;28:2756)は、AAV患者67人における3つのレジメンを比較した:(1)全量プレドニゾン(60mg/日、漸減);(2)アバコパン30mg/1日2回+低用量プレドニゾン(20mg、漸減);(3)アバコパン30mg/1日2回+プレドニゾンなし。また、全てにシクロホスファミド又はリツキシマブのいずれかを投与した。12週間の治療期間と12週間の追跡期間を設けた。
治療前に、C3a、sC5b−9及びプロパージンのレベルは、マッチした健常対照と比較して、AAV患者で有意に上昇した(幾何平均[95%]、C3a、67.2[57.5−78.7]対23.2[16.9−31.9]ng/mL、p<0.001;C5a、7.55[6.50−8.78]対5.19[3.87−6.95]ng/mL、p<0.05;sC5b−9、241(222−262)対155(136−178)ng/mL、p<0.001;プロパージン、18.4[16.9−20.0]対13.1[11.4−15.6]μg/mL、p<0.001)(図4)。プレドニゾンの全量投与を受けた対象では、Bb、C3a、及びC5aのレベルは、8日目と29日目に有意に低下し、85日目に再び上昇し、漸減と一致した(図5A、図6A、7A)。対照的に、アバコパンの投与は、循環補体レベルに影響を及ぼさなかった(図5B−C、図6C、図7B−C)。いずれの投与群においても、平均血漿sC5b−9値又はプロパージン値にベースラインからの変化は認められなかった(図8A−C及び図9A−C)。結果の要約を表1に示す。
アバコパンは、補体系への明らかな影響なしにAAVの急速な改善と関連した。特に、C5b−9(膜侵襲複合体)の集合、及び宿主防御(例えば、細菌感染)及び組織修復に重要な補体系の上流活性は、アバコパンの投与によって変化しなかった。対照的に、グルココルチコイドは、上流の補体活性化産物の循環レベルの用量依存的減少と関連した。
Claims (33)
- アバコパン又はその薬学的に許容される塩を経口投与することを含む、請求項1に記載の方法。
- アバコパンを投与することを含む、請求項1又は2に記載の方法。
- 約30mgのアバコパンを投与することを含む、請求項1〜3のいずれか1項に記載の方法。
- アバコパンを1日2回投与することを含む、請求項1〜4のいずれか1項に記載の方法。
- 少なくとも12週間、アバコパンを投与することを含む、請求項1〜5のいずれか1項に記載の方法。
- 補体因子Bbのレベルが有意に変化しない、請求項1〜6のいずれか1項に記載の方法。
- 補体因子Bbのレベルが、治療直前及び治療の少なくとも1週間又は約1ヵ月後に比較される、請求項7に記載の方法。
- 治療前後の補体因子Bbのレベルが、約0.8〜1.4μg/mLである、請求項7又は8に記載の方法。
- 治療後の補体因子Bbのレベルが、治療前のレベルの約30%、約20%、又は約10%以内である、請求項7〜9のいずれか1項に記載の方法。
- 補体因子C3aのレベルが有意に変化しない、請求項1〜10のいずれか1項に記載の方法。
- 補体因子C3aのレベルが、治療直前及び治療開始から約1〜約6時間後に比較される、請求項11に記載の方法。
- 補体因子C3aのレベルが、治療直前及び治療の少なくとも1週間又は約1ヵ月後に比較される、請求項11に記載の方法。
- 治療前後の補体因子C3aのレベルが、約25〜100ng/mLである、請求項11〜13のいずれか1項記載の方法。
- 治療後の補体因子C3aのレベルが、治療前のレベルの約30%、約20%、又は約10%以内である、請求項11〜14のいずれか1項に記載の方法。
- 補体因子C5aのレベルが有意に変化しない、請求項1〜15のいずれか1項に記載の方法。
- 補体因子C5aのレベルが、治療直前及び治療の少なくとも1週間又は約1ヵ月後に比較される、請求項16に記載の方法。
- 治療前後の補体因子C5aのレベルが、約4〜10ng/mLである、請求項16又17に記載の方法。
- 治療後の補体因子C5aのレベルが、治療前のレベルの約30%、約20%、又は約10%以内である、請求項16〜18のいずれか1項に記載の方法。
- それを必要とするヒトにおけるANCA関連血管炎が、抗MPO ANCA関連血管炎である、請求項1〜19のいずれか1項に記載の方法。
- それを必要とするヒトにおけるANCA関連血管炎が、抗PR3 ANCA関連血管炎である、請求項1〜19のいずれか1項に記載の方法。
- コルチコステロイドを投与することをさらに含む、請求項1〜21のいずれか1項に記載の方法。
- コルチコステロイドがプレドニゾンである、請求項22に記載の方法。
- CD20阻害剤を投与することをさらに含む、請求項1〜23のいずれか1項に記載の方法。
- CD20阻害剤がリツキシマブである、請求項24に記載の方法。
- シクロホスファミドを投与することをさらに含む、請求項1〜21のいずれか1項に記載の方法。
- アバコパン又はその薬学的に許容される塩を経口投与することを含む、請求項27に記載の方法。
- アバコパンを投与することを含む、請求項27又は28に記載の方法。
- 約30mgのアバコパンを投与することを含む、請求項27〜29のいずれか1項に記載の方法。
- アバコパンを1日2回投与することを含む、請求項27〜30のいずれか1項に記載の方法。
- 少なくとも12週間、アバコパンを投与することを含む、請求項27〜31のいずれか1項に記載の方法。
- 投与後の補体因子のレベルが、投与前のレベルの約30%、約20%、又は約10%以内である、請求項27〜32のいずれか1項に記載の方法。
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- 2019-06-06 CN CN201980038855.4A patent/CN112423752A/zh active Pending
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MA52808A (fr) | 2021-04-14 |
US11191756B2 (en) | 2021-12-07 |
KR20210018906A (ko) | 2021-02-18 |
SG11202011961YA (en) | 2020-12-30 |
US20190374524A1 (en) | 2019-12-12 |
US20220296576A1 (en) | 2022-09-22 |
BR112020024842A2 (pt) | 2021-03-02 |
CA3102403A1 (en) | 2019-12-12 |
AU2019282327A1 (en) | 2021-01-07 |
WO2019236820A1 (en) | 2019-12-12 |
EP3801519A1 (en) | 2021-04-14 |
IL279188A (en) | 2021-01-31 |
CL2020003171A1 (es) | 2021-06-04 |
MX2020013166A (es) | 2021-03-29 |
CN112423752A (zh) | 2021-02-26 |
EP3801519A4 (en) | 2022-03-30 |
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