NZ748496B2 - ANTI-N3pGlu AMYLOID BETA PEPTIDE ANTIBODIES AND USES THEREOF - Google Patents
ANTI-N3pGlu AMYLOID BETA PEPTIDE ANTIBODIES AND USES THEREOF Download PDFInfo
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- NZ748496B2 NZ748496B2 NZ748496A NZ74849617A NZ748496B2 NZ 748496 B2 NZ748496 B2 NZ 748496B2 NZ 748496 A NZ748496 A NZ 748496A NZ 74849617 A NZ74849617 A NZ 74849617A NZ 748496 B2 NZ748496 B2 NZ 748496B2
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K39/00—Medicinal preparations containing antigens or antibodies
- A61K2039/505—Medicinal preparations containing antigens or antibodies comprising antibodies
- A61K2039/507—Comprising a combination of two or more separate antibodies
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P25/00—Drugs for disorders of the nervous system
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P25/00—Drugs for disorders of the nervous system
- A61P25/28—Drugs for disorders of the nervous system for treating neurodegenerative disorders of the central nervous system, e.g. nootropic agents, cognition enhancers, drugs for treating Alzheimer's disease or other forms of dementia
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
-
- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07K—PEPTIDES
- C07K16/00—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies
- C07K16/18—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans
-
- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07K—PEPTIDES
- C07K2317/00—Immunoglobulins specific features
- C07K2317/90—Immunoglobulins specific features characterized by (pharmaco)kinetic aspects or by stability of the immunoglobulin
- C07K2317/92—Affinity (KD), association rate (Ka), dissociation rate (Kd) or EC50 value
Abstract
The invention is directed to a short term induction treatment with anti-N3pGlu A? antibodies of a disease characterized by deposition of A? in the brain, that include Alzheimer's disease (AD), Down's syndrome, and cerebral amyloid angiopathy (CAA). In certain embodiments, patients are administered an induction dose of 10 to 60 mg/kg of an anti-N3pGlu A? antibody for a period of 6 months or less. n induction dose of 10 to 60 mg/kg of an anti-N3pGlu A? antibody for a period of 6 months or less.
Description
ANTI-N3pGlu AMYLOID BETA PEPTIDE ANTIBODIES AND USES THEREOF
The present description relates to uses of anti-N3pGlu Aβ antibodies for the manufacture of
medicaments for the treatment of a disease, wherein the disease is characterized by deposition of
Amyloid Beta (Aβ) in a patient. More specifically, the present description relates to uses
comprising a short term induction treatment with N3pGlu Aβ antibodies of a disease
characterized by deposition of Aβ in the brain, including Alzheimer's disease (AD), Down's
syndrome, and cerebral amyloid angiopathy (CAA).
The deposits found in plaques of human patients are comprised of a heterogeneous
mixture of A β peptides. N3pGlu A β, also referred to as N3pE A β, A β pE3-42, or A β , is a
p3-42
truncated form of A β peptide and is found only in plaques. N3pGlu A β lacks the first two amino
acid residues at the N-terminus of human A β and has a pyroglutamate which was derived from
the glutamic acid at the third amino acid position. Although N3pGlu A β peptide is a minor
component of the deposited A β in the brain, studies have demonstrated that N3pGlu A β peptide
has aggressive aggregation properties and accumulates early in the deposition cascade.
Antibodies to N3pGlu A β are known in the art. For example, U.S. Patent Number
8,679,498 discloses anti-N3pGlu A β antibodies and methods of treating diseases such as
Alzheimer’s disease, with the antibodies. Passive immunization by long term chronic
administration of antibodies against the Aβ, including N3pGlu A β, found in deposits has been
shown to disrupt the Aβ aggregates and promote the clearance of plaques in the brain in various
animal models. However, in humans long term chronic administration of Aβ antibodies has led to
adverse events that include amyloid-related imaging abnormalities (ARIA), suggestive of
vasogenic edema and sulcal effusions (ARIA-E), as well as microhaemorrhages and haemosiderin
deposits (ARIA-H) as well as infusion site reactions and risk of immunogenicity. See Piazza and
Winblad, “Amyloid-Related Imaging Abnormalities (ARIA) in Immunotherapy Trials for
Alzheimer’s Disease: Need for Prognostic Biomarkers?” Journal of Alzheimer’s Disease, 52
(2016) 417-420.
The present invention overcomes the problems associated with long term chronic
administration, and/ or at least provides the public with a useful choice. Applicants found that
short term induction treatment with relatively high doses of anti-N3pGlu Aβ antibodies promotes
significant clearance of plaques in the brain of patients with Aβ deposits, and this clearance is
surprisingly maintained for an extended period of time. The short term induction treatment can
include a one-time dose of an anti-N3pGlu antibody, a biweekly dose of an anti-N3pGlu Aβ
antibody for a period of 6 months, or a monthly dose of an anti-N3pGlu Aβ antibody for a period
of 6 months or less. In addition to reducing the adverse events caused by long term chronic dosing
of antibodies against Aβ, additional benefits of the short term induction treatment include
improved patient compliance, reduced infusion site reactions and risk of immunogenicity,
significant cost savings for treatment as well as reduced disruption to the patient and caregiver’s
lives.
Summary of the Invention
The invention relates to use of an anti-N3pGlu Amyloid β antibody for the manufacture
of a medicament for the treatment and prevention of a disease characterized by Amyloid β
deposits in the brain, wherein the medicament comprises a dose of 10 to 60 mg/kg of an anti-
N3pGlu Amyloid β antibody,
wherein the anti-N3pGlu Amyloid β antibody comprises a light chain variable region
(LCVR) and a heavy chain variable region (HCVR), wherein said LCVR and HCVR is selected
from the group consisting of:
a) LCVR of SEQ ID NO: 25 and HCVR of SEQ ID NO: 26;
b) LCVR of SEQ ID NO: 25 and HCVR of SEQ ID NO: 27;
c) LCVR of SEQ ID NO: 25 and HCVR of SEQ ID NO: 34;
d) LCVR of SEQ ID NO: 9 and HCVR of SEQ ID NO: 8; and
e) LCVR of SEQ ID NO: 10 and HCVR of SEQ ID NO: 8, and
wherein the medicament is to be administered every two weeks, every four weeks, or
monthly for a period of 6 months.
Description of the Invention
Disclosed herein is a method of treating a disease characterized by deposition of Aβ,
comprising administering to a patient positive for amyloid deposits an induction dose of 10 to 60
mg/kg of an anti-N3pGlu Aβ antibody for a period of 6 month or less. Particularly, disclosed
herein is a method of treating a disease characterized by deposition of Aβ, comprising
administering to a patient positive for amyloid deposits an induction dose of 10 to 60 mg/kg of an
anti-N3pGlu Aβ antibody for a period of 6 month or less. More particularly, disclosed herein is a
method to treat a disease characterized by Aβ deposits in the brain of a human patient comprising
administering to the patient positive for amyloid deposits a one-time induction dose of 10 to 60
mg/kg of an anti-N3pGlu antibody. In another more particular embodiment, disclosed herein is a
method to treat a disease characterized by Aβ deposits in the brain of a patient positive for
amyloid deposits comprising administering to the patient an induction dose of 10 to 60 mg/kg
every two weeks of an anti-N3pGlu Aβ antibody for a period of 6 months or less. In another more
particular embodiment, disclosed herein is a method to treat a disease characterized by Aβ
deposits in the brain of a patient positive for amyloid deposits comprising administering to the
patient a monthly induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ antibody for a period of
6 months or less. In a preferred embodiment disclosed herein, the one-time induction dose
administered to a patient is 10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg. In a alternative preferred
embodiment disclosed herein, the biweekly and monthly induction dose administered to a patient
is 10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg for a period of 6 months In another more preferred
embodiment, the anti-N3pGlu Aβ antibody is selected from Table A.
Alternatively, disclosed herein is a method of treating a disease characterized by deposition of
Aβ, comprising administering to a patient positive for amyloid deposits a dose of 10 to 60 mg/kg
of an anti-N3pGlu Aβ antibody followed optionally by one or more dose of 10 to 60 mg/kg of an
anti-N3pGlu Aβ antibody for a period of 6 month or less. Particularly, disclosed herein is a
method to treat a disease characterized by Aβ deposits in the brain of a patient positive for
amyloid deposits comprising administering to the patient 1-12 separate doses of 10 to 60 mg/kg of
an anti-N3pGlu Aβ antibody in a period of 6 months or less. In another more particular
embodiment, disclosed herein is a method to treat a disease characterized by Aβ deposits in the
brain of a patient positive for amyloid deposits comprising administering to the patient 6 separate
doses of 10 to 60 mg/kg of an anti-N3pGlu Aβ antibody for a period of 6 months or less.
Alternatively, disclosed herein is a method to treat a disease characterized by Aβ deposits in the
brain of a patient positive for amyloid deposits comprising administering to the patient 12
separate doses of 10 to 60 mg/kg of an anti-N3pGlu Aβ antibody for a period of 6 months or less.
In a preferred embodiment disclosed herein, the 6 or 12 separate doses administered to a patient
are 20 to 40 mg/kg or 15 to 30 mg/kg (e.g., 6 separate doses of 20 mg/kg administered to a patient
over 6 months). In another preferred embodiment, the one-time, 6 or 12 separate doses
administered to a patient is 10mg/kg, 15 mg/kg, 20mg/kg, or 40mg/kg per dose. In another
preferred embodiment the 6 separate doses are separated by monthly interval and the 12 separate
doses are separated by intervals of 2 weeks. In a preferred embodiment, the anti-N3pGlu Aβ
antibody is selected from Table A.
In an embodiment, disclosed herein is a method of treating or preventing clinical or pre-
clinical Alzheimer’s disease, Down’s syndrome, and clinical or pre-clinical CAA in a patient
positive for amyloid deposits, comprising administering to a patient induction dose of 10 to 60
mg/kg of an anti-N3pGlu Aβ antibody for a period of 6 month or less. Particularly, disclosed
herein is a method of treating or preventing clinical or pre-clinical Alzheimer’s disease, Down’s
syndrome, and clinical or pre-clinical CAA in a patient positive for amyloid deposits, comprising
administering to the patient a one-time induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ
antibody. In another particular embodiment, disclosed herein is a method of treating or preventing
clinical or pre-clinical Alzheimer’s disease, Down’s syndrome, and clinical or pre-clinical CAA
in a patient positive for amyloid deposits, administering to the an induction dose of 10 to 60
mg/kg every two weeks of an anti-N3pGlu Aβ antibody for a period of 6 months or less. In
another particular embodiment, disclosed herein is a method of treating or preventing clinical or
pre-clinical Alzheimer’s disease, Down’s syndrome, and clinical or pre-clinical CAA in a patient
positive for amyloid deposits, administering to the patient a monthly induction dose of 10 to 60
mg/kg of an anti-N3pGlu Aβ antibody for a period of 6 months or less. In a preferred embodiment
disclosed herein for treating or preventing clinical or pre-clinical Alzheimer’s disease, Down’s
syndrome, and clinical or pre-clinical CAA, the one-time, biweekly (every two weeks) and
monthly induction dose administered to a patient is 20 to 40 mg/kg or 15 to 30 mg/kg. In a
preferred embodiment disclosed herein, the one-time induction dose administered to a patient is
10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg. In a alternative preferred embodiment disclosed
herein, the biweekly and monthly induction dose administered to a patient is 10mg/kg, 15 mg/kg,
20mg/kg or 40mg/kg for a period of 6 months In another more preferred embodiment, the anti-
N3pGlu Aβ antibody is selected from Table A.. The anti-N3pGlu Aβ antibody is preferably
selected from Table A.
In another embodiment, disclosed herein is a method of treating or preventing preclinical AD,
prodromal AD (sometimes also referred to as Aβ-related mild cognitive impairment, MCI or MCI
due to AD), mild AD, moderate AD and severe AD in a patient positive for amyloid deposits,
comprising administering to a patient an induction dose of an anti-N3pGlu Aβ antibody for a
period of 6 months or less. Particularly, disclosed herein is a method of treating or preventing
preclinical AD, prodromal AD, mild AD, moderate AD and severe AD in a patient positive for
amyloid deposits, comprising administering to a patient an induction dose of 10 to 60 mg/kg of an
anti-N3pGlu Aβ antibody for a period of 6 month or less. More particularly, disclosed herein is a
method of treating or preventing preclinical AD, prodromal AD, mild AD, moderate AD and
severe AD in a patient positive for amyloid deposits, comprising administering to the patient a
one-time induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ antibody. In another more
particular embodiment, disclosed herein is a method of treating or preventing preclinical AD,
prodromal AD, mild AD, moderate AD and severe AD in a patient positive for amyloid deposits,
administering to the an induction dose of 10 to 60 mg/kg every two weeks of an anti-N3pGlu Aβ
antibody for a period of 6 months or less. In another more particular embodiment, disclosed
herein is a method of treating or preventing preclinical AD, prodromal AD, mild AD, moderate
AD and severe AD in a patient positive for amyloid deposits, administering to the patient a
monthly induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ antibody for a period of 6
months or less. In a preferred embodiment disclosed herein for treating or preventing preclinical
AD, prodromal AD, mild AD, moderate AD and severe AD, the one-time, biweekly (every two
weeks) and monthly induction dose administered to a patient is 20 to 40 mg/kg or 15 to 30 mg/kg.
In a preferred embodiment disclosed herein, the one-time induction dose administered to a patient
is 10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg. In an alternative preferred embodiment disclosed
herein, the biweekly and monthly induction dose administered to a patient is 10mg/kg, 15 mg/kg,
20mg/kg or 40mg/kg for a period of 6 months In another more preferred embodiment, the anti-
N3pGlu Aβ antibody is selected from Table A.. The anti-N3pGlu Aβ antibody is preferably
selected from Table A.
In another embodiment, disclosed herein is a method of slowing cognitive decline in a patient
diagnosed with pre-clinical Alzheimer’s disease or clinical Alzheimer’s disease, comprising
administering to a patient an induction dose of an anti-N3pGlu Aβ antibody for a period of 6
months or less. Particularly, disclosed herein is a method of slowing cognitive decline in a patient
diagnosed with pre-clinical Alzheimer’s disease or clinical Alzheimer’s disease, comprising
administering to a patient an induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ antibody for
a period of 6 month or less. More particularly, disclosed herein is a method of slowing cognitive
decline in a patient diagnosed with pre-clinical Alzheimer’s disease or clinical Alzheimer’s
disease,, comprising administering to the patient a one-time induction dose of 10 to 60 mg/kg of
an anti-N3pGlu Aβ antibody. In another more particular embodiment, disclosed herein is a
method of slowing cognitive decline in a patient diagnosed with pre-clinical Alzheimer’s disease
or clinical Alzheimer’s disease,, administering to the patient an induction dose of 10 to 60 mg/kg
every two weeks of an anti-N3pGlu Aβ antibody for a period of 6 months or less. In another more
particular embodiment, disclosed herein is a method of slowing cognitive decline in a patient
diagnosed with pre-clinical Alzheimer’s disease or clinical Alzheimer’s disease,, administering to
the patient a monthly induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ antibody for a
period of 6 months or less. In a preferred embodiment disclosed herein for slowing cognitive
decline in a patient diagnosed with pre-clinical Alzheimer’s disease or clinical Alzheimer’s
disease, the one-time, biweekly and monthly induction dose administered to a patient is 20 to 40
mg/kg or 15 to 30 mg/kg. In a preferred embodiment disclosed herein, the one-time induction
dose administered to a patient is 10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg. In an alternative
preferred embodiment disclosed herein, the biweekly and monthly induction dose administered to
a patient is 10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg for a period of 6 months In another more
preferred embodiment, the anti-N3pGlu Aβ antibody is selected from Table A. The anti-N3pGlu
Aβ antibody is preferably selected from Table A.
In another embodiment, disclosed herein is a method of slowing functional decline in a
patient diagnosed with pre-clinical Alzheimer’s disease or clinical Alzheimer’s disease,
comprising administering to a patient an induction dose of an anti-N3pGlu Aβ antibody for a
period of 6 months or less. Particularly, disclosed herein is a method of slowing functional decline
in a patient diagnosed with pre-clinical Alzheimer’s disease or clinical Alzheimer’s disease,
comprising administering to a patient an induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ
antibody for a period of 6 month or less. More particularly, disclosed herein is a method of
slowing functional decline in a patient diagnosed with pre-clinical Alzheimer’s disease or clinical
Alzheimer’s disease, comprising administering to the patient a one-time induction dose of 10 to
60 mg/kg of an anti-N3pGlu Aβ antibody. In another more particular embodiment, disclosed
herein is a method of slowing functional decline in a patient diagnosed with pre-clinical
Alzheimer’s disease or clinical Alzheimer’s disease, administering to the patient an induction
dose of 10 to 60 mg/kg every two weeks of an anti-N3pGlu Aβ antibody for a period of 6 months
or less. In another more particular embodiment, disclosed herein is a method of slowing
functional decline in a patient diagnosed with pre-clinical Alzheimer’s disease or clinical
Alzheimer’s disease, administering to the patient a monthly induction dose of 10 to 60 mg/kg of
an anti-N3pGlu Aβ antibody for a period of 6 months or less. In a preferred embodiment
disclosed herein for slowing functional decline in a patient diagnosed with pre-clinical
Alzheimer’s disease or clinical Alzheimer’s disease, the one-time, biweekly and monthly
induction dose administered to a patient is 20 to 40 mg/kg or 15 to 30 mg/kg. In a preferred
embodiment disclosed herein, the one-time induction dose administered to a patient is 10mg/kg,
mg/kg, 20mg/kg or 40mg/kg. In an alternative preferred embodiment disclosed herein, the
biweekly and monthly induction dose administered to a patient is 10mg/kg, 15 mg/kg, 20mg/kg or
40mg/kg for a period of 6 months. The anti-N3pGlu Aβ antibody is preferably selected from
Table A.
In another embodiment, disclosed herein is a method of reducing brain Aβ amyloid plaque
load in a patient diagnosed with pre-clinical or clinical Alzheimer’s disease, comprising
administering to a patient an induction dose of an anti-N3pGlu Aβ antibody for a period of 6
months or less. Particularly, disclosed herein is a method of reducing brain Aβ amyloid plaque
load in a patient diagnosed with pre-clinical or clinical Alzheimer’s disease, comprising
administering to a patient an induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ antibody for
a period of 6 month or less. More particularly, disclosed herein is a method of reducing brain Aβ
amyloid plaque load in a patient diagnosed with pre-clinical or clinical Alzheimer’s disease,
comprising administering to the patient a one-time induction dose of 10 to 60 mg/kg of an anti-
N3pGlu Aβ antibody. In another more particular embodiment, disclosed herein is a method of
reducing brain Aβ amyloid plaque load in a patient diagnosed with pre-clinical or clinical
Alzheimer’s disease, administering to the patient an induction dose of 10 to 60 mg/kg every two
weeks of an anti-N3pGlu Aβ antibody for a period of 6 months or less. In another more particular
embodiment, disclosed herein is a method of reducing brain Aβ amyloid plaque load in a patient
diagnosed with pre-clinical or clinical Alzheimer’s disease, administering to the patient a monthly
induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ antibody for a period of 6 months or less.
In a preferred embodiment disclosed herein for a method of reducing brain Aβ amyloid plaque
load in a patient diagnosed with pre-clinical or clinical Alzheimer’s disease, the one-time,
biweekly and monthly induction dose administered to a patient is 20 to 40 mg/kg or 15 to 30
mg/kg. In a preferred embodiment disclosed herein, the one-time induction dose administered to a
patient is 10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg. In an alternative preferred embodiment
disclosed herein, the biweekly and monthly induction dose administered to a patient is 10mg/kg,
mg/kg, 20mg/kg or 40mg/kg for a period of 6 months. The anti-N3pGlu Aβ antibody is
preferably selected from Table A.
In another embodiment, disclosed herein is a method of preventing memory loss or cognitive
decline in clinically asymptomatic patients with low levels of Aβ1-42 in the cerebrospinal fluid
(CSF) and/or Aβ deposits in the brain, comprising administering to a patient an induction dose of
an anti-N3pGlu Aβ antibody for a period of 6 months or less. Particularly, disclosed herein is a
method of preventing memory loss or cognitive decline in clinically asymptomatic patients with
low levels of Aβ1-42 in the cerebrospinal fluid (CSF) and/or Aβ deposits in the brain, comprising
administering to a patient an induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ antibody for
a period of 6 month or less. More particularly, disclosed herein is a method of preventing memory
loss or cognitive decline in clinically asymptomatic patients with low levels of Aβ1-42 in the
cerebrospinal fluid (CSF) and/or Aβ deposits in the brain, comprising administering to the patient
a one-time induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ antibody. In another more
particular embodiment, disclosed herein is a method of preventing memory loss or cognitive
decline in clinically asymptomatic patients with low levels of Aβ1-42 in the cerebrospinal fluid
(CSF) and/or Aβ deposits in the brain, comprising administering to the patient an induction dose
of 10 to 60 mg/kg every two weeks of an anti-N3pGlu Aβ antibody for a period of 6 months or
less. In another more particular embodiment, disclosed herein is a method of preventing memory
loss or cognitive decline in clinically asymptomatic patients with low levels of Aβ1-42 in the
cerebrospinal fluid (CSF) and/or Aβ deposits in the brain, administering to the patient a monthly
induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ antibody for a period of 6 months or less.
In a preferred embodiment disclosed herein for a method of preventing memory loss or cognitive
decline in clinically asymptomatic patients with low levels of Aβ1-42 in the cerebrospinal fluid
(CSF) and/or Aβ deposits in the brain, the one-time, biweekly and monthly induction dose
administered to a patient is 20 to 40 mg/kg or 15 to 30 mg/kg. In another preferred embodiment
disclosed herein, the one-time induction dose administered to a patient is 10mg/kg, 15 mg/kg,
20mg/kg or 40mg/kg. In an alternative preferred embodiment disclosed herein, the biweekly and
monthly induction dose administered to a patient is 10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg for
a period of 6 months. The anti-N3pGlu Aβ antibody is preferably selected from Table A.
In another embodiment, disclosed herein is a method of treating clinically asymptomatic
patients known to have an Alzheimer's disease-causing genetic mutation, comprising
administering to a patient an induction dose of an anti-N3pGlu Aβ antibody for a period of 6
months or less. Particularly, the present description includes a method of treating clinically
asymptomatic patients known to have an Alzheimer's disease-causing genetic mutation,
comprising administering to a patient an induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ
antibody for a period of 6 month or less. More particularly, disclosed herein is a method of
treating clinically asymptomatic patients known to have an Alzheimer's disease-causing genetic
mutation, comprising administering to the patient a one-time induction dose of 10 to 60 mg/kg of
an anti-N3pGlu Aβ antibody. In another more particular embodiment, disclosed herein is a
method of treating clinically asymptomatic patients known to have an Alzheimer's disease-
causing genetic mutation, comprising administering to the patient an induction dose of 10 to 60
mg/kg every two weeks of an anti-N3pGlu Aβ antibody for a period of 6 months or less. In
another more particular embodiment, disclosed herein is a method of treating clinically
asymptomatic patients known to have an Alzheimer's disease-causing genetic mutation,
administering to the patient a monthly induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ
antibody for a period of 6 months or less. In the present description “clinically asymptomatic
patients known to have an Alzheimer's disease-causing genetic mutation”, include patients known
to have a PSEN1 E280A Alzheimer's disease-causing genetic mutation (Paisa mutation), a genetic
mutation that causes autosomal-dominant Alzheimer's disease or are at higher risk for developing
AD by virtue of carrying one or two APOE e4 alleles comprising administering to the said patient
a pharmaceutical composition of the present description. In a preferred embodiment disclosed
herein for a method of treating clinically asymptomatic patients known to have an Alzheimer's
disease-causing genetic mutation, the one-time, biweekly and monthly induction dose
administered to a patient is 20 to 40 mg/kg or 15 to 30 mg/kg. In another preferred embodiment
disclosed herein, the one-time induction dose administered to a patient is 10mg/kg, 15 mg/kg,
20mg/kg or 40mg/kg. In an alternative preferred embodiment disclosed herein, the biweekly and
monthly induction dose administered to a patient is 10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg for
a period of 6 months. The anti-N3pGlu Aβ antibody is preferably selected from Table A.
In a further embodiment, disclosed herein is a method of treating a disease characterized by
deposition of Aβ in the brain, comprising administering to a patient an induction dose of an anti-
N3pGlu Aβ antibody for a period of 6 months or less, wherein the Aβ deposit in the brain of a
human patient is reduced by 35-100% within 6 months post induction dose treatment.
Particularly, disclosed herein is a method of treating a disease characterized by deposition of Aβ,
comprising administering to a patient an induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ
antibody for a period of 6 month or less, wherein the Aβ deposit in the brain of a human patient is
reduced by 35-100% within 6 months post induction dose treatment. More particularly, disclosed
herein is a method to treat a disease characterized by Aβ deposits in the brain of a human patient
comprising administering to the patient a one-time induction dose of 10 to 60 mg/kg of an anti-
N3pGlu Aβ antibody, wherein the Aβ deposit in the brain of a human patient is reduced by 35-
100% within 6 months post induction dose treatment. In another more particular embodiment,
disclosed herein is a method to treat a disease characterized by Aβ deposits in the brain of a
patient comprising administering to the patient an induction dose of 10 to 60 mg/kg every two
weeks of an anti-N3pGlu Aβ antibody for a period of 6 months or less, wherein the Aβ deposit in
the brain of a human patient is reduced by 35-100% within 6 months post induction dose
treatment. In another more particular embodiment, disclosed herein is a method to treat a disease
characterized by Aβ deposits in the brain of a patient comprising administering to the patient a
monthly induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ antibody for a period of 6
months or less, wherein the Aβ deposit in the brain of a human patient is reduced by 35-100%
within 6 months post induction dose treatment. In a preferred embodiment disclosed herein, the
one-time induction dose administered to a patient is 10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg. In
an alternative preferred embodiment disclosed herein, the biweekly and monthly induction dose
administered to a patient is 10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg for a period of 6 months.
The anti-N3pGlu Aβ antibody is preferably selected from Table A.
In an embodiment, disclosed herein is a method of treating clinical or pre-clinical Alzheimer’s
disease, Down’s syndrome, and clinical or pre-clinical cerebral amyloid angiopathy, comprising
administering to a patient an induction dose of an anti-N3pGlu Aβ antibody for a period of 6
months or less, wherein the Aβ deposit in the brain of a human patient is reduced by 35-100%
within 6 months post induction dose treatment. Particularly, disclosed herein is a method of
treating clinical or pre-clinical Alzheimer’s disease, Down’s syndrome, and clinical or pre-clinical
cerebral amyloid angiopathy, comprising administering to a patient an induction dose of 10 to 60
mg/kg of an anti-N3pGlu Aβ antibody for a period of 6 month or less, wherein the Aβ deposit in
the brain of a human patient is reduced by 35-100% within 6 months post induction treatment.
More particularly, disclosed herein is a method of treating clinical or pre-clinical Alzheimer’s
disease, Down’s syndrome, and clinical or pre-clinical cerebral amyloid angiopathy, comprising
administering to the patient a one-time induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ
antibody, wherein the Aβ deposit in the brain of a human patient is reduced by 35-100% within 6
months post induction treatment. In another more particular embodiment, disclosed herein is a
method of treating clinical or pre-clinical Alzheimer’s disease, Down’s syndrome, and clinical or
pre-clinical cerebral amyloid angiopathy, comprising administering to the patient an induction
dose of 10 to 60 mg/kg every two weeks of an anti-N3pGlu Aβ antibody for a period of 6 months
or less, wherein the Aβ deposit in the brain of a human patient is reduced by 35-100% within 6
months post induction treatment. In another more particular embodiment, disclosed herein is a
method of treating clinical or pre-clinical Alzheimer’s disease, Down’s syndrome, and clinical or
pre-clinical cerebral amyloid angiopathy, comprising administering to the patient a monthly
induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ antibody for a period of 6 months or less,
wherein the Aβ deposit in the brain of a human patient is reduced by 35-100% within 6 months
post induction treatment. In a preferred embodiment, the anti-N3pGlu Aβ antibody is selected
from Table A.
In an embodiment, disclosed herein is a method of slowing cognitive and/or functional
decline in a patient diagnosed with pre-clinical Alzheimer’s disease or clinical Alzheimer’s
disease, comprising administering to a patient an induction dose of an anti-N3pGlu Aβ antibody
for a period of 6 months or less, wherein the Aβ deposit in the brain of a human patient is reduced
by 35-100% within 6 months post induction dose treatment. Particularly, disclosed herein is a
method of slowing cognitive and/or functional decline in a patient diagnosed with pre-clinical
Alzheimer’s disease or clinical Alzheimer’s disease, comprising administering to a patient an
induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ antibody for a period of 6 month or less,
wherein the Aβ deposit in the brain of a human patient is reduced by 35-100% within 6 months
post induction treatment. More particularly, disclosed herein is a method of slowing cognitive
and/or functional decline in a patient diagnosed with pre-clinical Alzheimer’s disease or clinical
Alzheimer’s disease, comprising administering to the patient a one-time induction dose of 10 to
60 mg/kg of an anti-N3pGlu Aβ antibody, wherein the Aβ deposit in the brain of a human patient
is reduced by 35-100% within 6 months post induction treatment. In another more particular
embodiment, disclosed herein is slowing cognitive and/or functional decline in a patient
diagnosed with pre-clinical Alzheimer’s disease or clinical Alzheimer’s disease, comprising
administering to the patient an induction dose of 10 to 60 mg/kg every two weeks of an anti-
N3pGlu Aβ antibody for a period of 6 months or less, wherein the Aβ deposit in the brain of a
human patient is reduced by 35-100% within 6 months post induction treatment. In another more
particular embodiment, disclosed herein is a method of slowing cognitive and/or functional
decline in a patient diagnosed with pre-clinical Alzheimer’s disease or clinical Alzheimer’s
disease, comprising administering to the patient a monthly induction dose of 10 to 60 mg/kg of an
anti-N3pGlu Aβ antibody for a period of 6 months or less, wherein the Aβ deposit in the brain of
a human patient is reduced by 35-100% within 6 months post induction treatment. In a preferred
embodiment disclosed herein, the one-time induction dose administered to a patient is 10mg/kg,
15 mg/kg, 20mg/kg or 40mg/kg. In an alternative preferred embodiment disclosed herein, the
biweekly and monthly induction dose administered to a patient is 10mg/kg, 15 mg/kg, 20mg/kg or
40mg/kg for a period of 6 months. The anti-N3pGlu Aβ antibody is preferably selected from
Table A
In an embodiment, disclosed herein is a method of treating clinical or pre-clinical Alzheimer’s
disease, Down’s syndrome, and clinical or pre-clinical CAA with an anti-N3pGlu Aβ antibody for
a period of 6 months or less, wherein the Aβ deposit in the brain of a human patient is reduced by
-100% within 6 months post induction treatment and maintained in a reduced state for a period
of 2-10 years post treatment. More preferably, for 2-5 years. Even more preferably, for 5-10
years. Particularly, disclosed herein is a method of treating clinical or pre-clinical Alzheimer’s
disease, Down’s syndrome, and clinical or pre-clinical cerebreal amyloid angiopathy, comprising
administering to a patient an induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ antibody for
a period of 6 month or less, wherein the Aβ deposit in the brain of a human patient is reduced by
-100% within 6 months post induction treatment and maintained in a reduced state for a period
of 2-10 years post treatment. More preferably, for 2-5 years. Even more preferably, for 5-10
years. More particularly, disclosed herein is a method of treating clinical or pre-clinical
Alzheimer’s disease, Down’s syndrome, and clinical or pre-clinical cerebral amyloid angiopathy,
comprising administering to the patient a one-time induction dose of 10 to 60 mg/kg of an anti-
N3pGlu Aβ antibody, wherein the Aβ deposit in the brain of a human patient is reduced by 35-
100% within 6 months post induction treatment and maintained in a reduced state for a period of
1-10 years post treatment. More preferably, for 2-5 years. Even more preferably, for 5-10 years.
In another more particular embodiment, disclosed herein is a method of treating clinical or pre-
clinical Alzheimer’s disease, Down’s syndrome, and clinical or pre-clinical cerebral amyloid
angiopathy, comprising administering to the patient an induction dose of 10 to 60 mg/kg every
two weeks of an anti-N3pGlu Aβ antibody for a period of 6 months or less, wherein the Aβ
deposit in the brain of a human patient is reduced by 35-100% within 6 months post induction
treatment and maintained in a reduced state for a period of 2-10 years post treatment. More
preferably, for 2-5 years. Even more preferably, for 5-10 years. In another more particular
embodiment, disclosed herein is a method of treating clinical or pre-clinical Alzheimer’s disease,
Down’s syndrome, and clinical or pre-clinical cerebral amyloid angiopathy, comprising
administering to the patient a monthly induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ
antibody for a period of 6 months or less, wherein the Aβ deposit in the brain of a human patient
is reduced by 35-100% within 6 months post induction treatment and maintained in a reduced
state for a period of 2-10 years post treatment. More preferably, for 2-5 years. Even more
preferably, for 5-10 years. In a preferred embodiment disclosed herein, the one-time induction
dose administered to a patient is 10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg. In an alternative
preferred embodiment disclosed herein, the biweekly and monthly induction dose administered to
a patient is 10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg for a period of 6 months. The anti-N3pGlu
Aβ antibody is preferably selected from Table A.
Disclosed herein is a method of treating a disease characterized by deposition of Aβ in the
brain, comprising administering to a patient an induction dose of an anti-N3pGlu Aβ antibody for
a period of 6 months or less followed by a maintenance dose of an anti-N3pGlu Aβ antibody
every 12, 3, 5 or 10 years post completion of the induction treatment. Particularly, disclosed
herein is a method to treat a disease characterized by Aβ deposits in the brain of a human patient
comprising administering to the patient positive for amyloid deposits a one-time induction dose of
to 60 mg/kg of an anti-N3pGlu Aβ antibody followed by a maintenance dose of an anti-
N3pGlu Aβ antibody every 1, 2, 3, 5 or 10 years post completion of the induction treatment. In
another more particular embodiment, disclosed herein is a method to treat a disease characterized
by Aβ deposits in the brain of a patient positive for amyloid deposits comprising administering to
the patient an induction dose of 10 to 60 mg/kg every two weeks of an anti-N3pGlu Aβ antibody
for a period of 6 months or less followed by a maintenance dose of an anti-N3pGlu Aβ antibody
every 1, 2, 3, 5 or 10 years post completion of the induction treatment. In another more particular
embodiment, disclosed herein is a method to treat a disease characterized by Aβ deposits in the
brain of a patient positive for amyloid deposits comprising administering to the patient a monthly
induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ antibody for a period of 6 months or less
followed by a maintenance dose of an anti-N3pGlu Aβ antibody every 1, 2, 3, 5 or 10 years post
completion of the induction treatment. In one particular embodiment the maintenance dose of an
Aβ antibody is given every year. In another particular embodiment the maintenance dose of an Aβ
antibody is given every 2 years. In another particular embodiment the maintenance dose of an Aβ
antibody is given every 3 years. In another particular embodiment the maintenance dose of an Aβ
antibody is given every 5 years. In another particular embodiment the maintenance dose of an Aβ
antibody is given every 10 years. In another particular embodiment the maintenance dose of an
Aβ antibody is given every 2 to 5 years. In another particular embodiment the maintenance dose
of an Aβ antibody is given every 5 to 10 years. In an embodiment disclosed herein the same anti-
N3pGlu Aβ antibody is used for the induction and maintenance dose. In another embodiment
disclosed herein different anti-N3pGlu antibodies are used for the induction and maintenance
doses. In an embodiment disclosed herein, the anti-N3pGlu Aβ antibody administered in the
induction and maintenance dose is selected from Table A.
In an embodiment, disclosed herein is a method of treating a disease characterized by
deposition of Aβ in the brain, comprising administering to a patient an induction dose of an anti-
N3pGlu Aβ antibody for a period of 6 months or less in simultaneous, separate, or sequential
combination with an effective amount of a BACE inhibitor. In a particular embodiment, disclosed
herein is a method of treating a disease characterized by deposition of Aβ in the brain comprising
administering to the patient a one-time induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ
antibody in simultaneous, separate, or sequential combination with an effective amount of a
BACE inhibitor. In another particular embodiment, disclosed herein is a method of treating a
disease characterized by deposition of Aβ in the brain comprising administering to the patient an
induction dose of 10 to 60 mg/kg every two weeks of an anti-N3pGlu Aβ antibody for a period of
6 months or less in simultaneous, separate, or sequential combination with an effective amount of
a BACE inhibitor. In another particular embodiment, disclosed herein is a method of treating a
disease characterized by deposition of Aβ in the brain, comprising administering to the patient a
monthly induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ antibody for a period of 6
months or less in simultaneous, separate, or sequential combination with an effective amount of a
BACE inhibitor. In another preferred embodiment disclosed herein, the one-time induction dose
administered to a patient is 10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg. In an alternative preferred
embodiment disclosed herein, the biweekly and monthly induction dose administered to a patient
is 10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg for a period of 6 months.
In a more particular embodiment of the present description, the anti-N3pGlu Aβ antibody is
preferably selected from Table A and the BACE inhibitor is selected from the group consisting of
a) a compound of formula
also referred to by the compound name N-[3-[(4aR,7aS)amino(5-
fluoropyrimidinyl)-4,4a,5,7-tetrahydropyrrolo[3,4-d][1,3]thiazin-7a-yl]
fluoro-phenyl]methoxy-pyrazinecarboxamide, or a pharmaceutically
acceptable salt thereof ;
b) tosylate salt of N-[3-[(4aR,7aS)amino(5-fluoropyrimidinyl)-4,4a,5,7-
tetrahydropyrrolo[3,4-d][1,3]thiazin-7a-yl]fluoro-phenyl]methoxy-
pyrazinecarboxamide;
c) crystalline form of 2 N-[3-[(4aR,7aS)amino(5-fluoropyrimidinyl)-
4a,5,6,7-tetrahydropyrrolo[3,4-d][1,3]thiazin-7a(4H)-yl]fluoro-phenyl]
methoxy-pyrazinecarboxamide; and
d) a compound of the formula
also referred to by the compound name N-[3-[(5R)Amino-5,6-dihydro-2,5-
dimethyl-1,1-dioxido-2H-1,2,4-thiadiazinyl]fluorophenyl]fluoro
pyridinecarboxamide or the generic name, verubecestat, or a pharmaceutically
acceptable salt thereof.
In another more particular embodiment of the present description, the anti-N3pGlu Aβ
antibody is preferably B12L and the BACE inhibitor is selected from the group consisting of
a) a compound of formula
also referred to by the compound name N-[3-[(4aR,7aS)amino(5-
fluoropyrimidinyl)-4,4a,5,7-tetrahydropyrrolo[3,4-d][1,3]thiazin-7a-yl]
fluoro-phenyl]methoxy-pyrazinecarboxamide, or a pharmaceutically
acceptable salt thereof ;
b) tosylate salt of N-[3-[(4aR,7aS)amino(5-fluoropyrimidinyl)-4,4a,5,7-
tetrahydropyrrolo[3,4-d][1,3]thiazin-7a-yl]fluoro-phenyl]methoxy-
pyrazinecarboxamide;
c) crystalline form of 2 N-[3-[(4aR,7aS)amino(5-fluoropyrimidinyl)-
4a,5,6,7-tetrahydropyrrolo[3,4-d][1,3]thiazin-7a(4H)-yl]fluoro-phenyl]
methoxy-pyrazinecarboxamide; and
d) a compound of the formula
also referred to by the compound name N-[3-[(5R)Amino-5,6-dihydro-2,5-
dimethyl-1,1-dioxido-2H-1,2,4-thiadiazinyl]fluorophenyl]fluoro
pyridinecarboxamide or the generic name, verubecestat, or a pharmaceutically
acceptable salt thereof.
In an embodiment, disclosed herein is a method of treating a disease characterized by
deposition of Aβ in the brain, comprising administering to a patient a one-time induction dose of
an anti-N3pGlu Aβ antibody for a period of 6 months or less in simultaneous, separate, or
sequential combination with an effective amount of an Aβ antibody. In a particular embodiment,
disclosed herein is a method of treating a disease characterized by deposition of Aβ in the brain,
comprising administering to a patient a one-time, biweekly or monthly induction dose of 10 to 60
mg/kg of an anti-N3pGlu Aβ antibody for a period of 6 months or less in simultaneous, separate,
or sequential combination with an effective amount of an Aβ antibody, wherein the Aβ antibody
comprises an amino acid light chain (LC) and an amino acid heavy chain (HC) selected from the
group consisting of;
A) LC of SEQ ID NO: 65 and HC of SEQ ID NO:66 (solanezumab);
B) LC of SEQ ID NO: 61 and HC of SEQ ID NO: 62 (crenezumab);
C) LC of SEQ ID NO: 57 and HC of SEQ ID NO: 58 (aducunumab);
D) LC of SEQ ID NO: 63 and HC of SEQ ID NO: 64 (BAN2401) and;
E) LC of SEQ ID NO: 59 and HC of SEQ ID NO: 60 (gantenerumab).
In a preferred embodiment disclosed herein, the one-time biweekly and monthly induction dose
administered to a patient is 10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg. The anti-N3pGlu Aβ
antibody is preferably selected from Table A.
In an embodiment, disclosed herein is a method of treating a disease characterized by
deposition of Aβ in the brain, comprising administering to a patient a one-time, biweekly or
monthly induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ antibody for a period of 6
months or less in simultaneous, separate, or sequential combination with an effective amount of a
kD pegylated anti-Aβ Fab antibody, wherein the anti-Aβ Fab comprises an amino acid light
chain variable region of SEQ ID NO: 55 and an amino acid heavy chain variable region of SEQ
ID NO:56. In a preferred embodiment disclosed herein, the one-time biweekly and monthly
induction dose administered to a patient is 10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg. The anti-
N3pGlu Aβ antibody is preferably selected from Table A.
Disclosed herein is a method of treating a disease characterized by deposition of Aβ in the
brain, comprising administering to a patient a one-time, biweekly or monthly induction dose of 10
to 60 mg/kg of an anti-N3pGlu Aβ antibody for a period of 6 months or less in simultaneous,
separate, or sequential combination with an effective amount of a symptomatic agent to treat
Alzheimer’s disease. Symptomatic agents can be selected from cholinesterase inhibitors (ChEIs)
and/or a partial N -methyl-D-aspartate (NMDA) antagonists. In a preferred embodiment the agent
is a ChEI. In another preferred embodiment the agent is a NMDA antagonist or a combination
agent comprising a ChEI and NMDA antagonist. In a more preferred embodiment disclosed
herein, the one-time induction dose administered to a patient is 10mg/kg, 15 mg/kg, 20mg/kg or
40mg/kg. In an alternative more preferred embodiment disclosed herein, the biweekly and
monthly induction dose administered to a patient is 10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg for
a period of 6 months. The anti-N3pGlu Aβ antibody is preferably selected from Table A.
In another embodiment the present description includes an anti-N3pGlu Aβ antibody for
use in the treatment of clinical or pre-clinical Alzheimer’s disease, Down’s syndrome, and clinical
or pre-clinical cerebral amyloid angiopathy, wherein the anti-N3pGlu Aβ antibody is administered
to a patient at a dose of 10 to 60 mg/kg for a period of 6 months or less. Particularly, the present
description includes an anti-N3pGlu Aβ antibody for use in treatment of clinical or pre-clinical
Alzheimer’s disease, Down’s syndrome, and clinical or pre-clinical cerebral amyloid angiopathy,
wherein the anti-N3pGlu Aβ antibody is administered to a patient as a one-time induction dose of
to 60 mg/kg of an anti-N3pGlu Aβ antibody. In another more particular embodiment, the
present description includes an anti-N3pGlu Aβ antibody for use in the treatment of clinical or
pre-clinical Alzheimer’s disease, Down’s syndrome, and clinical or pre-clinical cerebral amyloid
angiopathy, wherein the anti-N3pGlu Aβ antibody is administered to a patient as an induction
dose of 10 to 60 mg/kg every two weeks of an anti-N3pGlu Aβ antibody for a period of 6 months
or less. In another more particular embodiment, the present description an anti-N3pGlu Aβ
antibody for use in the treatment of clinical or pre-clinical Alzheimer’s disease, Down’s
syndrome, and clinical or pre-clinical cerebral amyloid angiopathy, wherein the anti-N3pGlu Aβ
antibody is administered to a patient as an induction dose of 10 to 60 mg/kg monthly for a period
of 6 months or less. In a preferred embodiment of the description for use in the treatment or
preventing of clinical or pre-clinical Alzheimer’s disease, Down’s syndrome, and clinical or pre-
clinical CAA, the one-time, biweekly and monthly induction dose administered to a patient is 20
to 40 mg/kg or 15 to 30 mg/kg. In a preferred embodiment of the present description, the one-time
induction dose administered to a patient is 10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg. In an
alternative preferred embodiment of the present description, the biweekly and monthly induction
dose administered to a patient is 10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg for a period of 6
months. Even more preferably, the anti-N3pGlu Aβ antibody is selected from Table A.
In another embodiment the present description includes an anti-N3pGlu Aβ antibody for
use in the treatment of prodromal AD, mild AD, moderate AD or severe AD, wherein the anti-
N3pGlu Aβ antibody is administered to a patient at a dose of 10 to 60 mg/kg for a period of 6
months or less. Particularly, the present description includes an anti-N3pGlu Aβ antibody for use
in the treatment of prodromal AD, mild AD, moderate AD or severe AD, wherein the anti-
N3pGlu Aβ antibody is administered to a patient as a one-time induction dose of 10 to 60 mg/kg
of an anti-N3pGlu Aβ antibody. In another more particular embodiment, the present description
includes an anti-N3pGlu Aβ antibody for use in the treatment of prodromal AD, mild AD,
moderate AD or severe AD, wherein the anti-N3pGlu Aβ antibody is administered to a patient as
an induction dose of 10 to 60 mg/kg every two weeks of an anti-N3pGlu Aβ antibody for a period
of 6 months or less. In another more particular embodiment, the present description includes an
anti-N3pGlu Aβ antibody for use in the treatment of prodromal AD, mild AD, moderate AD or
severe AD, wherein the anti-N3pGlu Aβ antibody is administered to a patient as an induction dose
of 10 to 60 mg/kg monthly for a period of 6 months or less. In a preferred embodiment of the
description for use in the in the treatment of prodromal AD, mild AD, moderate AD or severe
AD, the one-time, biweekly and monthly induction dose administered to a patient is 20 to 40
mg/kg or 15 to 30 mg/kg. In a preferred embodiment of the present description, the one-time
induction dose administered to a patient is 10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg. In an
alternative preferred embodiment of the present description, the biweekly and monthly induction
dose administered to a patient is 10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg for a period of 6
months. Even more preferably, the anti-N3pGlu Aβ antibody is selected from Table A.
In another embodiment the present description includes an anti-N3pGlu Aβ antibody for
use in preventing or slowing cognitive or functional decline in a patient diagnosed with a
condition selected from clinical or pre-clinical Alzheimer’s disease, Down’s syndrome, and
clinical or pre-clinical cerebral amyloid angiopathy, wherein the anti-N3pGlu Aβ antibody is
administered to a patient at a dose of 10 to 60 mg/kg for a period of 6 months or less. Particularly,
the present description includesan anti-N3pGlu Aβ antibody for use in preventing or slowing
cognitive decline in a patient diagnosed with a condition selected from clinical or pre-clinical
Alzheimer’s disease, Down’s syndrome, and clinical or pre-clinical cerebral amyloid angiopathy,
wherein the anti-N3pGlu Aβ antibody is administered to a patient as a one-time induction dose of
to 60 mg/kg of an anti-N3pGlu Aβ antibody. In another more particular embodiment, the
present description includes an anti-N3pGlu Aβ antibody for use in preventing or slowing
cognitive decline in a patient diagnosed with a condition selected from clinical or pre-clinical
Alzheimer’s disease, Down’s syndrome, and clinical or pre-clinical cerebral amyloid angiopathy,
moderate AD or severe AD, wherein the anti-N3pGlu Aβ antibody is administered to a patient as
an induction dose of 10 to 60 mg/kg every two weeks of an anti-N3pGlu Aβ antibody for a period
of 6 months or less. In another more particular embodiment, the present description includes an
anti-N3pGlu Aβ antibody for use in preventing or slowing cognitive decline in a patient
diagnosed with a condition selected from clinical or pre-clinical Alzheimer’s disease, Down’s
syndrome, and clinical or pre-clinical cerebral amyloid angiopathy, wherein the anti-N3pGlu Aβ
antibody is administered to a patient as an induction dose of 10 to 60 mg/kg monthly for a period
of 6 months or less. In a preferred embodiment of the description for use in preventing or slowing
cognitive decline in a patient diagnosed with a condition selected from clinical or pre-clinical
Alzheimer’s disease, Down’s syndrome, and clinical or pre-clinical cerebral amyloid angiopathy,
the one-time, biweekly and monthly induction dose administered to a patient is 20 to 40 mg/kg or
to 30 mg/kg. In a preferred embodiment of the present description, the one-time induction dose
administered to a patient is 10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg. In an alternative preferred
embodiment of the present description, the biweekly and monthly induction dose administered to
a patient is 10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg for a period of 6 months. Even more
preferably, the anti-N3pGlu Aβ antibody is selected from Table A.
In another embodiment the present description includes an anti-N3pGlu Aβ antibody for
use in reducing Aβ amyloid plaque load in the brain of a patient diagnosed with pre-clinical or
clinical Alzheimer’s disease, Down’s syndrome, and clinical or pre-clinical cerebral amyloid
angiopathy, wherein the anti-N3pGlu Aβ antibody is administered to a patient at a dose of 10 to
60 mg/kg for a period of 6 months or less. Particularly, the present description includes an anti-
N3pGlu Aβ antibody for use in reducing Aβ amyloid plaque load in the brain of a patient
diagnosed with pre-clinical or clinical Alzheimer’s disease, Down’s syndrome, and clinical or
pre-clinical cerebral amyloid angiopathy, wherein the anti-N3pGlu Aβ antibody is administered to
a patient as a one-time induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ antibody. In
another more particular embodiment, the present description includes an anti-N3pGlu Aβ
antibody for use in reducing Aβ amyloid plaque load in the brain of a patient diagnosed with pre-
clinical or clinical Alzheimer’s disease, Down’s syndrome, and clinical or pre-clinical cerebral
amyloid angiopathy, wherein the anti-N3pGlu Aβ antibody is administered to a patient as an
induction dose of 10 to 60 mg/kg every two weeks of an anti-N3pGlu Aβ antibody for a period of
6 months or less. In another more particular embodiment, the present description includes an anti-
N3pGlu Aβ antibody for use in reducing Aβ amyloid plaque load in the brain of a patient
diagnosed with pre-clinical or clinical Alzheimer’s disease, Down’s syndrome, and clinical or
pre-clinical cerebral amyloid angiopathy, wherein the anti-N3pGlu Aβ antibody is administered to
a patient as an induction dose of 10 to 60 mg/kg monthly for a period of 6 months or less. In a
preferred embodiment of the description for use in reducing Aβ amyloid plaque load in the brain
of a patient diagnosed with pre-clinical or clinical Alzheimer’s disease, Down’s syndrome, and
clinical or pre-clinical cerebral amyloid angiopathy, the one-time, biweekly and monthly
induction dose administered to a patient is 20 to 40 mg/kg or 15 to 30 mg/kg. In another preferred
embodiment of the present description, the one-time induction dose administered to a patient is
10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg. In an alternative preferred embodiment of the present
description, the biweekly and monthly induction dose administered to a patient is 10mg/kg, 15
mg/kg, 20mg/kg or 40mg/kg for a period of 6 months. Even more preferably, the anti-N3pGlu Aβ
antibody is selected from Table A.
In another embodiment the present description includes an anti-N3pGlu Aβ antibody for
use in treating clinically asymptomatic patients known to have Alzheimer’s disease causing
genetic mutation, wherein the anti-N3pGlu Aβ antibody is administered to a patient at a dose of
to 60 mg/kg for a period of 6 months or less. Particularly, the present description includes an
anti-N3pGlu Aβ antibody for use in treating asymptomatic patients known to have Alzheimer’s
disease causing genetic mutation, wherein the anti-N3pGlu Aβ antibody is administered to a
patient as a one-time induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ antibody. In another
more particular embodiment, the present description includesan anti-N3pGlu Aβ antibody for use
in treating asymptomatic patients known to have Alzheimer’s disease causing genetic mutation,
wherein the anti-N3pGlu Aβ antibody is administered to a patient as an induction dose of 10 to 60
mg/kg every two weeks of an anti-N3pGlu Aβ antibody for a period of 6 months or less. In
another more particular embodiment, the present description includes an anti-N3pGlu Aβ
antibody for use in treating asymptomatic patients known to have Alzheimer’s disease causing
genetic mutation, wherein the anti-N3pGlu Aβ antibody is administered to a patient as an
induction dose of 10 to 60 mg/kg monthly for a period of 6 months or less. In a preferred
embodiment of the description for use in treating asymptomatic patients known to have
Alzheimer’s disease causing genetic mutation, the one-time, biweekly and monthly induction
dose administered to a patient is 20 to 40 mg/kg or 15 to 30 mg/kg. In a preferred embodiment of
the present description, the one-time induction dose administered to a patient is 10mg/kg, 15
mg/kg, 20mg/kg or 40mg/kg. In an alternative preferred embodiment of the present description,
the biweekly and monthly induction dose administered to a patient is 10mg/kg, 15 mg/kg,
20mg/kg or 40mg/kg for a period of 6 months. The anti-N3pGlu Aβ antibody is selected from
Table A.
In another embodiment the present description includes a use of an anti-N3pGlu Aβ
antibody for the manufacture of a medicament for the treatment of clinical or pre-clinical
Alzheimer’s disease, Down’s syndrome, and clinical or pre-clinical cerebral amyloid angiopathy,
wherein the medicament comprises an induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ
antibody administered to a patient for a period of 6 months or less. Particularly, the present
description includes a use of an anti-N3pGlu Aβ antibody for the manufacture of a medicament
for the treatment of clinical or pre-clinical Alzheimer’s disease, Down’s syndrome, and clinical or
pre-clinical cerebral amyloid angiopathy, wherein the medicament comprises a one-time induction
dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ antibody administered to a patient.. In another more
particular embodiment, the present description includes a use of an anti-N3pGlu Aβ antibody for
the manufacture of a medicament for the treatment of clinical or pre-clinical Alzheimer’s disease,
Down’s syndrome, and clinical or pre-clinical cerebral amyloid angiopathy, wherein the
medicament comprises an induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ antibody
administered to a patient every two weeks for a period of 6 months or less. In another more
particular embodiment, the present description includes a use of an anti-N3pGlu Aβ antibody for
the manufacture of a medicament for the treatment of clinical or pre-clinical Alzheimer’s disease,
Down’s syndrome, and clinical or pre-clinical cerebral amyloid angiopathy, wherein the
medicament comprises an induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ antibody
administered to a patient every month for a period of 6 months or less. In a preferred embodiment
of the description the one-time, biweekly and monthly induction dose administered to a patient is
to 40 mg/kg or 15 to 30 mg/kg. In another preferred embodiment of the present description, the
one-time induction dose administered to a patient is 10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg. In
an alternative preferred embodiment of the present description, the biweekly and monthly
induction dose administered to a patient is 10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg for a period
of 6 months. Even more preferably, the anti-N3pGlu Aβ antibody is selected from Table A.
In another embodiment the present description includes a use of an anti-N3pGlu Aβ
antibody for the manufacture of a medicament for the treatment of prodromal AD, mild AD,
moderate AD or severe AD, wherein the medicament comprises an induction dose of 10 to 60
mg/kg of an anti-N3pGlu Aβ antibody administered to a patient for a period of 6 months or less.
Particularly, the present description includes a use of an anti-N3pGlu Aβ antibody for the
manufacture of a medicament for the treatment of prodromal AD, mild AD, moderate AD or
severe AD, wherein the medicament comprises a one-time induction dose of 10 to 60 mg/kg of an
anti-N3pGlu Aβ antibody administered to a patient for a period of 6 months or less. In another
more particular embodiment, the present description includes a use of an anti-N3pGlu Aβ
antibody for the manufacture of a medicament for the treatment of prodromal AD, mild AD,
moderate AD or severe AD, wherein the medicament comprises an induction dose of 10 to 60
mg/kg of an anti-N3pGlu Aβ antibody administered to a patient every two weeks for a period of 6
months or less. In another more particular embodiment, the present description includes a use of
an anti-N3pGlu Aβ antibody for the manufacture of a medicament for the treatment of prodromal
AD, mild AD, moderate AD or severe AD, wherein the medicament comprises an induction dose
of 10 to 60 mg/kg of an anti-N3pGlu Aβ antibody administered to a patient monthly for a period
of 6 months or less. In a preferred embodiment of the description the one-time, biweekly and
monthly induction dose administered to a patient is 20 to 40 mg/kg or 15 to 30 mg/kg. In another
preferred embodiment of the present description, the one-time induction dose administered to a
patient is 10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg. In an alternative preferred embodiment of
the present description, the biweekly and monthly induction dose administered to a patient is
10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg for a period of 6 months. Even more preferably, the
anti-N3pGlu Aβ antibody is selected from Table A.
In another embodiment the present description includes a use of an anti-N3pGlu Aβ
antibody for the manufacture of a medicament for preventing or slowing cognitive or functional
decline in a patient diagnosed with a condition selected from clinical or pre-clinical Alzheimer’s
disease, Down’s syndrome, and clinical or pre-clinical cerebral amyloid angiopathy, wherein the
medicament comprises an induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ antibody
administered to a patient for a period of 6 months or less. Particularly, the present description
includes a use of an anti-N3pGlu Aβ antibody for the manufacture of a medicament for
preventing or slowing cognitive decline in a patient diagnosed with a condition selected from
clinical or pre-clinical Alzheimer’s disease, Down’s syndrome, and clinical or pre-clinical
cerebral amyloid angiopathy, wherein the medicament comprises a one-time induction dose of 10
to 60 mg/kg of an anti-N3pGlu Aβ antibody administered to a patient for a period of 6 months or
less. In another more particular embodiment, the present description includes a use of an anti-
N3pGlu Aβ antibody for preventing or slowing cognitive decline in a patient diagnosed with a
condition selected from clinical or pre-clinical Alzheimer’s disease, Down’s syndrome, and
clinical or pre-clinical cerebral amyloid angiopathy, wherein the medicament comprises an
induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ antibody administered every two weeks
to a patient for a period of 6 months or less. In another more particular embodiment, the present
description includes a use of an anti-N3pGlu Aβ antibody for preventing or slowing cognitive
decline in a patient diagnosed with a condition selected from clinical or pre-clinical Alzheimer’s
disease, Down’s syndrome, and clinical or pre-clinical cerebral amyloid angiopathy, wherein the
medicament comprises a one-time induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ
antibody administered to a patient monthly for a period of 6 months or less. In a preferred
embodiment of the description the one-time, biweekly and monthly induction dose administered
to a patient is 20 to 40 mg/kg or 15 to 30 mg/kg. In another preferred embodiment of the present
description, the one-time induction dose administered to a patient is 10mg/kg, 15 mg/kg, 20mg/kg
or 40mg/kg. In an alternative preferred embodiment of the present description, the biweekly and
monthly induction dose administered to a patient is 10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg for
a period of 6 months. Even more preferably, the anti-N3pGlu Aβ antibody is selected from Table
In another embodiment the present description includes a use of an anti-N3pGlu Aβ
antibody for the manufacture of a medicament for treating asymptomatic patients known to have
an Alzheimer’s disease causing genetic mutation, wherein the medicament is administered to a
patient at a dosage of 10 to 60 mg/kg of the anti-N3pGlu Aβ antibody for a period of 6 months or
less. Particularly, the present description includes a use of an anti-N3pGlu Aβ antibody for the
manufacture of a medicament for treating asymptomatic patients known to have an Alzheimer’s
disease causing genetic mutation, wherein the medicament comprises a one-time induction dose
of 10 to 60 mg/kg of an anti-N3pGlu Aβ antibody administered to a patient for a period of 6
months or less. In another more particular embodiment, the present description includes a use of
an anti-N3pGlu Aβ antibody treating asymptomatic patients known to have an Alzheimer’s
disease causing genetic mutation, wherein the medicament comprises an induction dose of 10 to
60 mg/kg of an anti-N3pGlu Aβ antibody administered to a patient every two weeks for a period
of 6 months or less. In another more particular embodiment, the present description includes a use
of an anti-N3pGlu Aβ antibody treating asymptomatic patients known to have an Alzheimer’s
disease causing genetic mutation, wherein the medicament comprises an induction dose of 10 to
60 mg/kg of an anti-N3pGlu Aβ antibody administered to a patient monthly for a period of 6
months or less. In a preferred embodiment of the description the one-time, biweekly and monthly
induction dose administered to a patient is 20 to 40 mg/kg or 15 to 30 mg/kg. In another preferred
embodiment of the present description, the one-time induction dose administered to a patient is
10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg. In an alternative preferred embodiment of the present
description, the biweekly and monthly induction dose administered to a patient is 10mg/kg, 15
mg/kg, 20mg/kg or 40mg/kg for a period of 6 months. Even more preferably, the anti-N3pGlu Aβ
antibody is selected from Table A.
In another embodiment the present description includes a use of an anti-N3pGlu Aβ
antibody for the manufacture of a medicament for reducing Aβ deposits in the brain of a patient,
wherein the medicament comprises an induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ
antibody administered to a patient for a period of 6 months or less, and wherein the Aβ deposit in
the brain of a patient is reduced by 35-100% within 6 months post induction dose treatment.
Particularly the present description includes a use of an anti-N3pGlu Aβ antibody for the
manufacture of a medicament for reducing Aβ deposits in the brain of a patient, wherein the
medicament comprises a one-time induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ
antibody administered to a patient for a period of 6 months or less, and wherein the Aβ deposit in
the brain of a patient is reduced by 35-100% within 6 months post induction dose treatment.. In
another more particular embodiment, the present description includes a use of an anti-N3pGlu Aβ
antibody for the manufacture of a medicament for reducing Aβ deposits in the brain of a patient,
wherein the medicament comprises an induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ
antibody administered to a patient every two weeks for a period of 6 months or less, and wherein
the Aβ deposit in the brain of a patient is reduced by 35-100% within 6 months post induction
dose treatment.. In another more particular embodiment, the present description includes a use of
an anti-N3pGlu Aβ antibody for the manufacture of a medicament for reducing Aβ deposits in the
brain of a patient, wherein the medicament comprises an induction dose of 10 to 60 mg/kg of an
anti-N3pGlu Aβ antibody administered to a patient monthlyfor a period of 6 months or less, and
wherein the Aβ deposit in the brain of a patient is reduced by 35-100% within 6 months post
induction dose treatment.. In a preferred embodiment of the description the one-time, biweekly
and monthly induction dose administered to a patient is 20 to 40 mg/kg or 15 to 30 mg/kg. In
another preferred embodiment of the present description, the one-time induction dose
administered to a patient is 10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg. In an alternative preferred
embodiment of the present description, the biweekly and monthly induction dose administered to
a patient is 10mg/kg, 15 mg/kg, 20mg/kg or 40mg/kg for a period of 6 months. Even more
preferably, the anti-N3pGlu Aβ antibody is selected from Table A.
As used herein, “anti-N3pglu Aβ antibody” refers to an antibody that binds preferentially to
N3pGlu A β over A β or A β .The sequence of N3pGlu A β is the amino acid sequence of SEQ
1-40 1-42
ID NO: 31. In particular embodiments, the anti-N3pGlu Aβ antibodies comprise amino acid
sequences listed in Table A. More specifically, the anti-N3pGlu Aβ antibodies of the present
description comprises a light chain variable region (LCVR) and a heavy chain variable region
(HCVR), wherein said LCVR comprises LCDR1, LCDR2 and LCDR3 and HCVR comprises
HCDR1, HCDR2 and HCDR3 which are selected from the group consisting of:
a) LCDR1 is SEQ ID. NO: 17, LCDR2 is SEQ ID. NO: 18, LCDR3 is SEQ ID. NO:
19, HCDR1 is SEQ ID. NO: 20, HCDR2 is SEQ ID: NO: 22, and HCDR3 is SEQ
ID. NO: 23; and
b) LCDR1 is SEQ ID. NO: 17, LCDR2 is SEQ ID. NO: 18, LCDR3 is SEQ ID. NO:
19, HCDR1 is SEQ ID. NO: 21, HCDR2 is SEQ ID. NO: 22, and HCDR3 is SEQ
ID. NO: 24;
c) LCDR1 is SEQ ID. NO: 17, LCDR2 is SEQ ID. NO: 18, LCDR3 is SEQ ID. NO:
19, HCDR1 is SEQ ID. NO: 36, HCDR2 is SEQ ID. NO: 22, and HCDR3 is SEQ
ID. NO: 37;
d) LCDR1 is SEQ ID. NO: 4, LCDR2 is SEQ ID. NO: 6, LCDR3 is SEQ ID. NO: 7,
HCDR1 is SEQ ID. NO: 1, HCDR2 is SEQ ID. NO: 2, and HCDR3 is SEQ ID.
NO: 3; and
e) LCDR1 is SEQ ID. NO: 4, LCDR2 is SEQ ID. NO: 5, LCDR3 is SEQ ID. NO: 7,
HCDR1 is SEQ ID. NO: 1, HCDR2 is SEQ ID. NO: 2, and HCDR3 is SEQ ID.
NO: 3.
In other embodiments, the anti-N3pGlu Aβ antibodies of the present description comprise
a light chain variable region (LCVR) and a heavy chain variable region (HCVR), wherein said
LCVR and HCVR are selected from the group consisting of:
a) LCVR of SEQ ID NO: 25 and HCVR of SEQ ID NO: 26;
b) LCVR of SEQ ID NO: 25 and HCVR of SEQ ID NO: 27;
c) LCVR of SEQ ID NO: 32 and HCVR of SEQ ID NO: 34;
d) LCVR of SEQ ID NO: 9 and HCVR of SEQ ID NO: 8; and
e) LCVR of SEQ ID NO: 10 and HCVR of SEQ ID NO: 8.
In further embodiments, the anti-N3pGlu Aβ antibody comprises a light chain (LC) and a
heavy chain (HC), wherein said LC and HC are selected from the group consisting of :
a) LC of SEQ ID NO: 28 and HC of SEQ ID NO: 29;
b) LC of SEQ ID NO: 28 and HC of SEQ ID NO: 30;
c) LC of SEQ ID NO: 33 and HC of SEQ ID NO: 35;
d) LC of SEQ ID NO: 12 and HC of SEQ ID NO: 11; and
e) LC of SEQ ID NO: 13 and HC of SEQ ID NO: 11.
In other embodiments, the anti-N3pGlu Aβ antibody comprises two light chains (LC) and
two heavy chains (HC), wherein each LC and each HC are selected from the group consisting of
a) LC of SEQ ID NO: 28 and HC of SEQ ID NO: 29;
b) LC of SEQ ID NO: 28 and HC of SEQ ID NO: 30;
c) LC of SEQ ID NO: 33 and HC of SEQ ID NO: 35;
d) LC of SEQ ID NO: 12 and HC of SEQ ID NO: 11; and
e) LC of SEQ ID NO: 13 and HC of SEQ ID NO: 11.
In some embodiments, the anti-N3pGlu Aβ antibody comprises Antibody I, which has a
light chain (LC) and a heavy chain (HC) of SEQ ID NOs: 12 and 11 respectively. Antibody I
further has a light chain variable region (LCVR) and a heavy chain variable region (HCVR) of
SEQ ID NOs: 9 and 8 respectively. The HCVR of Antibody I further comprises HCDR1 of SEQ
ID NO: 1, HCDR2 of SEQ ID NO: 2, and HCDR3 of SEQ ID NO: 3. The LCVR of Antibody I
further comprises LCDR1 of SEQ ID NO: 4, LCDR2 of SEQ ID NO: 6 and LCDR3 of SEQ ID
NO: 7 respectively.
In some embodiments, the anti-N3pGlu Aβ antibody comprises Antibody II, which has a
light chain (LC) and a heavy chain (HC) of SEQ ID NOs: 13 and 11 respectively. Antibody II
further has a light chain variable region (LCVR) and a heavy chain variable region (HCVR) of
SEQ ID NOs: 10 and 8 respectively. The HCVR of Antibody II further comprises HCDR1 of
SEQ ID NO: 1, HCDR2 of SEQ ID NO: 2, and HCDR3 of SEQ ID NO: 3. The LCVR of
Antibody II further comprises LCDR1 of SEQ ID NO: 4, LCDR2 of SEQ ID. NO. 5, and LCDR3
of SEQ ID NO: 7 respectively.
In some embodiments, the anti-N3pGlu Aβ antibody comprises B12L, which has a light
chain (LC) and a heavy chain (HC) of SEQ ID NOs: 28 and 29 respectively. B12L further has a
light chain variable region (LCVR) and a heavy chain variable region (HCVR) of SEQ ID NOs:
and 26 respectively. The HCVR of B12L further comprises HCDR1 of SEQ ID NO: 20,
HCDR2 of SEQ ID NO: 22 and HCDR3 of SEQ ID NO: 23. The LCVR of B12L further
comprises LCDR1 of SEQ ID NO. 17, LCDR2 of SEQ ID NO: 18 and LCDR3 of SEQ ID NO:
19 respectively.
In some embodiments, the anti-N3pGlu Aβ antibody comprises R17L which has a light
chain (LC) and a heavy chain (HC) of SEQ ID NOs: 28 and 30 respectively. R17L further has a
light chain variable region (LCVR) and a heavy chain variable region (HCVR) of SEQ ID NOs:
and 27 respectively. The HCVR of R17L further comprises HCDR1 of SEQ ID NO: 21,
HCDR2 of SEQ ID NO: 22 and HCDR3 of SEQ ID NO: 24. The LCVR of R17L further
comprises LCDR1 of SEQ ID NO. 17, LCDR2 of SEQ ID NO: 18 and LCDR3 of SEQ ID NO:
19 respectively.
In some embodiments, the anti-N3pGlu Aβ antibody comprises hE8L which has a light chain
(LC) and a heavy chain (HC) of SEQ ID NOs: 33 and 35 respectively. hE8L further has a light
chain variable region (LCVR) and a heavy chain variable region (HCVR) of in SEQ ID NOs: 32
and 34 respectively. The HCVR of hE8L further comprises HCDR1 of SEQ ID NO: 36, HCDR2
of SEQ ID NO: 22 and HCDR3 of SEQ ID NO: 37. The LCVR of hE8L further comprises
LCDR1 of SEQ ID NO. 17, LCDR2 of SEQ ID NO. 18 and LCDR3 of SEQ ID NO: 19
respectively.
In some embodiments, the anti-N3pGlu Aβ antibody comprises Antibody VI which has a
light chain variable region (LCVR) and a heavy chain variable region (HCVR) of SEQ ID NOs:
39 and 40 respectively.
In some embodiments, the anti-N3pGlu Aβ antibody comprises Antibody VII which has a
light chain variable region (LCVR) and a heavy chain variable region (HCVR) of SEQ ID NOs:
41 and 42 respectively.
In some embodiments, the anti-N3pGlu Aβ antibody comprises Antibody VIII which has a
light chain variable region (LCVR) and a heavy chain variable region (HCVR) of SEQ ID NOs:
43 and 44 respectively.
In some embodiments, the anti-N3pGlu Aβ antibody comprises Antibody IX which has a
light chain variable region (LCVR) and a heavy chain variable region (HCVR) of SEQ ID NOs:
45 and 46 respectively.
In some embodiments, the anti-N3pGlu Aβ antibody comprises Antibody X which has a light
chain variable region (LCVR) and a heavy chain variable region (HCVR) of SEQ ID NOs: 47 and
48 respectively.
In some embodiments, the anti-N3pGlu Aβ antibody comprises Antibody XI which has a
light chain variable region (LCVR) and a heavy chain variable region (HCVR) of SEQ ID NOs:
49 and 50 respectively.
In some embodiments, the anti-N3pGlu Aβ antibody comprises Antibody XII which has a
light chain variable region (LCVR) and a heavy chain variable region (HCVR) of SEQ ID NOs:
51 and 52 respectively.
In some embodiments, the anti-N3pGlu Aβ antibody comprises Antibody XIII which has a
light chain variable region (LCVR) and a heavy chain variable region (HCVR) of SEQ ID NOs:
53 and 54 respectively.
A person of skill in the art would recognize that disclosed herein is a method of treating
or preventing clinical or pre-clinical Alzheimer’s disease, Down’s syndrome, and clinical or pre-
clinical CAA in a patient positive for amyloid deposits, comprising administering to a patient a
one-time, biweekly or monthly induction dose of an anti-N3pGlu Aβ antibody for a period of 6
months or less, wherein the anti-N3pGlu Aβ antibody comprises a light chain variable region
(LCVR) and a heavy chain variable region (HCVR), wherein said LCVR and HCVR are selected
from the group consisting of:
a) LCVR of SEQ ID NO: 25 and HCVR of SEQ ID NO: 26;
b) LCVR of SEQ ID NO: 25 and HCVR of SEQ ID NO: 27;
c) LCVR of SEQ ID NO: 32 and HCVR of SEQ ID NO: 34;
d) LCVR of SEQ ID NO: 9 and HCVR of SEQ ID NO: 8; and
e) LCVR of SEQ ID NO: 10 and HCVR of SEQ ID NO: 8.
Preferably the anti-N3pGlu Aβ antibody comprises a LCVR of SEQ ID NO: 25 and
HCVR of SEQ ID NO: 26. More preferably the anti-N3pGlu Aβ antibody is administered one-
time or biweekly. Even more preferably, the one-time or biweekly dose results in 35-100%
reduction in Aβ deposit in the brain of the patient within 6 months of administration of the
induction dose.
In another particular embodiments, disclosed herein is a method of treating or preventing
clinical or pre-clinical Alzheimer’s disease, Down’s syndrome, and clinical or pre-clinical CAA
in a patient positive for amyloid deposits, comprising administering to a patient a one-time,
biweekly or monthly induction dose of an anti-N3pGlu Aβ antibody for a period of 6 months or
less, wherein the anti- N3pGlu Aβ antibody comprises a light chain (LC) and a heavy chain (HC),
wherein said LC and HC are selected from the group consisting of :
a) LC of SEQ ID NO: 28 and HC of SEQ ID NO: 29;
b) LC of SEQ ID NO: 28 and HC of SEQ ID NO: 30;
c) LC of SEQ ID NO: 33 and HC of SEQ ID NO: 35;
d) LC of SEQ ID NO: 12 and HC of SEQ ID NO: 11; and
e) LC of SEQ ID NO: 13 and HC of SEQ ID NO: 11.
Preferably the anti-N3pGlu Aβ antibody comprises a LC of SEQ ID NO: 28 and HC of SEQ ID
NO: 29. More preferably the anti-N3pGlu Aβ antibody is administered one-time or biweekly.
Even more preferably, the one-time or biweekly dose results in 35-100% reduction in Aβ deposit
in the brain of the patient within 6 months of administration of the induction dose.
A further embodiment includes a method of treating or preventing clinical or pre-clinical
Alzheimer’s disease, Down’s syndrome, and clinical or pre-clinical CAA in a patient positive for
amyloid deposits, comprising administering to a patient a one-time, biweekly or monthly
induction dose of an anti-N3pGlu Aβ antibody for a period of 6 months or less, wherein the anti-
N3pGlu Aβ antibody comprises two light chains (LC’s) and two heavy chains (HC’s), wherein
each LC and HC is selected from the group consisting of:
a) LC of SEQ ID NO: 28 and HC of SEQ ID NO: 29;
b) LC of SEQ ID NO: 28 and HC of SEQ ID NO: 30;
c) LC of SEQ ID NO: 33 and HC of SEQ ID NO: 35;
d) LC of SEQ ID NO: 12 and HC of SEQ ID NO: 11; and
e) LC of SEQ ID NO: 13 and HC of SEQ ID NO: 11.
Preferably the anti-N3pGlu Aβ antibody comprises a two LC’s of SEQ ID NO: 28 and
HC’s of SEQ ID NO: 29. More preferably the anti-N3pGlu Aβ antibody is administered one-time
or biweekly. Even more preferably, the one-time or biweekly dose results in 35-100% reduction
in Aβ deposit in the brain of the patient within 6 months of administration of the induction dose.
Disclosed herein is a method of treating or preventing clinical or pre-clinical Alzheimer’s
disease, Down’s syndrome, and clinical or pre-clinical CAA in a patient positive for amyloid
deposits, comprising administering to a patient a one-time, biweekly or monthly induction dose
of 10 to 60 mg/kg of an anti-N3pGlu Aβ antibody for a period of 6 month or less, wherein the
anti-N3pGlu Aβ antibody comprises a light chain variable region (LCVR) and a heavy chain
variable region (HCVR), wherein said LCVR and HCVR are selected from the group consisting
of:
a) LCVR of SEQ ID NO: 25 and HCVR of SEQ ID NO: 26;
b) LCVR of SEQ ID NO: 25 and HCVR of SEQ ID NO: 27;
c) LCVR of SEQ ID NO: 32 and HCVR of SEQ ID NO: 34;
d) LCVR of SEQ ID NO: 9 and HCVR of SEQ ID NO: 8; and
e) LCVR of SEQ ID NO: 10 and HCVR of SEQ ID NO: 8.
Preferably the anti-N3pGlu Aβ antibody comprises a LCVR of SEQ ID NO: 25 and HCVR of
SEQ ID NO: 26. More preferably, the one-time, biweekly (every two weeks) and monthly
induction dose administered to a patient is 10mg/kg, 15 mg/kg, 20mg/kg, 40mg/kg, 20 to 40
mg/kg or 15 to 30 mg/kg. Even more preferably the induction dose of the anti-N3pGlu Aβ
antibody is administered one-time or biweekly. Even more preferably, the one-time or biweekly
dose results in 35-100% reduction in Aβ deposit in the brain of the patient within 6 months of
administration of the induction dose.
In an embodiment, disclosed herein is a method of treating or preventing clinical or pre-
clinical Alzheimer’s disease, Down’s syndrome, and clinical or pre-clinical CAA in a patient
positive for amyloid deposits, comprising administering to a patient a one-time, biweekly or
monthly induction dose of 10 to 60 mg/kg of an anti-N3pGlu Aβ antibody for a period of 6 month
or less, wherein the anti- N3pGlu Aβ antibody comprises a light chain (LC) and a heavy chain
(HC), wherein said LC and HC are selected from the group consisting of :
a) LC of SEQ ID NO: 28 and HC of SEQ ID NO: 29;
b) LC of SEQ ID NO: 28 and HC of SEQ ID NO: 30;
c) LC of SEQ ID NO: 33 and HC of SEQ ID NO: 35;
d) LC of SEQ ID NO: 12 and HC of SEQ ID NO: 11; and
e) LC of SEQ ID NO: 13 and HC of SEQ ID NO: 11.
Preferably the anti-N3pGlu Aβ antibody comprises a LC of SEQ ID NO: 28 and a HC of
SEQ ID NO: 29. More preferably, the one-time, biweekly (every two weeks) and monthly
induction dose administered to a patient is 10mg/kg, 15 mg/kg, 20mg/kg, 40mg/kg, 20 to 40
mg/kg or 15 to 30 mg/kg. Even more preferably the induction dose of the anti-N3pGlu Aβ
antibody is administered one-time or biweekly. Even more preferably, the one-time or biweekly
dose results in 35-100% reduction in Aβ deposit in the brain of the patient within 6 months of
administration of the induction dose.
Disclosed herein is a method of treating or preventing clinical or pre-clinical Alzheimer’s
disease, Down’s syndrome, and clinical or pre-clinical CAA in a patient positive for amyloid
deposits, comprising administering to a patient a one-time, biweekly or monthly induction dose
of 10 to 60 mg/kg of an anti-N3pGlu Aβ antibody for a period of 6 month or less, wherein the
anti- N3pGlu Aβ antibody comprises two light chains (LC) and two heavy chains (HC), wherein
each LC and HC is selected from the group consisting of:
a) LC of SEQ ID NO: 28 and HC of SEQ ID NO: 29;
b) LC of SEQ ID NO: 28 and HC of SEQ ID NO: 30;
c) LC of SEQ ID NO: 33 and HC of SEQ ID NO: 35;
d) LC of SEQ ID NO: 12 and HC of SEQ ID NO: 11; and
e) LC of SEQ ID NO: 13 and HC of SEQ ID NO: 11.
Preferably the anti-N3pGlu Aβ antibody comprises two LC’s of SEQ ID NO: 28 and two
HC’s of SEQ ID NO: 29. More preferably, the one-time, biweekly (every two weeks) and
monthly induction dose administered to a patient is 10mg/kg, 15 mg/kg, 20mg/kg, 40mg/kg, 20 to
40 mg/kg or 15 to 30 mg/kg. Even more preferably the induction dose of the anti-N3pGlu Aβ
antibody is administered one-time or biweekly. Even more preferably, the one-time or biweekly
dose results in 35-100% reduction in Aβ deposit in the brain of the patient within 6 months of
administration of the induction dose.
One of ordinary skill in the art will appreciate and recognize that “anti-N3pGlu Aβ
antibody”, and the specific antibodies, “hE8L”, “B12L” and “R17L” are identified and disclosed
along with methods for making and using said antibodies by one of ordinary skill in the art as set
forth in U.S. Patent No. 8,679,498 B2, entitled “Anti-N3pGlu Amyloid Beta Peptide Antibodies
and Uses Thereof”, issued March 25, 2014 (U.S. Serial No. 13/810,895). See for example Table 1
of U.S. Patent No. 8,679,498 B2. Each of these three antibodies (e.g., “hE8L”, “B12L” and
“R17L”) may be used as the anti-N3pGlu Aβ antibody of the present description. One of ordinary
skill in the art will appreciate and recognize that “anti-N3pGlu Aβ antibody”, and the specific
antibodies, “Antibody VI”, “Antibody VII”, “Antibody VIII”, and “Antibody IX” are identified
and disclosed along with methods for making and using said antibodies by one of ordinary skill in
the art as set forth in WO2010/009987A2, entitled “Diagnosed Antibody Assay”. Each of these
four antibodies (e.g., “Antibody VI”, “Antibody VII”, “Antibody VIII”, and “Antibody IX”) may
be used as the anti-N3pGlu Aβ antibody of the present description.
One of ordinary skill in the art will appreciate and recognize that “anti-N3pGlu Aβ
antibody”, and the specific antibodies, “Antibody X” and “Antibody XI” are identified and
disclosed along with methods for making and using said antibodies by one of ordinary skill in the
art as set forth in A2, entitled “Monoclonal Antibodies Targeting Aβ
Monoclonal Antibodies”. Each of these two antibodies (e.g., “Antibody X”and “Antibody XI”)
may be used as the anti-N3pGlu Aβ antibody of the present description.
One of ordinary skill in the art will appreciate and recognize that “anti-N3pGlu Aβ
antibody”, and the specific antibodies, “Antibody XII” and “Antibody XIII” are identified and
disclosed along with methods for making and using said antibodies by one of ordinary skill in the
art as set forth in A1, entitled “Antibodies Specific to Pyroglutamated Aβ”.
Each of these two antibodies (e.g., “Antibody XII” and “Antibody XIII”) may be used as the anti-
N3pGlu Aβ antibody of the present description.
One of ordinary skill in the art will appreciate and recognize that “Aβ antibody”, and the
specific antibody, “aducanumab” is identified and disclosed along with methods for making and
using said antibody by one of ordinary skill in the art as set forth in WO14089500A1, entitled “A
Method of Reducing Brain Amyloid Plaques Using Anti-Aβ Antibodies”, published June 12,
2014. This may be used as the Aβ antibody of the present description.
One of ordinary skill in the art will appreciate and recognize that “Aβ antibody”, and the
specific antibody, “gantenerumab” is identified and disclosed along with methods for making and
using said antibody by one of ordinary skill in the art as set forth in WO2007068429, entitled
“Antibodies Against Amyloid Beta 4 with Glycosylated in the Variable Region”, published June
21, 2007. This may be used as the Aβ antibody of the present description.
One of ordinary skill in the art will appreciate and recognize that “Aβ antibody”, and the
specific antibody, “crenezumab” is identified and disclosed along with methods for making and
using said antibody by one of ordinary skill in the art as set forth in 2015120280A1, entitled
“Methods of treating alzheimer's disease”, published August 13, 2015. This may be used as the
Aβ antibody of the present description.
One of ordinary skill in the art will appreciate and recognize that “Aβ antibody”, and the
specific antibody, “BAN 2401” is identified and disclosed along with methods for making and
using said antibody by one of ordinary skill in the art as set forth in US 8025878 B2, entitled
“Protofibril selective antibodies and the use thereof”, issued September 27, 2011. This may be
used as the Aβ antibody of the present description.
One of ordinary skill in the art will appreciate and recognize that “Aβ antibody”, and the
specific antibody, “solanezumab” is identified and disclosed along with methods for making and
using said antibody by one of ordinary skill in the art as set forth in US Patent No. 7,195,761 B2,
entitled “Humanized Antibodies that Sequester ABeta Peptide”, issued March 27, 2007. This may
be used as the Aβ antibody of the present description.
One of ordinary skill in the art will appreciate and recognize that “Aβ antibody”, and the
specific antibody, “Antibody XIV” is identified and disclosed along with methods for making and
using said antibody by one of ordinary skill in the art as set forth in U.S. Patent No. 8,066,999 B1,
entitled “Pegylated Aβ FAB”, issued November 29, 2011 (U.S. Application No. 12/521,309).
This may be used as the Aβ antibody of the present description.
The compound of formula:
,
or a pharmaceutically acceptable salt thereof, is disclosed as a BACE inhibitor and can be
prepared by one of ordinary skill in the art as set forth in U.S. Patent No. 8,841,293 B1, entitled
“Tetrahydropyrrolothiazine Compounds”, issued September 23, 2014 (U.S. Application No.
14/195,897); see in particular, Example 4, N-[3-[(4aR,7aS)amino(5-fluoropyrimidinyl)-
4,4a,5,7-tetrahydropyrrolo[3,4-d][1,3]thiazin-7a-yl]fluoro-phenyl]methoxy-pyrazine
carboxamide. The tosylate salt of N-[3-[(4aR,7aS)amino(5-fluoropyrimidinyl)-4,4a,5,7-
tetrahydropyrrolo[3,4-d][1,3]thiazin-7a-yl]fluoro-phenyl]methoxy-pyrazinecarboxamide
can be prepared by one of ordinary skill in the art as set forth in . The
crystalline form of N-[3-[(4aR,7aS)amino(5-fluoropyrimidinyl)-4,4a,5,7-
tetrahydropyrrolo[3,4-d][1,3]thiazin-7a-yl]fluoro-phenyl]methoxy-pyrazinecarboxamide
can be prepared by one of ordinary skill in the art as set forth in , entitled “A
Tetrahydropyrrolo[3,4-D][1,3] Thiazine-Derivative as BACE Inhibitor”.
The compound of the formula:
or a pharmaceutically acceptable salt thereof, is disclosed as a BACE inhibitor and can be
prepared by one of ordinary skill in the art as set forth in U.S. Patent No. 8,729,071 B1, entitled
“Iminothiadiazine Dioxide Compounds As BACE Inhibitors, Compositions and Their Use” issued
May 20, 2014. Crystalline forms and crystalline forms of the tosylate salt of N-[3-[(5R)
Amino-5,6-dihydro-2,5-dimethyl-1,1-dioxido-2H-1,2,4-thiadiazinyl]fluorophenyl]fluoro-
2-pyridinecarboxamide, verubecestat, are disclosed and can be prepared by one of ordinary skill
in the art as set forth in WO2016/053767, entitled “Novel Crystalline forms of a BACE Inhibitor,
Compositions, and their Use”.
In addition, amino acid sequences for certain anti-N3pGlu Aβ antibodies used in the
present description are included below in Table A:
Table A-Antibody Amino Acid Sequences
Anti-N3pGlu Antibody LCVR HCVR LC HC
Antibody I 9 8 12 11
Antibody II 10 8 13 11
Antibody III (B12L) 25 26 28 29
Antibody IV (R17L) 25 27 28 30
Antibody V(hE8L) 32 34 33 35
Antibody VI (56) 39 40
Antibody VII (66) 41 42
Antibody VIII(173) 43 44
Antibody IX (243) 45 46
Antibody X (9D5H6) 47 48
Antibody XI (8C4) 49 50
Antibody XII (5C9 (LuAb1h) 51 52
Antibody XIII (2E83 (LuAb2h)
53 54
With respect to “Antibody I”, “Antibody II”, “Antibody III”, “Antibody IV”, and
“Antibody V”, additional amino acid sequences for such antibodies are included in Table B:
Table B-Antibody CDR Amino Acid Sequences
Antibody SEQ ID NOs
Antibody LCDR1 LCDR2 LCDR3 HCDR1 HCDR2 HCDR3
I 4 6 7 1 2 3
II 4 5 7 1 2 3
III (B12L) 17 18 19 20 22 23
IV (R17L) 17 18 19 21 22 24
V (hE8L) 17 18 19 36 22 37
As used herein, an “antibody” is an immunoglobulin molecule comprising two Heavy
Chain (HC) and two Light Chain (LC) interconnected by disulfide bonds. The amino terminal
portion of each LC and HC includes a variable region responsible for antigen recognition via the
complementarity determining regions (CDRs) contained therein. The CDRs are interspersed with
regions that are more conserved, termed framework regions. Assignment of amino acids to CDR
domains within the LCVR and HCVR regions of the antibodies of the present description is based
on the following: Kabat numbering convention (Kabat, et al., Ann. NY Acad. Sci. 190:382-93
(1971); Kabat et al., Sequences of Proteins of Immunological Interest, Fifth Edition, U.S.
Department of Health and Human Services, NIH Publication No. 91-3242 (1991)), and North
numbering convention (North et al., A New Clustering of Antibody CDR Loop Conformations,
Journal of Molecular Biology, 406:228-256 (2011)). Following the above method, the CDRs of
the present description were determined (Table B).
The anti-N3pGlu Aβ antibodies of the present description include kappa LC and IgG HC.
In a particular embodiment, the anti-N3pglu Aβ antibodies of the present description are of the
human IgG1 isotype.
The antibodies of the present description are monoclonal antibodies (“mAbs”).
Monoclonal antibodies can be produced, for example, by hybridoma technologies, recombinant
technologies, phage display technologies, synthetic technologies, e.g., CDR-grafting, or
combinations of such or other technologies known in the art. The monoclonal antibodies of the
present description are human or humanized. Humanized antibodies can be engineered to contain
one or more human framework regions (or substantially human framework regions) surrounding
CDRs derived from a non-human antibody. Human framework germline sequences can be
obtained from ImunoGeneTics (INGT) via their website, http://imgt.cines.fr, or from The
Immunoglobulin FactsBook by Marie-Paule Lefranc and Gerard Lefranc, Academic 25 Press,
2001, ISBN 012441351.Techinques for generating human or humanized antibodies are well
known in the art. In another embodiment of the present description, the antibody, or the nucleic
acid encoding the same, is in isolated form. As used herein, the term “isolated” refers to a
protein, peptide or nucleic acid that is not found in nature and is free or substantially free from
other macromolecular species found in a cellular environment. “Substantially free”, as used
herein, means the protein, peptide or nucleic acid of interest comprises more than 80% (on a
molar basis) of the macromolecular species present, preferably more than 90% and more
preferably more than 95%.
The anti-N3pGlu Aβ antibody of the present description is administered as a pharmaceutical
composition. The pharmaceutical composition comprising an antibody of the present description
can be administered to a patient at risk for, or exhibiting, diseases or disorders as described herein
by parental routes (e.g., subcutaneous, intravenous, intraperitoneal, intramuscular). Subcutaneous
and intravenous routes are preferred.
The terms “treatment,” “treating” or “to treat” and the like include restraining, slowing or
stopping the progression or severity of an existing symptom, condition, disease, or disorder in a
patient. The term “patient” refers to a human.
The term “prevention” means prophylactic administration of the antibody of the present
description to an asymptomatic patient or a patient with pre-clinical Alzheimer’s disease to
prevent onset or progression of the disease.
The terms “disease characterized by deposition of Aβ’ or a disease characterized by Aβ
deposits” are used interchangeably and refer to a disease that is pathologically characterized by
Aβ deposits in the brain or in brain vasculature. This includes diseases such as Alzheimer’s
disease, Down’s syndrome, and cerebral amyloid angiopathy. A clinical diagnosis, staging or
progression of Alzheimer’s disease can be readily determined by the attending diagnostician or
health care professional, as one skilled in the art, by using known techniques and by observing
results. This generally includes some form of brain plaque imagining, mental or cognitive
assessment (e.g. Clinical Dementia Rating – summary of boxes (CDR-SB), Mini-Mental State
Exam (MMSE) or Alzheimer’s Disease Assessment Scale-Cognitive (ADAS-Cog)) or functional
assessment (e.g. Alzheimer’s Disease Cooperative Study-Activities of Daily Living (ADCS-
ADL). The cognitive and functional assessment can be used to determine changes in a patients
cognition (e.g. cognitive decline) and function (e.g. functional decline). “Clinical Alzheimer’s
disease” as used herein is a diagnosed stage of Alzheimer’s disease. It includes conditions
diagnosed as prodromal Alzheimer’s disease, mild Alzheimer’s disease, moderate Alzheimer’s
disease and severe Alzheimer’s disease. The term “pre-clinical Alzheimer’s disease” is a stage
that precedes clinical Alzheimer’s disease, where measurable changes in biomarkers (such as CSF
Aβ42 levels or deposited brain plaque by amyloid PET) indicate the earliest signs of a patient
with Alzheimer’s pathology, progressing to clinical Alzheimer’s disease. This is usually before
symptoms such as memory loss and confusion are noticeable. Pre-clinical Alzheimer’s disease
also includes pre-symptomatic autosomal dominant carriers, as well as patients with higher risk
for developing AD by virtue of carrying one or two APOE e4 alleles.
For patients undergoing brain plaque imaging, a patient is positive for amyloid deposits when
amyloid is detected in the brain by methods such as amyloid imaging with radiolabeled PET
compounds. An example of one such amyloid PET imaging compound is florbetapir F 18, which
bind with high specificity to amyloid plaques. The chemical formula of florbetapir F 18 is
C H FN O . Amyloid imaging with radiolabeled PET compounds can be used to determine if
25 2 3
Aβ deposit in the brain of a human patient is reduced by 35-100% within 6 months post induction
treatment. A person of skill in the art can correlate the standardized uptake value ratio (SUVR)
values obtained from amyloid imaging (with radiolabeled PET compounds) to calculate the %
reduction in Aβ deposit in the brain of the patient before and after treatment. The SUVr values
can be converted to standardized centiloid units, where 100 is average for AD and 0 is average for
young controls, allowing comparability amongst amyloid PET tracers, and calculation of
reduction according to centiloid units (Klunk et al., Alzheimers Dement, 2015;11:1-15) . As used
herein, “a period of 6 months or less” refers to a period of time that is 6 months or less than 6 full
consecutive calendar months, and wherein each month has 28-31 days. At the least this period
includes a one-time induction dose given in a single administration.
A reduction or slowing of cognitive decline can be measured by cognitive assessments such
as Clinical Dementia Rating – summary of boxes (CDR-SB), Mini-Mental State Exam (MMSE)
or Alzheimer’s Disease Assessment Scale-Cognitive (ADAS-Cog). A reduction or slowing of
functional decline can be measured by functional assessments such as Alzheimer’s Disease
Cooperative Study-Activities of Daily Living (ADCS-ADL).
An “induction dose” is a dose of an anti-N3pGlu Aβ antibody that causes a sharp reduction in
Aβ deposit in the brain of a human patient within 6 months of treatment. A “one-time” dose is an
induction dose that is administered once to a patient. A “one-time” dose can also be a dose that is
administered to a patient once with a prolonged period of time, such as 2-10 years, between doses
if such a dose is needed. Whether a patients needs more than one “one-time” induction dose can
be determined by a diagnostician or health care professional by using known techniques and by
observing results. A “biweekly” dose is a dose of that is administered to a patient every two
weeks.
A “maintenance dose” is a dose administered to a patient after the induction dose treatment.
A maintenance dose is an amount of antibody or drug administered to maintain the desired
therapeutic response including reduced Aβ deposit in the brain of a human patient. A
maintenance dose can be dose that is the same or lower in amount of antibody or drug compared
to the induction dose.
As used herein, “mg/kg” means an amount, in milligrams, of antibody or drug administered to
a patient based on his or her bodyweight in kilograms. A dose is given at one time. For example,
a 10mg/kg dose of antibody for a patient weighing 70 kg would be a single 700 mg dose of
antibody given in a single administration. Similarly, a 40mg/kg dose of antibody for a patient
weighing 80 kg would be a 3200 mg dose of antibody given at a single administration.
As used herein, the phrase “in combination with” refers to the administration of an anti-
N3pGlu Aβ antibody of the present description, with another molecule (a “combination
molecule,” such as a BACE inhibitor, symptomatic agent or Aβ antibody), simultaneously, or
sequentially in any order, or any combination thereof. The two molecules may be administered
either as part of the same pharmaceutical composition or in separate pharmaceutical compositions.
The anti-N3pGlu Aβ antibody can be administered prior to, at the same time as, or subsequent to
administration of the combination molecule, or in some combination thereof. Where the
combination molecule is administered at repeated intervals (e.g. during a standard course of
treatment), the anti-N3pGlu Aβ antibody can be administered prior to, at the same time as, or
subsequent to, each administration of the combination molecule, or some combination thereof, or
at different intervals in relation to therapy with the combination molecule, or in a single or series
of dose(s) prior to, at any time during, or subsequent to the course of treatment with the
combination molecule. One of ordinary skill in the art would recognize that a BACE inhibitor
refers to a therapeutic agent, preferably a small molecule that inhibits the beta-secretase 1
enzyme, and can prevent the formation of amyloid plaque. Examples of BACE inhibitors are
herein disclosed.
“Symptomatic agents,’ as used herein refer to therapeutic agents used to treat the
cognitive manifestations of Alzheimer's symptomatically and have not shown to have any effect
on Alzheimer disease progression. These include acetyl cholinesterase inhibitors and NMDA
receptor antagonists. The cholinesterase inhibitors approved for the management of AD
symptoms include: donepezil (brand name Aricept™), galantamine (Razadyne™), and
rivastigmine (branded as Exelon and Exelon™ Patch). Memantine (also known as NAMEDA®)
is an approved NMDA receptor antagonist. NAMZARIC® is a combination agent comprising
both an acetyl cholinesterase inhibitor and NMDA receptor antagonist.
The term “comprising” as used in this specification and claims means “consisting at least
in part of”. When interpreting statements in this specification, and claims which include the term
“comprising”, it is to be understood that other features that are additional to the features prefaced
by this term in each statement or claim may also be present. Related terms such as “comprise”
and “comprised” are to be interpreted in similar manner.
In this specification where reference has been made to patent specifications, other
external documents, or other sources of information, this is generally for the purpose of providing
a context for discussing the features of the invention. Unless specifically stated otherwise,
reference to such external documents is not to be construed as an admission that such documents,
or such sources of information, in any jurisdiction, are prior art, or form part of the common
general knowledge in the art.
Certain statements that appear herein are broader than what appears in the statements of
the invention. These statements are provided in the interests of providing the reader with a better
understanding of the invention and its practice. The reader is directed to the accompanying claim
set which defines the scope of the invention.
The following Examples and assays demonstrate that the antibodies of the present
description are useful for treating a disease characterized by deposition of Aβ, such as of
Alzheimer’s disease, Down’s syndrome, and CAA. It should be understood however, that the
following Examples are set forth by way of illustration and not limitation, and that various
modifications may be made by one of ordinary skill in the art.
Examples
Example 1: Single dose efficacy in aged transgenic mice
Single dose longitudinal effects of the murine surrogate mE8c anti-N3pGlu antibody
(IgG2a) (U.S. Patent No. 8,679,498 B1) observed in aged PDAPP transgenic mice (18.5 to 20-
months old). To mimic Aβ deposition rates and conditions in humans with Alzheimer’s disease,
mice are placed on a chow diet containing a BACE inhibitor LY2811376 (0.015%) four days
prior to receiving a single intraperitoneal injection of biotinylated mE8c antibody or biotinylated
control antibody of the same isotype, and remain on this diet for the duration of the study. A
prior 4-month study demonstrated in aged PDAPP mice treated with the BACE inhibitor in feed
resulted in a level of BACE inhibition that led to no change in the deposited Aβ over the 4-month
interval (i.e. no further deposition and no clearance of deposited Aβ occurred). Animals are
sacrificed 4, 8, 12, or 16 weeks after the single injection of biotinylated mE8c antibody (20 mg/kg
or 100 mg/kg) or biotinylated control antibody (100mg/kg) An additional control group of
transgenic mice is sacrificed at study initiation (time zero cohort) and at 4, 8, 12, or 16 weeks (age
matched control cohort). Hippocampus tissue is analyzed by acid urea gels to measure the Aβ1-
42 via denaturing conditions.
Following the procedure essentially as described above, there was no significant
difference in the levels of Aβ1-42 between the isotype control injected at 4, 8, 12, or 16-weeks
(age matched control cohort) as compared to the time zero cohort. As such, the control animals
were combined into one control group for comparison with animals injected with biotinylated
mE8c antibody. Mice that received a single injection of 20mg/kg biotinylated mE8c antibody had
reduced levels of hippocampal Aβ1-42 as compared to control animals at 4-weeks (-6%), 8-weeks
(-32%; Dunnett’s multiple comparison, p = 0.0091), 12-weeks (-17%), and 16-weeks (-19%).
The aged PDAPP mice that received a single injection of 100mg/kg biotinylated mE8c antibody
had reduced levels of hippocampal Aβ1-42 as compared to control animals at 4-weeks (-23%), 8-
weeks (-28%; Dunnett’s multiple comparison, p = 0.0252), 12-weeks (-14%), and 16-weeks (-
17%).
Example 2: Single dose target engagement in aged transgenic mice
To determine in-vivo target engagement of deposited plaque after a single dose of
N3pGlu antibody, frozen hemi-brains from the single dose antibody study described in Example 1
are analyzed histologically to determine the percent area of hippocampus demonstrating antibody
bound to plaque at 0, 4, 8, 12, and 16 weeks after a single dose of antibody.
Brains are sectioned and immunohistochemistry is performed on sister sections with an
anti-human antibody (to detect the bound N3pGlu antibody) and 3D6 (to detect the total amount
of deposited target in the section). Percent area bound by the N3pGlu antibody is normalized
against the total amount of deposited target in the section.
Following procedures essentially as described above, the total area covered by deposited
Aβ was not significantly different across all groups and the average hippocampal area covered by
the stain varied from 27 to 39%. Little to no target engagement was observed for control animals.
Significant target engagement was observed 4, 8, 12, and 16-weeks after the single dose of 20
mg/kg (2.8% (p <0.0001), 1.9% (p <0.0001), 1.1% (p=0.003), 0.6% (p=0.0323), respectively) or
100mg/kg (5.5% (p <0.0001), 4.0% (p <0.0001), 2.6% (p <0.0001), 1.5% (p=0.0002),
respectively) of biotinylated mE8c antibody (as compared to controls). Dunn non-parametric
analysis was used to determine p-values. The average area of target engagement in mE8c-injected
animals was highest after 4-weeks of treatment and the average target engagement decreased
longitudinally at the subsequent 8, 12, and 16-week time points (1.9%, 1.1%, 0.6% respectively
for the 20 mg/kg mE8c group, and 4.0%, 2.6%, and 1.5% respectively for the 100 mg/kg mE8c
group). Due to the high level of variability, significant differences were not observed between the
and 100mg/kg mE8c single dose injected animals for the matched time points except for week
12 and 16 (p-value=0.0465, 0.0432 unadjusted Wilcoxon).
Example 3: Single-Dose and Multiple-Dose, Dose-Escalation Clinical Trial for Alzheimer’s
Disease
A phase I, double-blind, randomized, placebo-controlled, parallel-group, single-dose
followed by multiple-dose, dose-escalation study in patients with MCI due to AD or mild-to-
moderate AD was conducted to assess the safety, tolerability, and PK of single and multiple IV
doses of LY3002813 (Antibody III). AD patients were enrolled into the single-ascending dose
(SAD) phase and were each administered a single intravenous (IV) dose of Antibody III (5 dosing
cohorts from 0.1 mg/kg IV to 10 mg/kg IV) or placebo followed by a 12-week follow-up period
for each dose level. After the follow-up period, the same patients proceeded into the multiple-
ascending dose (MAD) phase (5 cohorts) and were administered IV doses of Antibody III (0.3
mg/kg IV to 10 mg/kg IV) or placebo approximately once per month for up to 4 doses depending
on the initial doses. This phase concluded with a 12-week follow-up period.
The results of the single-dose study, wherein the PK of Antibody III was assessed up to
84 days after a single dose, showed the mean terminal elimination half-life was approximately 4
days after single-dose administration from 0.1 mg/kg to 3.0 mg/kg, and was increased to
approximately 10 days (243 hours) at the 10-mg/kg dose level. The mean clearance values at
each dose level ranged from 26.3 mL/hour (10 mg/kg) to 35.6 mL/hour (1.0 mg/kg).
The results of the multiple-dose study, wherein patients entered the multiple-dose phase
12 weeks after receiving a single dose in the SAD phase, showed Antibody III concentrations
were significantly lower following multiple doses of Antibody III than following the first single
dose. In contrast to the other dose levels, at the 10-mg/kg dose level, Antibody III concentrations
were generally similar to those observed after single-dose administration. Most patients at dose
levels ≤3 mg/kg had serum Antibody III concentrations below the limits of detection 28 days after
dosing. Patients receiving 10 mg/kg had sustained quantifiable concentrations 28 days after
dosing.
Greater than 90% of the patients with AD had treatment-emergent antidrug antibodies
(ADAs) 3 months after the first dose at all dose groups; titers tended to increase by the end of the
MAD phase and persist 3 months after the last dose. The rapid decline of Antibody III
concentrations after multiple-dose administration may be at least partly associated with the
presence of ADAs. Treatment group also experienced increased infusion related reactions upon
multiple dosing.
Florbetapir scans were performed at baseline and after the last MAD dose, separated by
approximately 7 months. The change in whole grey matter standardized uptake value ratio (SUVr)
with cerebellum as a reference region was compared across dose cohorts, and the SUVr values
were converted to standardized centiloid (CL) units. There was a significant reduction in cerebral
amyloid (as assessed by florbetapir PET imaging) in the 6 patients who received 3 to 5 doses of
mg/kg of Antibody III intravenously over 6 months, without cerebral vasogenic edema or
microhemorrhage complications in this dose group. The mean reduction of 44 CL units
corresponds to a mean 40-50% reduction in brain amyloid.
Florbetapir scans in extended follow up from three subjects treated with 3-5 doses of 10
mg/kg IV of Antibody III (vs 2 placebo) demonstrated sustained amyloid removal 18 months after
last dose. The data indicate that short term (and possibly single) dose of anti-N3pGlu Aβ
antibodies (such as Antibody III) is sufficient to result in a sustained removal of amyloid.
Chronic dosing with anti-N3pGlu Aβ antibodies is not required to maintain clearance of cerebral
amyloid.
Example 4: Single-Dose and Multiple-Dose Clinical Trial for Alzheimer’s Disease
As a result of the significant target engagement (amyloid reduction by florbetapir PET)
that was identified after 3 to 5 doses of LY3002813 (Antibody III) 10 mg/kg intravenously over 6
months, a Phase 1b study is in progress to confirm that different dosing regimens (single-dose,
short-term “induction” dosing with higher, more frequent dosing; and chronic dosing for maximal
PD effect) can mitigate immunogenicity and immune safety issues, and produce sustained
amyloid reduction. A phase Ib, double-blind, randomized within cohort, placebo-controlled,
parallel-group, single-and multiple-dose study in patients with MCI due to AD or mild-to-
moderate AD is being conducted to assess the safety, tolerability, and PK of single and multiple
IV doses of Antibody III. The study will be conducted in at least seven cohorts, including single
IV doses at 10 mg/kg, 20 mg/kg, or 40 mg/kg (cohorts 1, 2, and 3, respectively), IV doses every
two weeks for 24 weeks at 10 mg/kg or 20 mg/kg (cohorts 4 and 5, respectively), and IV doses
every four weeks for up to 72 weeks at 10 mg/kg or 20 mg/kg (cohorts 6 and 7, respectively).
The primary target engagement outcome is the reduction of cerebral amyloid as measured
by quantitative amyloid PET imaging (florbetapir CL) assessed at baseline and at 12 weeks, 24
weeks, 36 weeks, 48 weeks, and 72 weeks after starting treatment.
The results demonstrate that 10mg/kg, 20mg/kg and 40mg/kg single doses and 10mg/kg
multiple doses of Antibody III can reduce amyloid at 12 weeks (mean reductions in cohorts to
date ranging from -12 to -39 CL by florbetapir PET). For the patients who have had additional
scans beyond 12 weeks, the amyloid clearance is sustained in the single dose cohorts, and further
amyloid clearance is observed with dosing in the multiple dose cohort.
Example 5: Expression and Purification of Engineered N3pGlu Aβ Antibodies
Anti-N3pGlu Aβ antibodies of the present description can be expressed and purified
essentially as follows. An appropriate host cell, such as HEK 293 EBNA or CHO, is either
transiently or stably transfected with an expression system for secreting antibodies using an
optimal predetermined HC:LC vector ratio or a single vector system encoding both HC and LC.
Clarified media, into which the antibody has been secreted, is purified using any of many
commonly-used techniques. For example, the medium may be conveniently applied to a Protein A
or G Sepharose FF column that has been equilibrated with a compatible buffer, such as phosphate
buffered saline (pH 7.4). The column is washed to remove nonspecific binding components. The
bound antibody is eluted, for example, by pH gradient (such as 0.1 M sodium phosphate buffer
pH 6.8 to 0.1 M sodium Citrate buffer (pH 2.5).Antibody fractions are detected, such as by SDS-
PAGE, and then are pooled. Further purification is optional, depending on the intended use. The
antibody may be concentrated and/or sterile filtered using common techniques. Soluble aggregate
and multimers may be effectively removed by common techniques, including size exclusion,
hydrophobic interaction, ion exchange, or hydroxyapatite chromatography. The purity of the
antibody after these chromatography steps is greater than 99%. The product may be immediately
frozen at -70 C. or may be lyophilized. The amino acid sequences for the anti- N3pGlu Aβ
antibodies are included in Table A.
Example 6: Binding Affinity and Kinetics
The binding affinity and kinetics of anti-N3pGlu Aβ antibody of the present description
(Antibody I or Antibody II) to pE3-42 Aβ peptide or to Aβ 1-40 peptide is measured by surface
plasmon resonance using BIACORE® 3000 (GE Healthcare). The binding affinity is measured by
capturing the anti-N3pGlu Aβ antibody via immobilized protein A on a BIACORE® CMS chip,
and flowing pE3-42 Aβ peptide or Aβ 1-40 peptide, starting from 100 nM in 2-fold serial dilution
down to 3.125 nM. The experiments are carried out at 25 °C in HBS-EP buffer (GE Healthcare
BR100669; 10 mM HEPES, 150 mM NaCl, 3 mM EDTA, 0.05% surfactant P20, pH 7.4).
For each cycle, the antibody is captured with 5 μL injection of antibody solution at a 10
μg/mL concentration with 10 μL/min. flow rate. The peptide is bound with 250 μL injection at 50
μL/min, and then dissociated for 10 minutes. The chip surface is regenerated with 5 μL injection
of glycine buffer at pH 1.5 at 10 μL/mL flow rate. The data is fit to a 1: 1 Langmiur binding
, k , and to calculate K .Following procedures essentially as described above,
model to derive kon off D
the following parameters (shown in Table C) were observed.
Table C. Binding affinity and kinetics.
-4
Antibody k (x10 1/MS) k (x10 1/s) K (nM)
on off D
I 1.39 1.31 0.71
II 3.63 1.28 0.35
III 3.62 2.7 0.75
IV 4.03 3.72 0.92
V 5.78 3.21 0.55
No appreciable binding to Aβ 1-40 was detected, indicating that Antibodies I-V bound
preferentially to pE3-42 Aβ peptide as compared to Aβ 1-40.
Example 7: Ex Vivo Target Engagement
To determine ex vivo target engagement on brain sections from a fixed PDAPP brain,
immunohistochemical analysis is performed with an exogenously added anti-N3pGlu Aβ
antibodies of the present description (hE8L, B12L, R17L, Antibody I or Antibody II). Cryostat
serial coronal sections from aged PDAPP mice (25-month old) are incubated with 20 μg/mL of an
exemplified N3pGlu Aβ antibody of the present description. Secondary HRP reagents specific for
human IgG are employed and the deposited plaques are visualized with DAB-Plus (DAKO).
Biotinylated murine 3D6 antibody followed by Step-HRP secondary is used as a positive control.
The positive control antibody (biotinylated 3D6) labeled significant quantities of deposited Aβ in
the PDAPP hippocampus, and the anti – N3pGlu Aβ antibodies (hE8L, B12L, R17L, Antibody I
or Antibody II) labeled a subset of deposits. These histological studies demonstrated that the anti
– N3pGlu Aβ antibodies of the present description engaged deposited Aβ target ex vivo.
Example 8: Synthesis of N-[3-[(4aR,7aS)Amino(5-fluoropyrimidinyl)-4,4a,5,7-
tetrahydropyrrolo[3,4-d][1,3]thiazin-7a-yl]fluoro-phenyl]methoxy-pyrazine
carboxamide; toluenesulfonic acid
Crystalline Form 2 N-[3-[(4aR,7aS)amino(5-fluoropyrimidinyl)-4,4a,5,7-
tetrahydropyrrolo[3,4-d][1,3]thiazin-7a-yl]fluoro-phenyl]methoxy-pyrazinecarboxamide
hydrated (149.15 mg) is added to ethyl acetate (2 mL). The sample is stirred at 1000 rpm at a
temperature of 80 C. p-Toluenesulfonic acid (70 mg dissolved in ethyl acetate (1 mL)) is added
to the stirring solution, and it is stirred overnight at 80 C to produce a slurry of a white solid
which is isolated by vacuum filtration to provide the title compound.
Alternative Preparation A of N-[3-[(4aR,7aS)Amino(5-fluoropyrimidinyl)-4,4a,5,7-
tetrahydropyrrolo[3,4-d][1,3]thiazin-7a-yl]fluoro-phenyl]methoxy-pyrazinecarboxamide;
toluenesulfonic acid
N-[3-[(4aR,7aS)amino(5-fluoropyrimidinyl)-4,4a,5,7-tetrahydropyrrolo[3,4-
d][1,3]thiazin-7a-yl]fluoro-phenyl]methoxy-pyrazinecarboxamide (9.5 g, 19 mmol) and
p-toluenesulfonic acid (3.80 g, 19.8 mmol) are added to tetrahydrofuran (31 mL), water (7.9 mL),
and 2-propanol (8.6 mL). The solution is heated to 40 °C. To the warm solution is added 2-
propanol (200.0 mL) over approximately 3 hours. The mixture is seeded shortly after the start of
the 2-propanol addition with a portion of the title compound (500 mg, 0.75 mmol). After the
solvent addition is complete, the mixture is cooled to approximately 20 °C over 1-3 hours. The
mixture is heated from approximately 20 °C to approximately 55 °C over a target time of 2 hours.
The temperature is held at 55 °C for 1 hour and then cooled to about 20 °C over approximately 4
hours. The slurry is stirred for at least 10 hours at approximately 20 °C. The slurry is filtered and
the wet cake is washed with water (57 mL). The product is dried in vacuo at 45 °C for at least 10
hours to give the title compound (10.4 g, 81%). ES/MS (m/z): 500 (M+H).
Alternative Preparation B of N-[3-[(4aR,7aS)Amino(5-fluoropyrimidinyl)-4,4a,5,7-
tetrahydropyrrolo[3,4-d][1,3]thiazin-7a-yl]fluoro-phenyl]methoxy-pyrazinecarboxamide;
toluenesulfonic acid
N-[3-[(4aR,7aS)amino(5-fluoropyrimidinyl)-4,4a,5,7-tetrahydropyrrolo[3,4-
d][1,3]thiazin-7a-yl]fluoro-phenyl]methoxy-pyrazinecarboxamide hydrated (20.7 g) is
slurried at 170 rpm in 60:40 THF:H2O (85 mL) in a 500 mL 3-necked round bottomed flask
mechanical motor/agitator attached to a glass shaft
equipped with a nitrogen bubbler, IKA
having a TEFLON banana blade, and a thermocouple connected to a programmable J-KEM
temperature controller. p-Toluenesulfonic acid monohydrate (7.6 g, 1.03 eq) is dissolved in a
mixture of 60:40 THF:H O (20 mL) and the solution added all at once to the stirring N-[3-
[(4aR,7aS)amino(5-fluoropyrimidinyl)-4,4a,5,7-tetrahydropyrrolo[3,4-d][1,3]thiazin-7a-
yl]fluoro-phenyl]methoxy-pyrazinecarboxamide slurry at 23 °C, leading almost
immediately to a clear reddish tan solution. The agitation rate is then increased to 200 rpm as
over 15 minutes, water (22 mL) is added to the solution, which is then seeded with N-[3-
[(4aR,7aS)amino(5-fluoropyrimidinyl)-4,4a,5,7-tetrahydropyrrolo[3,4-d][1,3]thiazin-7a-
yl]fluoro-phenyl]methoxy-pyrazinecarboxamide toluenesulfonic acid (750 mg, 3 wt %
seed load) and is then stirred at 23 °C for a further 15 minutes. Over 6 hours, water (226 mL,
total solvent of 353 mL; or 13.6 vol., final solvent ratio of 17.5:82.5 THF:H O) is added to the
slurry, which is then stirred overnight (22 hours) at 23 °C. The slurry is filtered via vacuum,
rinsed with 15:85 THF:H O (2×20 mL), then left on vacuum for 20 minutes while cracks which
form in the product wet cake are manually pressed closed. The wet solids are dried at 40 °C
under vacuum for about 72 hours to give the title compound as a white crystalline solid (24.07 g,
90.0 wt %).
The crystalline N-[3-[(4aR,7aS)amino(5-fluoropyrimidinyl)-4,4a,5,7-
tetrahydropyrrolo[3,4-d][1,3]thiazin-7a-yl]fluoro-phenyl]methoxy-pyrazinecarboxamide;
toluenesulfonic acid is characterized by an XRD pattern using CuKa radiation as having
diffraction peaks (2-theta values) as described in Table D below, and in particular having peaks at
diffraction angle 2-theta of 5.0° in combination with one or more of the peaks selected from the
group consisting of 19.6°, 13.8°, and 18.5°; with a tolerance for the diffraction angles of 0.2
degrees.
Table D: X-ray powder diffraction peaks of crystalline Example 8
Angle (2-Theta°) +/- Relative Intensity (% of
Peak
0.2° most intense peak)
1 5.0 100.0
2 13.4 22.9
3 13.8 37.3
4 14.4 20.2
15.3 28.8
6 17.5 25.9
7 18.5 30.7
8 19.6 45.8
9 20.4 17.7
25.6 30.1
Sequences
<SEQ ID NO: 1; PRT1; Artificial> (HCDR1 - Antibody I and Antibody II)
KASGYTFTDYYIN
<SEQ ID NO: 2; PRT1; Artificial> (HCDR2 - Antibody I and Antibody II)
WINPGSGNTKYNEKFKG
<SEQ ID NO: 3; PRT1; Artificial> (HCDR3 - Antibody I and Antibody II)
TREGETVY
<SEQ ID NO: 4; PRT1; Artificial> (LCDR1 - Antibody I and Antibody II)
KSSQSLLYSRGKTYLN
<SEQ ID NO: 5; PRT1; Artificial> (LCDR2 - Antibody II)
YAVSKLDS
<SEQ ID NO: 6; PRT1; Artificial> (LCDR2 - Antibody I)
YDVSKLDS
<SEQ ID NO: 7; PRT1; Artificial> (LCDR3 - Antibody I and Antibody II)
VQGTHYPFT
<SEQ ID NO: 8; PRT1; Artificial> (HCVR - Antibody I and Antibody II)
QVQLVQSGAEVKKPGSSVKVSCKASGYTFTDYYINWVRQAPGQGLEWMGWINPGSGNT
KYNEKFKGRVTITADESTSTAYMELSSLRSEDTAVYYCTREGETVYWGQGTLVTVSS
<SEQ ID NO: 9; PRT1; Artificial> (LCVR - Antibody I)
DVVMTQSPLSLPVTLGQPASISCKSSQSLLYSRGKTYLNWFQQRPGQSPRRLIYDVSKLDS
GVPDRFSGSGSGTDFTLKISRVEAEDVGVYYCVQGTHYPFTFGQGTKLEIK
<SEQ ID NO: 10; PRT1; Artificial> (LCVR - Antibody II)
DIQMTQSPSTLSASVGDRVTITCKSSQSLLYSRGKTYLNWLQQKPGKAPKLLIYAVSKLD
SGVPSRFSGSGSGTEFTLTISSLQPDDFATYYCVQGTHYPFTFGQGTKLEIK
<SEQ ID NO: 11; PRT1; Artificial> (HC - Antibody I and Antibody II)
QVQLVQSGAEVKKPGSSVKVSCKASGYTFTDYYINWVRQAPGQGLEWMGWINPGSGNT
KYNEKFKGRVTITADESTSTAYMELSSLRSEDTAVYYCTREGETVYWGQGTLVTVSSAS
TKGPSVFPLAPSSKSTSGGTAALGCLVKDYFPEPVTVSWNSGALTSGVHTFPAVLQSSGL
YSLSSVVTVPSSSLGTQTYICNVNHKPSNTKVDKKVEPKSCDKTHTCPPCPAPELLGGPSV
FLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHNAKTKPREEQYNST
YRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQPREPQVYTLPPSRDELT
KNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSFFLYSKLTVDKSRWQ
QGNVFSCSVMHEALHNHYTQKSLSLSPG
<SEQ ID NO: 12; PRT1; Artificial> (LC - Antibody I)
DVVMTQSPLSLPVTLGQPASISCKSSQSLLYSRGKTYLNWFQQRPGQSPRRLIYDVSKLDS
GVPDRFSGSGSGTDFTLKISRVEAEDVGVYYCVQGTHYPFTFGQGTKLEIKRTVAAPSVFI
FPPSDEQLKSGTASVVCLLNNFYPREAKVQWKVDNALQSGNSQESVTEQDSKDSTYSLS
STLTLSKADYEKHKVYACEVTHQGLSSPVTKSFNRGEC
<SEQ ID NO: 13; PRT1; Artificial> (LC - Antibody II)
DIQMTQSPSTLSASVGDRVTITCKSSQSLLYSRGKTYLNWLQQKPGKAPKLLIYAVSKLD
SGVPSRFSGSGSGTEFTLTISSLQPDDFATYYCVQGTHYPFTFGQGTKLEIKRTVAAPSVFI
FPPSDEQLKSGTASVVCLLNNFYPREAKVQWKVDNALQSGNSQESVTEQDSKDSTYSLS
STLTLSKADYEKHKVYACEVTHQGLSSPVTKSFNRGEC
<SEQ ID NO: 14; DNA; Artificial> Exemplified DNA for Expressing Antibody Heavy Chain of
SEQ ID NO: 11
CAGGTGCAGCTGGTGCAGTCTGGGGCTGAGGTGAAGAAGCCTGGGTCCTCGGTGAAG
GTCTCCTGCAAGGCTTCTGGATACACCTTCACCGACTATTATATCAACTGGGTGCGAC
AGGCCCCTGGACAAGGGCTTGAGTGGATGGGATGGATCAACCCTGGCAGTGGTAATA
CAAAGTACAATGAGAAGTTCAAGGGCAGAGTCACGATTACCGCGGACGAATCCACG
AGCACAGCCTACATGGAGCTGAGCAGCCTGAGATCTGAGGACACGGCCGTGTATTAC
TGTACAAGAGAAGGCGAGACGGTCTACTGGGGCCAGGGAACCCTGGTCACCGTCTCC
TCAGCCTCCACCAAGGGCCCATCGGTCTTCCCGCTAGCACCCTCCTCCAAGAGCACCT
CTGGGGGCACAGCGGCCCTGGGCTGCCTGGTCAAGGACTACTTCCCCGAACCGGTGA
CGGTGTCGTGGAACTCAGGCGCCCTGACCAGCGGCGTGCACACCTTCCCGGCTGTCC
TACAGTCCTCAGGACTCTACTCCCTCAGCAGCGTGGTGACCGTGCCCTCCAGCAGCTT
GGGCACCCAGACCTACATCTGCAACGTGAATCACAAGCCCAGCAACACCAAGGTGG
ACAAGAAAGTTGAGCCCAAATCTTGTGACAAAACTCACACATGCCCACCGTGCCCAG
CACCTGAACTCCTGGGGGGACCGTCAGTCTTCCTCTTCCCCCCAAAACCCAAGGACA
CCCTCATGATCTCCCGGACCCCTGAGGTCACATGCGTGGTGGTGGACGTGAGCCACG
AAGACCCTGAGGTCAAGTTCAACTGGTACGTGGACGGCGTGGAGGTGCATAATGCCA
AGACAAAGCCGCGGGAGGAGCAGTACAACAGCACGTACCGTGTGGTCAGCGTCCTC
ACCGTCCTGCACCAGGACTGGCTGAATGGCAAGGAGTACAAGTGCAAGGTCTCCAAC
AAAGCCCTCCCAGCCCCCATCGAGAAAACCATCTCCAAAGCCAAAGGGCAGCCCCGA
GAACCACAGGTGTACACCCTGCCCCCATCCCGGGACGAGCTGACCAAGAACCAGGTC
AGCCTGACCTGCCTGGTCAAAGGCTTCTATCCCAGCGACATCGCCGTGGAGTGGGAG
AGCAATGGGCAGCCGGAGAACAACTACAAGACCACGCCCCCCGTGCTGGACTCCGA
CGGCTCCTTCTTCCTCTATAGCAAGCTCACCGTGGACAAGAGCAGGTGGCAGCAGGG
GAACGTCTTCTCATGCTCCGTGATGCATGAGGCTCTGCACAACCACTACACGCAGAA
GAGCCTCTCCCTGTCTCCGGGT
<SEQ ID NO: 15; DNA; Artificial> Exemplified DNA for Expressing Antibody Light Chain of
SEQ ID NO: 12
GATGTTGTGATGACTCAGTCTCCACTCTCCCTGCCCGTCACCCTTGGACAGCCGGCCT
CCATCTCCTGCAAGTCTAGTCAAAGCCTCCTGTACAGTCGCGGAAAAACCTACTTGA
ATTGGTTTCAGCAGAGGCCAGGCCAATCTCCAAGGCGCCTAATTTATGATGTTTCTAA
ACTGGACTCTGGGGTCCCAGACAGATTCAGCGGCAGTGGGTCAGGCACTGATTTCAC
ACTGAAAATCAGCAGGGTGGAGGCTGAGGATGTTGGGGTTTATTACTGCGTGCAAGG
TACACACTACCCTTTCACTTTTGGCCAAGGGACCAAGCTGGAGATCAAACGGACCGT
GGCTGCACCATCTGTCTTCATCTTCCCGCCATCTGATGAGCAGTTGAAATCTGGAACT
GCCTCTGTTGTGTGCCTGCTGAATAACTTCTATCCCAGAGAGGCCAAAGTACAGTGG
AAGGTGGATAACGCCCTCCAATCGGGTAACTCCCAGGAGAGTGTCACAGAGCAGGA
CAGCAAGGACAGCACCTACAGCCTCAGCAGCACCCTGACGCTGAGCAAAGCAGACT
ACGAGAAACACAAAGTCTACGCCTGCGAAGTCACCCATCAGGGCCTGAGCTCGCCCG
TCACAAAGAGCTTCAACAGGGGAGAGTGC
<SEQ ID NO: 16; DNA; Artificial> Exemplified DNA for Expressing Antibody Light Chain of
SEQ ID NO: 13
GACATCCAGATGACCCAGTCTCCTTCCACCCTGTCTGCATCTGTAGGAGACAGAGTCA
CCATCACTTGCAAGTCCAGTCAGAGTCTCCTGTACAGTCGCGGAAAAACCTATTTGA
ACTGGCTCCAGCAGAAACCAGGGAAAGCCCCTAAGCTCCTGATCTATGCTGTCTCCA
AACTGGACAGTGGGGTCCCATCAAGGTTCAGCGGCAGTGGATCTGGGACAGAATTCA
CTCTCACCATCAGCAGCCTGCAGCCTGATGATTTTGCAACTTATTACTGCGTGCAGGG
TACACATTATCCTTTCACTTTTGGCCAGGGGACCAAGCTGGAGATCAAACGGACCGT
GGCTGCACCATCTGTCTTCATCTTCCCGCCATCTGATGAGCAGTTGAAATCTGGAACT
GCCTCTGTTGTGTGCCTGCTGAATAACTTCTATCCCAGAGAGGCCAAAGTACAGTGG
AAGGTGGATAACGCCCTCCAATCGGGTAACTCCCAGGAGAGTGTCACAGAGCAGGA
CAGCAAGGACAGCACCTACAGCCTCAGCAGCACCCTGACGCTGAGCAAAGCAGACT
ACGAGAAACACAAAGTCTACGCCTGCGAAGTCACCCATCAGGGCCTGAGCTCGCCCG
TCACAAAGAGCTTCAACAGGGGAGAGTGC
<SEQ ID NO: 17; PRT1; Artificial> (LCDR1- B12L/R17L/hE8L)
KSSQSLLYSRGKTYLN
<SEQ ID NO: 18; PRT1; Artificial> (LCDR2 - B12L/R17L/hE8L)
AVSKLDS
<SEQ ID NO: 19; PRT1; Artificial> (LCDR3 - B12L/R17L/hE8L)
VQGTHYPFT
<SEQ ID NO: 20; PRT1; Artificial> (HCDR1 - B12L)
GYDFTRYYIN
<SEQ ID NO: 21; PRT1; Artificial> (HCDR1 - R17L)
GYTFTRYYIN
<SEQ ID NO: 22; PRT1; Artificial> (HCDR2 - B12L/R17L/hE8L)
WINPGSGNTKYNEKFKG
<SEQ ID NO: 23; PRT1; Artificial> (HCDR3 - B12L)
EGITVY
<SEQ ID NO: 24; PRT1; Artificial> (HCDR3 - R17L)
EGTTVY
<SEQ ID NO: 25; PRT1; Artificial> (LCVR - B12L/R17L)
DIVMTQTPLSLSVTPGQPASISCKSSQSLLYSRGKTYLNWLLQKPGQSPQLLIYAVSKLDS
GVPDRFSGSGSGTDFTLKISRVEAEDVGVYYCVQGTHYPFTFGQGTKLEIK
<SEQ ID NO: 26; PRT1; Artificial> (HCVR - B12L)
QVQLVQSGAEVKKPGSSVKVSCKASGYDFTRYYINWVRQAPGQGLEWMGWINPGSGN
TKYNEKFKGRVTITADESTSTAYMELSSLRSEDTAVYYCAREGITVYWGQGTTVTVSS
<SEQ ID NO: 27; PRT1; Artificial> (HCVR – R17L)
QVQLVQSGAEVKKPGSSVKVSCKASGYTFTRYYINWVRQAPGQGLEWMGWINPGSGNT
KYNEKFKGRVTITADESTSTAYMELSSLRSEDTAVYYCAREGTTVYWGQGTTVTVSS
<SEQ ID NO: 28; PRT1; Artificial> (LC - B12L/R17L)
DIVMTQTPLSLSVTPGQPASISCKSSQSLLYSRGKTYLNWLLQKPGQSPQLLIYAVSKLDS
GVPDRFSGSGSGTDFTLKISRVEAEDVGVYYCVQGTHYPFTFGQGTKLEIKRTVAAPSVFI
FPPSDEQLKSGTASVVCLLNNFYPREAKVQWKVDNALQSGNSQESVTEQDSKDSTYSLS
STLTLSKADYEKHKVYACEVTHQGLSSPVTKSFNRGEC
<SEQ ID NO: 29; PRT1; Artificial> (HC - B12L)
QVQLVQSGAEVKKPGSSVKVSCKASGYDFTRYYINWVRQAPGQGLEWMGWINPGSGN
TKYNEKFKGRVTITADESTSTAYMELSSLRSEDTAVYYCAREGITVYWGQGTTVTVSSAS
TKGPSVFPLAPSSKSTSGGTAALGCLVKDYFPEPVTVSWNSGALTSGVHTFPAVLQSSGL
YSLSSVVTVPSSSLGTQTYICNVNHKPSNTKVDKKVEPKSCDKTHTCPPCPAPELLGGPSV
FLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHNAKTKPREEQYNST
YRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQPREPQVYTLPPSRDELT
KNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSFFLYSKLTVDKSRWQ
QGNVFSCSVMHEALHNHYTQKSLSLSPG
<SEQ ID NO: 30; PRT1; Artificial> (HC – R17L)
QVQLVQSGAEVKKPGSSVKVSCKASGYTFTRYYINWVRQAPGQGLEWMGWINPGSGNT
KYNEKFKGRVTITADESTSTAYMELSSLRSEDTAVYYCAREGTTVYWGQGTTVTVSSAS
TKGPSVFPLAPSSKSTSGGTAALGCLVKDYFPEPVTVSWNSGALTSGVHTFPAVLQSSGL
YSLSSVVTVPSSSLGTQTYICNVNHKPSNTKVDKKVEPKSCDKTHTCPPCPAPELLGGPSV
FLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHNAKTKPREEQYNST
YRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQPREPQVYTLPPSRDELT
KNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSFFLYSKLTVDKSRWQ
QGNVFSCSVMHEALHNHYTQKSLSLSPG
N3pGlu Aβ (SEQ ID NO: 31)
[pE]FRHDSGYEVHHQKLVFFAEDVGSNKGAIIGLMVGGVVIA
<SEQ ID NO, 32; PRTl; Artificial> (LCVR-hE8L)
DIVMTQTPLSLSVTPGQPASISCKSSQSLLYSRGKTYLNWLLQKPGQSPQLLIYAVSKLDS
GVPDRFSGSGSGTDFTLKISRVEAEDVGVYYCVQGTHYPFTFGQGTKLEIK
<SEQ ID NO, 33; PRTl; Artificial> (LC-hE8L)
DIVMTQTPLSLSVTPGQPASISCKSSQSLLYSRGKTYLNWLLQKPGQSPQLLIYAVSKLDS
GVPDRFSGSGSGTDFTLKISRVEAEDVGVYYCVQGTHYPFTFGQGTKLEIKRTVAAPSVFI
FPPSDEQLKSGTASVVCLLNNFYPREAKVQWKVDNALQSGNSQESVTEQDSKDSTYSLS
STLTLSKADYEKHKVYACEVTHQGLSSPVTKSFNRGEC
<SEQ ID NO, 34; PRTl; Artificial> (HCVR-hE8L)
QVQLVQSGAEVKKPGSSVKVSCKASGYTFTDYYINWVRQAPGQGLEWMGWINPGSGNT
KYNEKFKGRVTITADESTSTAYMELSSLRSEDTAVYYCAREGETVYWGQGTTVTVSS
<SEQ ID NO, 35; PRTl; Artificial> (HC-hE8L)
QVQLVQSGAEVKKPGSSVKVSCKASGYTFTDYYINWVRQAPGQGLEWMGWINPGSGNT
KYNEKFKGRVTITADESTSTAYMELSSLRSEDTAVYYCAREGETVYWGQGTTVTVSSAS
TKGPSVFPLAPSSKSTSGGTAALGCLVKDYFPEPVTVSWNSGALTSGVHTFPAVLQSSGL
YSLSSVVTVPSSSLGTQTYICNVNHKPSNTKVDKKVEPKSCDKTHTCPPCPAPELLGGPSV
FLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHNAKTKPREEQYNST
YRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQPREPQVYTLPPSRDELT
KNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSFFLYSKLTVDKSRWQ
QGNVFSCSVMHEALHNHYTQKSLSLSPG
<SEQ ID NO: 36; PRT1; Artificial> (HCDR1-hE8L)
GYTFTDYYIN
<SEQ ID NO: 37; PRT1; Artificial> (HCDR3-hE8L)
EGETVY
<SEQ ID NO: 38; PRT1; Artificial> (Aβ 1-42)
DAEFRHDSGYEVHHQKLVFFAEDVGSNKGAIIGLMVGGVVIA
<SEQ ID NO: 39; PRT1; Artificial> (LCVR – Antibody VI)
MVSSAQFLFLLVLWIQETNGDVVMTQTPLTLSVTIGQPASISCKSSQSLL
YSDGKTYLNWLLQRPGQSPMRLIYLVSKLDSGVPDRFTGSGSGTDFTLK
ISRVEAEDLGVYYCVQGTHFPFTFGSGTKLEIKRADAAPTVSIFPP
<SEQ ID NO: 40; PRT1; Artificial> (HCVR – Antibody VI)
MGWSGVFLFLLSGTAGVHSEVQLQQSGPELVKPGASMKISCKASGYSFTG
YTMNWVKQSHGKNLEWIGLINPYSGVTRYNQKFKGKATLIVDKSSSTAYM
ELLSLTSEDSAVYYCTREAKREWDETYWGQGTLVTVSAAKTTPPSV
<SEQ ID NO: 41; PRT1; Artificial> (LCVR – Antibody VII)
MVSTAQFLFLLVLWIQETNGDVVMTQTPLTLSVTIGQPASISCKSSQSLL
YSDGKTYLNWLLQRPGQSPMRLIYLVSKLDSGVPDRFTGSGSGTDFTLK
ISRVEAEDLGVYYCVQGTHFPFTFGSGTKLEIKRADAAPTVSIFPPS
<SEQ ID NO: 42; PRT1; Artificial> (HCVR – Antibody VII)
MGWSGVFIFLLSGTAGVHSEVQLQQSGPELVKPGASMKISCKASGYSFTG
YTMNWVKQSHGKNLEWIGLINPYNGVTRYNQKFKGKATLIVDKSSSTAY
MELLSLTSEDSAVYYCTREAKREWDETYWGQGTLVTVSAAKTTPPSVYPL
<SEQ ID NO: 43; PRT1; Artificial> (LCVR – Antibody VIII)
MKLPVRLLVLVFWIPVSSSDVVMTQTPLSLPVSLGDQASISCRSSQSLVH
SDGNTYLHWYLQKPGQSPKLLIYKVSNRFSGVPDRFSGSGSGTDFTLKIS
RVEAEDLGVYFCSQSTHVPPTFGGGTKLEIKRADAAPTVSIFPPSS
<SEQ ID NO: 44; PRT1; Artificial> (HCVR – Antibody VIII)
MDFGLSLLIFVLILKGVQCEVKLVESGGGLVQPGGSRKLSCAASGFTFSDY
GMAWVRQAPGKGPEWVAFISNLAYSIYYADTVTGRFTISRENAKNTLYLEM
SSLRSEDTAMYYCARYDYDNILDYVMDYWGQGTSVTVSSAKTTPPSVYPL
<SEQ ID NO: 45; PRT1; Artificial> (LCVR – Antibody IX)
MKLPVRLLVLWIQETKGDVVLTQTPLTLSVTIGQPASISCKSSQSLLYSN
GKTYLNWLLQRPGQSPKRLIYVVSKLDSGVPDRFTGSGSGTDFTLKISRV
EAEDLGVYYCVQGTHFPFTFGSGTKLEIKRADAAPTVSIFPPSS
<SEQ ID NO: 46; PRT1; Artificial> (HCVR – Antibody IX)
MGWSGVFLFLLSVTEGVHSQVQLQQSGAELVRPGSSVKISCKASGYIFNN
YWINWVKQRPGQGLEWIGQIYPGDGDTNYNGKFKGKATLTADKSSSTAY
MQLSSLTSEDSAVYFCAREGYIVYWGQGTLVTVSAAKTTPPSVYPL
<SEQ ID NO: 47; PRT1; Artificial> (LCVR – Antibody X)
DVVMTQTPLSLPVSLGDQASISCRSSQSLLHSNGNTYLHWYLQKPGQSPKLLI
YKVSNRFSGVPDRFSGSGSGTDFTLKISRVEAEDLGVYFCSQSTHVPLTFGAGT
<SEQ ID NO: 48; PRT1; Artificial> (HCVR – Antibody X)
QLQQSGAELMKPGASVKISCKATGYTFSSYWIEWVKQRPGHGLEWIGEILPGR
GSTHYNEKFKGKATFTADTSSNTAYMQLSSLTSEDSAVYYCARSPITTSDYWG
QGTTLTVSS
<SEQ ID NO: 49; PRT1; Artificial> (LCVR – Antibody XI)
SCRSSQSLVHSNGNTYLHWYLQKPGQSPKLLIYKVSNRFSGVPDRFSGSGSGT
DFTLKISRVEAEDLGVYFCSQSTHVPLTFGAGT
<SEQ ID NO: 50; PRT1; Artificial> (HCVR – Antibody XI)
AELKKPGASVKISCKATGYTFRSYWIEWVKQRPGHGLEWIGEILPGRGSTKY
NEKFKGKATFTADTSSNTANMQLSSLTSEDSAVYYCARSPITTSDY
<SEQ ID NO: 51; PRT1; Artificial> (LCVR – Antibody XII)
DVVLTQTPFTLSVTIGQPASISCKSSQSLLHSNGESYLNWLFQRPGQSPKRLIY
AVSKLDSGVPDRFTGSGSGTDFTLKISRVEAEDLGVYYCVQGTHFPFTFGGG
TKLEIK
<SEQ ID NO: 52; PRT1; Artificial> (HCVR – Antibody XII)
QIQLQQSGPELVKPGAAVKISCKASGYTFTDYYLNWVKQKPGQGLEWIGWIY
PGSGNVKYNEKFKGKATLTADTSSNTAHMQLSSLTSEDTAVYFCTREGLIVY
WGQGTLVTVSA
<SEQ ID NO: 53; PRT1; Artificial> (LCVR – Antibody XIII)
DVVLTQTPLTLSVTIGQPASISCKSSQSLLYSNGKTYLNWLLQRPGQSPKRLIY
VVSKLDSGVPDRFTGSGSGTDFTLKISRVEAEDLGVYYCVQGTHYPFTFGGGT
KLEIK
<SEQ ID NO: 54; PRT1; Artificial> (HCVR – Antibody XIII)
QIQLQQSGPDLVKPGASVKISCKASGYTFTDYYINWVKQKPGQGLEWIGWLNP
GSGNTKYNEKFKGKATMTVDTTSSTVYMQLSSLTSEDSAVYFCTREGPIDYWG
RGTSVTVSS
<SEQ ID NO: 55; PRT1; Artificial> (LCVR – Antibody XIV)
DIVMTQTPLSLSVTPGQPASISCSSSQSLIYSDGNAYLHWYLQKP
GQSPQLLIYKVSNRFSGVPDRFSGSGSGTDFTLKISRVEAEDVG
VYYCTQSTHSPWTFGGGTKVEIK
<SEQ ID NO: 56; PRT1; Artificial> (HCVR – Antibody XIV)
EVQLVESGGGLVKPGGSLRLSCAASGYTFSRYSMSWVRQAPG
KGLEWVGQINIRGCNTYYPDTVKGRFTISRDDSKNTLYLQMNS
LKTEDTAVYYCTTGDFWGQGTLVTVSS
<SEQ ID NO: 57; PRT1; Artificial> (LC – Antibody XV)
DIQMTQSPSSLSASVGDRVTITCRASQSISSYLNWYQQKPGKAPKLLIYA
ASSLQSGVPSRFSGSGSGTDFTLTISSLQPEDFATYYCQQSYSTPLTFGG
GTKVEIKRTVAAPSVFIFPPSDEQLKSGTASVVCLLNNFYPREAKVQWKV
DNALQSGNSQESVTEQDSKDSTYSLSSTLTLSKADYEKHKVYACEVTHQG
LSSPVTKSFNRGEC
<SEQ ID NO: 58; PRT1; Artificial> (HC – Antibody XV)
QVQLVESGGGVVQPGRSLRLSCAASGFAFSSYGMHWVRQAPGKGLEWVAV
IWFDGTKKYYTDSVKGRFTISRDNSKNTLYLQMNTLRAEDTAVYYCARDR
GIGARRGPYYMDVWGKGTTVTVSSASTKGPSVFPLAPSSKSTSGGTAALG
CLVKDYFPEPVTVSWNSGALTSGVHTFPAVLQSSGLYSLSSVVTVPSSSL
GTQTYICNVNHKPSNTKVDKRVEPKSCDKTHTCPPCPAPELLGGPSVFLF
PPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHNAKTKPRE
EQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQP
REPQVYTLPPSREEMTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKT
TPPVLDSDGSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSL
<SEQ ID NO: 59; PRT1; Artificial> (LC – Antibody XVI)
DIVLTQSPATLSLSPGERATLSCRASQSVSSSYLAWYQQKPGQAPRLLIYGASSRATGVPA
RFSGSGSGTDFTLTISSLEPEDFATYYCLQIYNMPITFGQGTKVEIKRTVAAPSVFIFPPSDE
QLKSGTASVVCLLNNFYPREAKVQWKVDNALQSGNSQESVTEQDSKDSTYSLSSTLTLS
KADYEKHKVYACEVTHQGLSSPVTKSFNRGEC
<SEQ ID NO: 60; PRT1; Artificial> (HC – Antibody XVI)
QVELVESGGGLVQPGGSLRLSCAASGFTFSSYAMSWVRQAPGKGLEWVSAINAS
GTRTYYADSVKGRFTISRDNSKNTLYLQMNSLRAEDTAVYYCARGKGNTHKPYGYVRY
FDVWGQGTLVTVSSASTKGPSVFPLAPSSKSTSGGTAALGCLVKDYFPEPVTVSWNSGAL
TSGVHTFPAVLQSSGLYSLSSVVTVPSSSLGTQTYICNVNHKPSNTKVDKKVEPKSCDKT
HTCPPCPAPELLGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVE
VHNAKTKPREEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQ
PREPQVYTLPPSRDELTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDSDG
SFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGK
<SEQ ID NO: 61; PRT1; Artificial> (LC – Antibody XVII)
DIVMTQSPLSLPVTPGEPASISCRSSQSLVYSNGDTYLHWYLQKPGQSPQLLIY
KVSNRFSGVPDRFSGSGSGTDFTLKISRVEAEDVGVYYCSQSTHVPWTFGQGT
KVEIKRTVAAPSVFIFPPSDEQLKSGTASVVCLLNNFYPREAKVQWKVDNALQ
SGNSQESVTEQDSKDSTYSLSSTLTLSKADYEKHKVYACEVTHQGLSSPVTKSF
NRGEC
<SEQ ID NO: 62; PRT1; Artificial> (HC – Antibody XVII)
EVQLVESGGGLVQPGGSLRLSCAASGFTFSSYGMSWVRQAPGKGLELVASIN
SNGGSTYYPDSVKGRFTISRDNAKNSLYLQMNSLRAEDTAVYYCASGDYWG
QGTTVTVSSASTKGPSVFPLAPCSRSTSESTAALGCLVKDYFPEPVTVSWNSG
ALTSGVHTFPAVLQSSGLYSLSSVVTVPSSSLGTKTYTCNVDHKPSNTKVDKR
VESKYGPPCPPCPAPEFLGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSQEDP
EVQFNWYVDGVEVHNAKTKPREEQFNSTYRVVSVLTVLHQDWLNGKEYKC
KVSNKGLPSSIEKTISKAKGQPREPQVYTLPPSQEEMTKNQVSLTCLVKGFYPS
DIAVEWESNGQPENNYKTTPPVLDSDGSFFLYSRLTVDKSRWQEGNVFSCSVM
HEALHNHYTQKSLSLSLG
<SEQ ID NO: 63; PRT1; Artificial> (LC – Antibody XVIII)
DVVMTQSPLSLPVTPGAPASISCRSSQSIVHSNGNTYLEWYLQKPGQSPK
LLIYKVSNRFSGVPDRFSGSGSGTDFTLRISRVEAEDVGIYYCFQGSHVP
PTFGPGTKLEIKRTVAAPSVFIFPPSDEQLKSGTASVVCLLNNFYPREAK
VQWKVDNALQSGNSQESVTEQDSKDSTYSLSSTLTLSKADYEKHKVYACE
VTHQGLSSPVTKSFNRGEC
<SEQ ID NO: 64; PRT1; Artificial> (HC – Antibody XVIII)
EVQLVESGGGLVQPGGSLRLSCSASGFTFSSFGMHWVRQAPGKGLEWVAY
ISSGSSTIYYGDTVKGRFTISRDNAKNSLFLQMSSLRAEDTAVYYCAREG
GYYYGRSYYTMDYWGQGTTVTVSSASTKGPSVFPLAPSSKSTSGGTAALG
CLVKDYFPEPVTVSWNSGALTSGVHTFPAVLQSSGLYSLSSVVTVPSSSL
GTQTYICNVNHKPSNTKVDKRVEPKSCDKTHTCPPCPAPELLGGPSVFLF
PPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHNAKTKPRE
EQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQP
REPQVYTLPPSREEMTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKT
TPPVLDSDGSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSL
SPGK
<SEQ ID NO: 65; PRT1; Artificial> (LC – Antibody XIX)
DVVMTQSPLSLPVTLGQPASISCRSSQSLIYSDGNAYLHWFLQKPGQSPRLLIY
KVSNRFSGVPDRFSGSGSGTDFTLKISRVEAEDVGVYYCSQSTHVPWTFGQGT
KVEIKRTVAAPSVFIFPPSDEQLKSGTASVVCLLNNFYPREAKVQWKVDNALQ
SGNSQESVTEQDSKDSTYSLSSTLTLSKADYEKHKVYACEVTHQGLSSPVTKSF
NRGEC
<SEQ ID NO: 66; PRT1; Artificial> (HC – Antibody XIX)
EVQLVESGGGLVQPGGSLRLSCAASGFTFSRYSMSWVRQAPGKGLELVAQINS
VGNSTYYPDTVKGRFTISRDNAKNTLYLQMNSLRAEDTAVYYCASGDYWGQG
TLVTVSSASTKGPSVFPLAPSSKSTSGGTAALGCLVKDYFPEPVTVSWNSGALTS
GVHTFPAVLQSSGLYSLSSVVTVPSSSLGTQTYICNVNHKPSNTKVDKKVEPKSC
DKTHTCPPCPAPELLGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFN
WYVDGVEVHNAKTKPREEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKAL
PAPIEKTISKAKGQPREPQVYTLPPSRDELTKNQVSLTCLVKGFYPSDIAVEWESN
GQPENNYKTTPPVLDSDGSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSL
SPGK
WE
Claims (15)
1. Use of an anti-N3pGlu Amyloid β antibody for the manufacture of a medicament for the treatment and prevention of a disease characterized by Amyloid β deposits in the brain, 5 wherein the medicament comprises a dose of 10 to 60 mg/kg of an anti-N3pGlu Amyloid β antibody, wherein the anti-N3pGlu Amyloid β antibody comprises a light chain variable region (LCVR) and a heavy chain variable region (HCVR), wherein said LCVR and HCVR is selected from the group consisting of: 10 a) LCVR of SEQ ID NO: 25 and HCVR of SEQ ID NO: 26; b) LCVR of SEQ ID NO: 25 and HCVR of SEQ ID NO: 27; c) LCVR of SEQ ID NO: 25 and HCVR of SEQ ID NO: 34; d) LCVR of SEQ ID NO: 9 and HCVR of SEQ ID NO: 8; and e) LCVR of SEQ ID NO: 10 and HCVR of SEQ ID NO: 8, and 15 wherein the medicament is to be administered every two weeks, every four weeks or monthly for a period of 6 months.
2. Use according to claim 1, wherein the medicament is for reducing Amyloid β plaque load in the brain of a patient diagnosed with pre-clinical or clinical Alzheimer’s disease, 20 Down’s syndrome, or clinical or pre-clinical cerebral amyloid angiopathy.
3. Use according to claim 1, wherein the medicament is for slowing cognitive decline in a patient diagnosed with pre-clinical or clinical Alzheimer’s disease, Down’s syndrome, or clinical or pre-clinical cerebral amyloid angiopathy.
4. The use according to any one of claims 1-3, wherein the medicament comprises a dose of 10 to 40 mg/kg of an anti-N3pGlu Amyloid β antibody. 30
5. The use according to claim 4, wherein the medicament comprises a dose of 10 to 20 mg/kg of an anti-N3pGlu Amyloid β antibody.
6. The use according to claim 4, wherein the medicament comprises a dose of 15 to 30 mg/kg of an anti-N3pGlu Amyloid β antibody.
7. The use according to any one of claims 1-3, wherein the medicament comprises adose 5 selected from 10 mg/kg, 15 mg/kg, 20 mg/kg and 40 mg/kg an anti-N3pGlu Amyloid β antibody.
8. The use according to any one of claims 1-7, wherein the anti-N3pGlu Amyloid β antibody in the medicament is a human or humanized antibody.
9. The use according to any one of claims 1-8, wherein the anti-N3pGlu Amyloid β antibody in the medicament comprises a light chain (LC) and a heavy chain (HC), wherein said LC and HC is selected from the group consisting of: a) LC of SEQ ID NO: 28 and HC of SEQ ID NO: 29; 15 b) LC of SEQ ID NO: 28 and HC of SEQ ID NO: 30; c) LC of SEQ ID NO: 28 and HC of SEQ ID NO: 35; d) LC of SEQ ID NO: 12 and HC of SEQ ID NO: 11; and e) LC of SEQ ID NO: 13 and HC of SEQ ID NO: 11. 20
10. The use according to claim 8, wherein the anti-N3pGlu Aβ antibody in the medicament comprises a light chain (LC) of SEQ ID NO: 28 and a heavy chain (HC) of SEQ ID NO:
11. The use according to any one of claims 1-10, wherein the dose is followed by 25 maintenance dose with the same anti-N3pGlu Amyloid β antibody every 1, 2, 3, 5 or 10 years post completion of the dose.
12. The use according to any one of claims 1-11, wherein the dose is in simultaneous, separate, or sequential combination with an effective amount of a BACE inhibitor.
13. The use according to any one of claims 1-11, wherein the dose in simultaneous, separate, or sequential combination with an effective amount of a symptomatic agent for the treatment of Alzheimer’s disease.
14. The use according to any one of claims 1-13, wherein the presence of amyloid plaques in the brain is determined by amyloid PET imaging scans.
15. Use according to any one of claims 1-14 substantially as herein described with reference 5 to any example thereof. 11394637_1
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201662357579P | 2016-07-01 | 2016-07-01 | |
US62/357,579 | 2016-07-01 | ||
PCT/US2017/038999 WO2018005282A1 (en) | 2016-07-01 | 2017-06-23 | ANTI-N3pGlu AMYLOID BETA PEPTIDE ANTIBODIES AND USES THEREOF |
Publications (2)
Publication Number | Publication Date |
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NZ748496A NZ748496A (en) | 2021-02-26 |
NZ748496B2 true NZ748496B2 (en) | 2021-05-27 |
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