JP7187505B2 - 長時間作用型凝固因子およびその製造方法 - Google Patents
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Description
(a)凝固因子を、3個の絨毛性ゴナドトロピンCTPを前記凝固因子のカルボキシ末端に結合することにより、修飾するステップ、
(b)上記ステップ(a)で修飾した凝固因子を前記緩衝液、および前記等張化剤と約6.4のpHで混合するステップ、および
(c)前記製剤をシリンジにプレフィルするステップ、を含む。
(a)所定量のCTP修飾凝固因子を有する前記CTP修飾凝固因子の週1回剤形を処方するステップ、および
(b)前記製剤をシリンジに充填するステップ、を含む。
第IX凝固因子の生成および利用
プライマー103R:5´ TTGAGGAAGATGTTCGTGTA 3´(第IX因子のSspI部位を含む)(配列番号37)
プライマー98:5´ ATTACAGTTGTCGCAGGTGA 3´(配列番号38)。
プライマー99R:5´ GCTGGAGCTAGTGAGCTTTGTTTTTTCCTT 3´(配列番号39)。
プライマー100:5´ GCTCACTAGCTCCAGCAGCAAGGCC 3´(配列番号40)。
プライマー27R:5´ TTTTCACTGCATTCTAGTTGTGG 3´(配列番号41)。
第二の反応は、プライマー100およびプライマー27Rならびにテンプレートとして、402-2-p72-3のプラスミドDNA(hGH-CTP-CTP)を用いて行った。PCR増幅の結果、約258bpの生成物を得た。
最後の反応(pcr 3)を、プライマー98および27R、ならびにテンプレートとして前の2つの反応の生成物の混合物を用いて行った。PCR増幅の結果、約790bpの生成物を得て、TAクローニングベクター(Invitrogen,カタログK2000-01)に連結した。SspI-EcoRIフラグメントを単離した(TA 3-3)。
誤りが第IX因子配列中で見出され、そのフラグメントを置き換えて、正しいDNA配列を有する第IX因子-ctp-ctpの挿入物を形成した。
プライマー75:ctcccagttcaattacagct(配列番号42)。
プライマー122r:ggaaaaactgcctcagcacgggtgagc(配列番号43)
プライマー123:gtgctgaggcagtttttcctgatgtggactat(配列番号44)
プライマー124r:caacacagtgggcagcag(配列番号45)。
精製FIX-CTP3の、FIX-CTP4およびFIX-CTP5に対する比較評価
全てのFIX-CTP試料(3、4および5個のCTP)を、材料がないという理由で、Jacalinカラムのみで精製した。
FIX-/-血友病マウスモデルのFIX-CTP3処置
FIX-CTP3 γ-カルボキシル化富化タンパク質、rhFIXおよびrFIXa(活性化FIX)を、12%のTris-グリシンゲルに対して、Precision Plus Dual Color Protein Marker(Bio-Rad)を用いてロードした。SDS-PAGEクマシー分析を、クマシーブルー試薬(800ngのタンパク質)を用いてゲルを染色することにより行った(図12)。ウエスタンイムノブロットを、100ngのタンパク質と、抗ヒトFIXポリクローナル抗体(図12B)、抗ヒトγ-カルボキシル化モノクローナル抗体(American Diagnosticsカタログ番号499,3570)(図12C)、抗FIXプロペプチドポリクローナル抗体(図12D)、および抗CTPポリクローナル抗体(図12E)とを用いて行った。前に報告されたとおり、FIX-CTP3は、75KDaに移動した。
aPTTアッセイに対する発色アッセイにおいて示されるとおり、算出されたFIX-CTP3活性の不一致は、aPTTアッセイの優れた感度およびインビボとの関連性によって、説明可能である。発色活性アッセイでは、過剰量の試薬および酵素が存在し、これは、強度の劣るFIX形態を活性化し得る。FIX-CTP比活性値の相違は、異なる試薬および自動装置の使用によって、説明できる。ノースカロライナ大学で算出された活性値を、PK-PD試験計画のために用いた。
凝固因子FVIIの生成および利用
精製したFVII-CTP3、FVII-CTP4およびFVII-CTP5の比較評価
FVIII欠乏血友病マウスを用いたFVII-CTP3の実現可能性に関する試験
注射開始の少なくとも4日前、Harlan Laboratories Israel社から雄SDラット24匹が到着した。個体は健常な若年成体であり、試験開始時、約200グラムであった。処置開始時の体重の個体のばらつきは、各性別の平均重量の±20%を超えてはいけない。この試験に用いる個体の健康状態を到着時に検査する。健康状態が良好な個体のみを実験室条件に馴化させ、試験に用いる。
A.NovoSeven(登録商標)RT:(31.7.12に調製したロット番号AU61553*)A280によるFVIIa濃度:0.86mg/ml。FVIIa Staclot活性アッセイ:56,867U/mg。注射用量:946μg/kg。*いずれも同じロット番号のNovoSeven(登録商標)アリコートのプール。
B.クローン28:MOD-5014 RS12-001:A280で0.77mg/ml**。FVIIa Staclot活性アッセイ:34,162U/mg。注射用量:850μg FVIIa/kg。
A.NovoSeven(登録商標)RT:(1.1.13に調製したロット番号AU61347)A280によるFVIIa濃度:0.82mg/ml、無菌NS緩衝液で0.4mg/mlに希釈。FVIIa Staclot活性アッセイ:55,688 U/mg。注射用量:360μg/kgおよび20,047.7U/kg。
B.クローン61:MOD-5014バッチ75:A280で1.9mg/ml**、製剤緩衝液で0.89mg/mlに希釈。注射用量:20,047.7U/kg。FVIIa凝固活性:FVIIa Staclot活性アッセイで25,002*U/mg。
C.クローン61:MOD-5014バッチ81A:A280で2.36mg/ml(試験当日の朝にろ過し、280nmで再測定した)、製剤緩衝液で0.4mg/mlに希釈。注射用量:360μg FVIIa/kg。FVIIa凝固活性:FVIIa Staclot活性アッセイで24943U/mg。
D.クローン61:MOD-5014バッチ81A:A280で2.36mg/ml、製剤緩衝液で0.89mg/mlに希釈。注射用量:20,047.7U/kg。FVIIa凝固活性:FVIIa Staclot活性アッセイで24,943U/mg。
アンチトロンビン(AT)とヘパリンの存在下でのMOD-5014およびNovoSevenの効力を評価した。一定濃度のMOD-5014およびNovoSeven(0.7ng/ml)に様々な濃度のAT(1.68mg/ml~0.032μg/ml)および1U/μlのヘパリンを添加し、FX活性化を測定した。アンチトロンビンに対するIC50値は、MOD-5014が49.65μg/ml、NovoSevenが65.70μg/mlであった。結果を表121、図52に示す。
・ヒト血漿(FVIII欠乏)BIORECLAMATION(カタログ番号HMPLCITFACT8DEF、ロット番号BRH779222~BRH779233)。
・FVII欠乏血漿、カタログ番号HBM-DP030K。
WBCT
グループ1対グループ2~8
グループ3対グループ7
グループ5対グループ8
・1±0.5時間後、4±0.5時間後および8時間±0.5時間後のバイタルサイン(血圧、脈拍、呼吸数、体温)
・1±0.5時間後、4±0.5時間後および8±0.5時間後のECG
・4±0.5時間後の安全性臨床検査(血液学検査、生化学検査および尿検査)による評価
・30±5分後、2時間±20分後、4±0.5時間後および8±1時間後の凝固パネル
・30±5分後、2時間±20分後、4±0.5時間後および8±1時間後の薬物動態
・30±5分後、2時間±20分後、4±0.5時間後および8±1時間後の薬力学。アッセイには以下のものを含める:
○STAClotアッセイによるFVIIa活性
○トロンボラストグラフィー(thrombolastography)(任意選択)
○トロンビン生成
・併用薬
・IV投与終了から10分後および2時間±20分後の投与部位における局所皮膚反応
・有害事象
・スクリーニング期間:投与前の第-28日~第-1日
・治療:1日の単回投与
・追跡:急性安全性に関して少なくとも72時間、安全性に関して7日および免疫原性に関して30日。
1.スクリーニング来院時の年齢が18~65歳の男性。
2.阻害因子の有無を問わず、中等度ないし重度の先天性血友病AまたはB(それぞれFVIIIまたはFIXレベルが正常の3%以下であると定義される)と診断されている。
3.体格指数(BMI)が35.0kg/m2未満である。
4.十分に静脈が確保できる。
5.生殖可能な男性は、投与後90日間はバリア型避妊具(コンドーム)を使用することに同意しなければならず、試験期間中および投与後90日間は精子提供が制限される。
1.試験全体を通じた有害事象および併用薬の使用
2.免疫原性、中和抗体が認められない
3.ECG、バイタルサイン、身体検査(神経学的評価を含む)
4.血清化学検査プロファイル、肝酵素、血液学検査、凝固パネル(PT時間、aPTT、トロンビン/アンチトロンビン複合体、プロトロンビンフラグメント1+2、D-二量体)および尿検査を含めた臨床検査パラメータ
5.局所耐容性(注射部位反応)。
Cmax-MOD-5014の最大血漿中濃度
Tmax-Cmaxまでの時間
Tlag-MOD-5014の吸収遅延時間
AUC-最終濃度≧定量限界(LOQ)となる部分までの曲線下面積AUC(0-t)および無限時間までの曲線下面積AUCinf
λz-消失速度定数
t1/2-半減期
Vss-定常状態での容積、クリアランスおよび回収率
第1/2a相試験を裏付ける第VIIA因子-CTPの安全性および有効性の総合的評価
Vi=用量/C0
から見かけの初期分布容積(Vi)を算出した。
t1/2=ln(2)/λ
AUC0-∞=AUC0-24h+C24h/λ
(式中、C24hは24時間後の濃度である)。用量をAUC0-∞で除した商から血清クリアランス(CL)を算出した。終末相(Vz)および定常状態(Vss)における容積を以下の方程式から算出した:
Vss=用量×AUMC/AUC2
Vz=CL/λ
(式中、AUMCは1次モーメント曲線下面積である)。
投与前の活性測定値はBLQとし、PKパラメータの推定では「欠測値」に設定した。
1個体あたり2回の測定値の平均値(mU/mL)であり、投与前の活性測定値はBLQとし、PKパラメータの推定では「欠測値」に設定し、#404の投与前の値は無視できるものと見なし、同じく欠測値に設定した。
・フローサイトメトリーによって評価される血小板結合
・血小板表面でのトロンビン生成によって評価される血小板結合
を検討した。
・MOD-5014の合成基質切断
・合成基質切断によって測定されるMOD-5014の組織因子(TF)
・第X因子(FX)活性化によって測定されるMOD-5014のTF結合
・TF結合MOD-5014によるFX活性化の動態
・FX活性化によって測定されるMOD-5014の脂質結合
・脂質結合MOD-5014による因子活性化の動態
・アンチトロンビン(AT)によるMOD-5014の不活化
・TFPIによるMOD-5014の不活化
・MOD-5014 GMP-1:2.5mg/ml(A280に基づく)
・MOD-5000と称するNovoSevenロット番号CU60430:0.943mg/ml(A280に基づく)
速度=k1[VIIa]
k1=27.5mol pNA/(分・モルVIIa)
に当てはめた。
速度=k1[VIIa]+k2[VIIa/TF]
血漿中の第X因子の濃度は8μg/mL(約135nM)である。
解析:FX添加量の増大に伴い、FVIIaがすべてFXと結合する時点まで、FXと結合する脂質表面のFVIIaが増加したはずである。上記の時点での反応は、FXが活性化される速度によって制限される。したがって、FX活性化の速度はFXの濃度の増大とともに増大し、曲線の形状は漸近的に最大速度に近づくものとなるはずである。予想される通り、FVIIaのFXに対する親和性はTF不在下で低下し(Kmが大きくなり)、FXa生成速度はTF不在下で低下している(図125)。
v=Vt=0e-k*時間
Claims (25)
- 第VIIa(FVII)凝固因子を投与するための医薬製剤の製造における、絨毛性ゴナドトロピンカルボキシ末端ペプチド(CTP)修飾ポリペプチドの使用であって、
前記医薬製剤は、緩衝剤と、等張化剤と、前記CTP修飾ポリペプチドとを含み、
前記CTP修飾ポリペプチドは、前記FVII凝固因子および前記凝固因子のカルボキシ末端に結合した3つの絨毛性ゴナドトロピンカルボキシ末端ペプチド(CTP)からなり、
前記CTP修飾ポリペプチドが、シグナルペプチドを含まず、
前記医薬製剤のpHが6.4であり、
前記緩衝剤が、20mMクエン酸塩と、13.3mMグリシンとを含み、
前記等張化剤が150mM塩化ナトリウムであることを特徴とする使用。 - 第VIIa(FVII)凝固因子の投与頻度を減らすようにFVII凝固因子を投与するための医薬製剤の製造における、絨毛性ゴナドトロピンカルボキシ末端ペプチド(CTP)修飾ポリペプチドの使用であって、
前記医薬製剤は、緩衝剤と、等張化剤と、前記CTP修飾ポリペプチドとを含み、
前記CTP修飾ポリペプチドは、前記FVII凝固因子および前記凝固因子のカルボキシ末端に結合した3つの絨毛性ゴナドトロピンカルボキシ末端ペプチド(CTP)からなり、
前記CTP修飾ポリペプチドが、シグナルペプチドを含まず、
前記医薬製剤のpHが6.4であり、
前記緩衝剤が、20mMクエン酸塩と、13.3mMグリシンとを含み、
前記等張化剤が150mM塩化ナトリウムであることを特徴とする使用。 - 第VIIa(FVII)凝固因子の生物学的半減期を延長させるようにFVII凝固因子を投与するための医薬製剤の製造における、絨毛性ゴナドトロピンカルボキシ末端ペプチド(CTP)修飾ポリペプチドの使用であって、
前記医薬製剤は、緩衝剤と、等張化剤と、前記CTP修飾ポリペプチドとを含み、
前記CTP修飾ポリペプチドは、前記FVII凝固因子および前記凝固因子のカルボキシ末端に結合した3つの絨毛性ゴナドトロピンカルボキシ末端ペプチド(CTP)からなり、
前記CTP修飾ポリペプチドが、シグナルペプチドを含まず、
前記医薬製剤のpHが6.4であり、
前記緩衝剤が、20mMクエン酸塩と、13.3mMグリシンとを含み、
前記等張化剤が150mM塩化ナトリウムであることを特徴とする使用。 - 第VII(FVII)凝固因子の曲線下面積(AUC)を改善するようにFVII凝固因子を投与するための医薬製剤の製造における、絨毛性ゴナドトロピンカルボキシ末端ペプチド(CTP)修飾ポリペプチドの使用であって、
前記医薬製剤は、緩衝剤と、等張化剤と、前記CTP修飾ポリペプチドとを含み、
前記CTP修飾ポリペプチドは、前記FVII凝固因子および前記凝固因子のカルボキシ末端に結合した3つの絨毛性ゴナドトロピンカルボキシ末端ペプチド(CTP)からなり、
前記CTP修飾ポリペプチドが、シグナルペプチドを含まず、
前記医薬製剤のpHが6.4であり、
前記緩衝剤が、20mMクエン酸塩と、13.3mMグリシンとを含み、
前記等張化剤が150mM塩化ナトリウムであることを特徴とする使用。 - 請求項1~4のいずれか1項に記載の使用であって、
前記医薬製剤が、薬学的に許容される担体を含み、前記薬学的に許容される担体は、ポリエチレングリコール(PEG)、炭酸カルシウム、リン酸カルシウム、糖類、デンプン、セルロース誘導体、ゼラチン、および植物からなる群から選択される、使用。 - 請求項1~5のいずれか1項に記載の使用であって、
前記医薬製剤が、液体製剤である、使用。 - 請求項1~6のいずれか1項に記載の使用であって、
少なくとも1つの前記CTPの配列が、配列番号1および配列番号2からなる群より選択されるアミノ酸配列からなる、使用。 - 請求項1~7のいずれか1項に記載の使用であって、
少なくとも1つの前記CTPが短縮されている、使用。 - 請求項1~8のいずれか1項に記載の使用であって、
少なくとも1つの前記CTPがグリコシル化されている、使用。 - 請求項1~9のいずれか1項に記載の使用であって、
少なくとも1つの前記CTPが、選択に応じてリンカーを介して前記凝固因子に結合されており、前記リンカーが、例えばペプチド結合である、使用。 - 請求項1~10のいずれか1項に記載の使用であって、
前記CTP修飾ポリペプチドの配列が、配列番号46に記載されたものである、使用。 - 請求項1~11のいずれか1項に記載の使用であって、
前記FVII凝固因子が、活性化された第VII凝固因子(FVIIa)を含む、使用。 - 請求項12に記載の使用であって、
前記CTP修飾ポリペプチドが、ジスルフィド結合によって連結された軽鎖と重鎖とを含む、使用。 - 請求項13に記載の使用であって、
前記軽鎖のアミノ酸配列が、配列番号46の残基1~152の配列を含み、前記重鎖のアミノ酸配列が、配列番号46の残基153~460の配列を含む、使用。 - 請求項13または14のいずれか1項に記載の使用であって、
SDS-PAGEゲル上での前記軽鎖と前記重鎖の分離が変性条件下で起こり、前記軽鎖が25kDaの分子量に移動し、前記重鎖が60kDaの分子量に移動する、使用。 - 請求項13~15のいずれか1項に記載の使用であって、
前記ジスルフィド結合が、配列番号46のシステイン残基135とシステイン残基262との間で生ずる、使用。 - 請求項1~16のいずれか1項に記載の使用であって、
前記医薬製剤は対象に投与される、使用。 - 請求項17に記載の使用であって、
前記対象がヒト成人またはヒト小児である、使用。 - 請求項17または18に記載の使用であって、
前記対象が、血液凝固障害を有する、使用。 - 請求項19に記載の使用であって、
前記血液凝固障害が血友病である、使用。 - 請求項20に記載の使用であって、
前記血友病が、血友病Aまたは血友病Bを含む、使用。 - 請求項20に記載の使用であって、
前記血友病が、阻害因子を有する血友病Aまたは血友病Bを含む、使用。 - 請求項17~22のいずれか1項に記載の使用であって、
前記投与が皮下経路または静脈内経路を介するものである、使用。 - 請求項17~23のいずれか1項に記載の使用であって、
前記CTP修飾ポリペプチドは、毎日、1日置きに、2日置きに、週1回、週2回もしくは2週間に1回またはその任意の組合せで投与される、使用。 - 請求項17~24のいずれか1項に記載の使用であって、
前記CTP修飾ポリペプチドの前記投与は、50μg/kg~400μg/kgの範囲の用量で行われる、使用。
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EP3310347B1 (en) | 2015-06-19 | 2021-08-04 | OPKO Biologics Ltd. | Long-acting coagulation factors and methods of producing same |
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ノボセブンHI静注用1mg ノボセブンHI静注用2mg ノボセブンHI静注用5mg,添付文書,第5版,ノボ ノルディスク ファーマ株式会社,2013年05月 |
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