WO2010100200A2

WO2010100200A2 - Lyophilised antibody formulation

Info

Publication number: WO2010100200A2
Application number: PCT/EP2010/052709
Authority: WO
Inventors: Bhas A. Dani
Original assignee: Novartis Ag
Priority date: 2009-03-05
Filing date: 2010-03-03
Publication date: 2010-09-10
Also published as: AR075715A1; TW201036650A; WO2010100200A3; US20100226928A1

Abstract

Anti-sclerostin antibodies are formulated as Iyophilisates. The lyophilisates can be reconstituted to give a solution with a high concentration of the antibody active ingredient for delivery to a patient without high levels of antibody aggregation. The lyophilisate can be reconstituted with an aqueous reconstituent to provide an aqueous composition in which the antibody has a concentration of at least 25 mg/ml. The lyophilisate may include one or more of a sugar, a buffering agent, a surfactant, and/or a free amino acid.

Description

LYOPHILISED ANTIBODY FORMULATION

TECHNICAL FIELD

This invention is in the field of monoclonal antibody pharmaceutical formulation,

BACKGROUND Sclerostin is a key negative regulator of Wnt signalling in bone and is a target for therapeutics designed to treat conditions associated with low bone mass, such as osteoporosis. Monoclonal antibodies which bind to sclerostin are known for use in therapy e.g. see references 1 to 10.

BPS804 is one such antibody (IgG2). It was disclosed as "MORQ5813" in reference 10 (the complete contents of which are incorporated herein by reference). It has a V_H domain with amino acid SEQ ID NO: 1 and a V_L domain with amino acid SEQ ID NO: 2. The variable domains may be expressed as SEQ ID NOs: 9 and 10 to give a functional anti-scleiostin antibody.

Aggregation is a major route of degradation in pharmaceutical formulations of monoclonal antibodies, especially at high concentrations. Aggregation can potentially lead to increased immune response in patients, leading to safety concerns. Thus it must be minimised or prevented. It is an object of the invention to provide further and improved formulations of anϋ-sclerostin antibodies, and in particular formulations with low levels of antibody aggregation,

DISCLOSURE OF THE INVENTION

Monoclonal antibodies (mAbs) are typically formulated either in aqueous form ready for parenteral administration or as l lyophilisate for reconstitulion with a suitable diluent prior to administration. According to the invention, an anti-scleroslin antibody is formulated as a lyophilisate. Suitable formulation can provide a lyophilisate which can be reconstituted to give a solution with a high concentration of the antibody active ingredient for delivery to a patient without high levels of antibody aggregation. High concentrations of antibody are useful as they reduce the amount of material which must be delivered to a patient. Reduced dosing volumes minimise the time taken to deliver a fixed dose to the patient.

Thus the invention provides a lyophilisate comprising an anti-sclcrostin monoclonal antibody, wherein the lyophilisate can be reconstituted with an aqueous reconslituent to provide an aqueous composition in which the antibody has a concentration of at least 25mg/ml.

The invention also provides an aqueous pharmaceutical composition comprising an anti-sclerosϋn monoclonal antibody, wherein the antibody has a concentration of at least 25mg/ιnl.

The invention also provides a lyophilisate comprising: an anti-sclerostin monoclonal antibody; a sugar; a buffering agent; and a surfactant. The lyophilisate preferably also includes a free amino acid. The invention also provides, an aqueous pharmaceutical composition comprising: an aπti-sclerostin monoclonal antibody; a sugar; a buffering agent; and a surfactant. The composition preferably also includes a free amino acid.

The invention also provides a lyophiJisate comprising an anti-sclerostin monoclonal antibody, wherein the iyophilLsatc can be reconstituted with an aqueous reconstituent to provide an aqueous composition in which less than 1% of the anti-sclerostin monoclonal antibody Ls aggregated.

The invention also provides an aqueous pharmaceutical composition comprising an anti-sclerostin monoclonal antibody, wherein less than 1% of the anti-sclerostin monoclonal antibody is aggregated.

The invention also provides a process for preparing a lyophilisale, comprising steps of: (i) preparing an aqueous solution comprising an anti-sclerostin monoclonal antibody, a sugar, a buffering agent, a surfactant, and optionally a free amino acid; and (ii) lyophilLsing the aqueous solution.

The invention also provides a process for preparing a composition, comprising a step of mixing a lyophilisate with an aqueous reconslituent, wherein the lyophilisale comprises an anti-sclerostin monoclonal antibody, a sugar, a buffering agent a surfactant, and optionally a free amino acid.

Lyoph Hi sates

Techniques for lyoph ilisation of mAbs are well known in the art e.g. see references 1 1 to 19. For example, monoclonal antibody products SYNAGlS¹", RFΛ4ICADE™, RAPTiVA™, SIMULHCT™ XOLAI II™ and HERCEPTIN^{I M} are supplied as lyophilisates, These antibodies are reconstituted to various final concentrations e.g. SIMULKCT'^M is reconstituted to a concentration of 4 mg/ml antibody, REMICADE™ is reconstituted to a concentration of 10 mg/ml, HERCEPTIN™ to 21 mg/ml, SYNΛGIS™ and RAPϋVA™ to 100 mg/ml, and XOLAIR™ to 125 mg/ml.

Lyophilisates of the invention can be reconstituted to give aqueous compositions with an anti- sclerostin antibody concentration of at least 25 mg/ml. The antibody concentration can be much higher than 25 mg/ml e.g. >5Q mg/ml, >75 mg/ml, >100 mg/ml, >125 mg/ml, >150 mg/ml or higher. Furthermore, the lyophilisates of the invention are stable such that, even afler storage for 4 weeks at 2-8"Cj they can be reconstituted to give aqueous compositions in which less than 1% of the total anti-sclerostin antibody is aggregated (as measured by SRC-H PLC) e.g. <0.5%, <Q.4%, <0.3%, etc.

The lyophilisale may include, in addition to the anti-sclerostin mAb, further components such as one or more of the following: (i) a sugar; (ii) a buffering agent; (iii) a surfactant; and (iv) a free amino acid. Inclusion of each of such additional components (i). (ii) and (iii) is typical, and can give compositions with low aggregation of the anti-sclerostin mAb. Inclusion of component (iv) is advantageous because it has been shown to further reduce aggregation after storage.

Suitable sugars for use with the invention include, but are not limited to, monosaccharides, disaccharides and tπsaccharides. For example, the sugar may be sucrose, trehalose, raflϊnose, maltose, sorbitol or maπnilol. The sugar may be a sugar alcohol or an amino sugar. Sucrose is particularly useful.

Suitable buffering agents for use with the invention include, but arc not limited to, a histidine buffer, a citrate buffer, a phosphate butter, a succinate buffer, an acetate buffer, or a Tris buffer. A histidine buffer is particularly useful.

Suitable surfactants for use wilh the invention include, but are not limited to, non-ionic surfactants, ionic surfactants and zwitterionic surfactants. Typical surfactants for use with the invention include, but are not limited to, sorbitan fatty acid esters (e.g. sorbitan monocaprylate, sorbitan mønolauratc, sorbitan monαpalmitate), sorbitan trioleate, glycerine fatty acid esters (e.g. glycerine monocaprylate, glycerine monomyrtstate, glycerine monostearate), polyglycerine fatty acid esters (e.g. decaglyceryl monostearate, decaglyceryl distearatc, decaglyceryl monolinoleate), polyoxyethylenc sorbitan fatty acid esters (e.g. polyoxyethylene sorbitan monolaurate, polyoxyethylene sorbitan monoolcate, polyoxyethylene sorbitan monostearate, polyoxyethylene sorbitan monopttlmitate. polyoxyethylene sorbitan trioleate, polyoxyethylene sorbitan tristearale), polyoxyethylene sorbitol fatty acid esters (e.g. polyoxyethylene sorbitol tetrastearate, polyoxyethylenc sorbitol tetraoleate), polyoxyethylene glycerine fatty acid esters (e.g. polyoxyethylene glyceryl monostearate), polyethylene glycol fatty acid esters (e.g. polyethylene glycol distearate), polyoxyethylene alkyl ethers (e.g. polyoxyethylene lauryl ether), polyoxyethylene polyoxypropylene alkyl ethers (e.g. polyoxyethylene polyoxy propylene glycol, polyoxyethylene polyoxypropylene propyl ether, polyoxyethylene poiyoxypropyler>e cetyl ether), polyoxyethylene alkylphcnyl ethers (e.g. polyoxyethylene nonylphenyl ether), polyoxyethylene hydrogenated castor oils (e.g. polyoxyethylene castor oil. polyoxyethylene hydrogenated castor oil), polyoxyethylene beeswax derivatives (e.g. polyoxyethylene sorbitol beeswax), polyoxyethylene lanolin derivatives (e.g. polyoxyethylene lanolin), and polyoxyethylene fatty acid amides (e.g. polyoxyethylene stearic acid amide); C₁₀-Cj₈ alkyl sulfates (e.g. sodium cetyl sulfate, sodium lauryl sulfate, sodium oleyl sulfate), polyoxyethylene Cio-Cig alkyl ether sulfate with an average of 2 to 4 moles of ethylene oxide units added (e.g. sodium polyoxyethylene lauryl sulfate), and CVCi₈ alkyl sulfosuccinate ester salts (e.g. sodium lauryl sulfosuccinate ester); and natural surfactants such as lecithin, glycerυphospholipid, sphingophospholipids (e.g. sphingomyelin), and sucrose esters of Cu-C-ig fatty acids. A composition may include one or more of these surfactants. Preferred surfactants are polyoxyethylene sorbitan fatly acid esters e.g. polysorbate 20, 40, 60 or 80. Polysorbate 80 (Tween 80) is particularly useful.

Suitable free amino acids for use with the invention include, but are not limited to, arginine, lysine, histidine, ornithine, isoleucine, leucine, alanine, glycine glutamic acid or aspartic acid. The inclusion of a basic amino acid is preferred Le. arginine, lysine and/or histidine. If a composition includes histidine then this may act both as a buffering agent and a free amino acid, but when a histidine buffer is used it is typical to include a non-histidine free amino acid e.g. to include histidine buffer and lysine. An amino acid may be present in its D- and/or L- form, but the L-form is typical. The amino acid may be present as any suitable salt e.g. a hydrochloride salt, such as Arginine-HCI.

When present, components (i) to (iv) will be at a pre-lyophilusation concentration sufficient to maintain the anti-sclerostin antibody in a form which is active and soluble after storage (under normal conditions) and reconstitution. The components will also be present after reconstitution.

Thus a sugar may be present before Iyophilisation at a concentration of between 3 and 300 mM e.g. 15-200 mM, 30-150 mM, 80-100 mM. A concentration of 90 mM sucrose or trehalose is useful.

A buffering agent may be present before Iyophilisation at a concentration of between 1 and 60 mM e.g. 3-30 mM, 6-20 mM, 8- 1 S mM. A concentration of JO mM histidinc buffer is useful. A surfactant may be present before Iyophilisation at a concentration of up to 0.2% (by volume) e.g. 0.01-0.1%, 0.01 -0.08%, 0.01-0.04%. A concentration of 0.02% polysorbate 80 is useful.

A free amino acid may be present before Iyophilisation at a concentration of between 2 and 80 m M e.g. 3-50 mM, 6-30 mM, 10-25 mM, 15-20 mM. A concentration of 17 mM arginine-HCI is useful.

A formulation containing histidine buffer, sucrose and polysorbate 80 has been shown to be suitable for Iyophilisation of antibody BPS804. Additional inclusion of arginine reduces BPS804 aggregation,

A lyophiiisate may include active ingredients in addition to the mAb. For instance, further pharmacological agents may be included, such as chemotherapeutic compounds. For instance, methotrexate may be included, and it is known to include methotrexate sodium in lyophilisates.

The pH of an aqueous mAb formulation prior to Iyophilisation may be in the range 4.0-8.0, which a pH in the range 6.0-7.4 being typical. Some anti-sclerostin antibodies are not stable in aqueous solution above pit 6.0 and so a composition may have a pH in the range of 5.0 to 6.0. For instance, a pre-lyophilisatiαn pH of 5.3+0.1 Ls suitable for BPS804.

Aqueous reconstiiuthn

Before a lyophiiisate can be administered to a patient it should be reconstituted with an aqueous reconsthucnt. This step permits antibody and other components in the lyophiiisate to re-dissolve to give a solution which is suitable for injection to a patient.

The volume of aqueous material used for reconstitution dictates the concentration of mAb in a resulting pharmaceutical composition. Reconstitution with a smaller volume of reconstituent than the pre-lyophilisatϊon volume provides a composition which is more concentrated than before Iyophilisation. As mentioned above, lyophilisates of the invention can be reconstituted to give aqueous compositions with an anti-sclerostin antibody concentration of at least 25 mg/ml (or higher), and the volume of reconstituent will be selected accordingly. Typical rcconslituents for lyophilised mAbs include sterile water or buffer, optionally containing a preservative. If the lyophiiisatc includes a buffering ugent then the reconstituent may include further buffering agent (which may be the same as or different from the lyophilisate's buffering agent) or it may instead include no buffering agent {e.g. WFI₁ physiological saline). When present, components (i) to (iv) mentioned above will be at a concentration sufficient to maintain the anlksclerostin antibody in active soluble form, after reconstitution, under normal storage conditions while retaining pharmaceutical acceptability at the point of use.

Thus a sugar may be present after reconstitution at a concentration of between IO and 800 mM e.g. 50-500 mM, 100-400 mM, 200-300 mM. A concentration of 270 mM sucrose or trehalose is useful. Λ buffering agent may be present afler reconstilution at a concentration of between 2 and 200 mM e.g. 5-150 mM, 10-100 mM, 15-50 mM, 20-40 mM, 25-35 mM. A concentration of 30 mM histidine buffer is useful.

A surfactant may be present afler reconstitution at a concentration of up to 0.5% (by volume) e.g. 0.001-0.2%, 0.01-0.1%, 0.04-0.08%, 0.05-0.07%. A concentration of 0.06% polysorbate 80 is useful. A free amino acid may be present after reconstitution at a concentration of between 5 and 250 mM e.g. i 0-150 mM, 20-100 mM, 40-80 mM, 50-70 mM. A concentration of 51 mM arginme-HCI is useful.

An aqueous reconstituem may include pharmacological agents, such as chcmotherapeutic compounds, facilitating co-deiivery together with the mAb. After reconstitution, compositions of the invention include anti-sclerostin antibody, and less than 1% of the total anti-scleroslin antibody is aggregated (as measured by SEC-MPLC) e.g. <0,5%, <0.4%. <0.3%, etc.

Ideally, aqueous reconstfrution does not result in formation of a gel. If the pH of the aqueous reconstituenl for BPS804 is too high, for instance, the reconstituted material can spontaneously form a gel, but it is preferred that aqueous compositions of the invention will remain as liquid solutions.

Pharmaceutical compositions

Lyophilisates of the invention can be reconstituted to give aqueous pharmaceutical compositions. Such compositions are pharmaceutically acceptable and are suitable for administration to a patient, in addition to mAb and water they may include further components, derived from the lyophilisate and/or the reconstituem. Such components include, but are not limited to, buffers, salts, amino acids, glycerol, alcohols, preservatives, surfactants, etc. A thorough discussion of such pharmaceutical ingredients is available in reference 20. The use of mAbs as the active ingredient of pharmaceuticals is now widespread, including the products HERCEPTIN™ (trastuzumab), RlTUXAN ™ (rituximab), SYNAGJS™ (palivizumab), etc. Techniques for purification of mAbs to a pharmaceutical grade are well known in the art.

The composition will usually be sterile, at least at the time of its formation. The composition will usually be non-pyrogenic e.g. containing <1 EU (endotoxin unit, a standard measure) per dose, and preferably <0.l EU per dose. The composition is preferably gluten-free.

Within formulations of the invention, a mAb preferably makes up at least 80% by weight (e.g. at least 90% 95%, 97%, 98%, 99% or more) of the total protein in the formulation. The mAb is thus in purified form.

Target diseases and disorders

Anii-sclerostin antibodies can be used to treat or prevent a variety of diseases or disorders. These include diseases and disorders in which bone mineral density (BMD) Is abnormally and/or pathological Iy high relative tυ healthy subjects, such as sclerostcosis, Van Buchem disease, bone overgrowth disorders_* and Simpson-GoJabi-Behmel syndrome (SGBS). They also include diseases and disorders in which bone mineral density (BMD) is abnormally and/or pathologically low relative to healthy subjects, such as osteoporosis (primary and/or secondary), osteopenia, osteomalacia, osteogenesis imperfecta (01), avascular necrosis (osteonecrosis), fractures and implant healing (dental implants and hip implants), bone loss due to other disorders (e.g. associated with H)V infection, cancers, or arthritis). Further sclcrostitwclated disorders include, but are not limited to, rheumatoid arthritis, osteoarthritis, arthritis, hypophosphatasia (including adult-onset hypophosphatasia) and the formation and/or presence of osteolytic lesions.

The disease/disorder will generally be mediated by sclerostin, or be associated with or characterized by aberrant selerostin levels. These include cancers and osteoporotic conditions {e.g. osteoporosis or osteopenia). Sclerostin -related cancers can include myeloma {e.g. multiple myeloma with osteolytic lesions), breast cancer, colon cancer, melanoma, hepatocellular cancer, epithelial cancer, esophageal cancer, brain cancer, lung cancer, prostate cancer, or pancreatic cancer, as well as any metastases thereof.

A sclet'ostin-related disorder can also include renal and cardiovascular conditions, due at least to sclerostin's expression in the kidney and cardiovasculature. Said disorders include, but are not limited to, such renal disorders as glomerular diseases (e.g. acute and chronic glomerulonephritis, rapidly progressive glomerulonephritis, nephrotic syndrome, focal proliferative glomerulonephritis, glomerular lesions associated with systemic disease, such as systemic lupus erythematosus, Goodpasture's syndrome, multiple myeloma, diabetes (e.g. type 2 diabetes), polycystic kidney disease, neoplasia, sickle cell disease, and chronic inflammatory diseases), tubular diseases (e.g. acute tubular necrosis and acute renal failure, polycystic renal disease, medullary sponge kidney, medullary cystic disease, nephrogenic diabetes, and renal tubular acidosis), tubulointerstitial diseases (e.g. pyelonephritis, drug and toxin induced tubulointerstUial nephritis, hypercalcemic nephropathy, and hypokalemic nephropathy) acute and rapidly progressive renal failure, chronic renal failure, nephrolithiasis, gout, vascular diseases (e.g. hypertension and nephrosclerosis, microangiopathic hemolytic anemia, atheroembolic renal disease, diffuse cortical necrosis, and renal infarcts), or tumors {e.g. renal cell carcinoma and nephroblastoma).

Target diseases/disorders also include cardiovascular disorders such as ischemic heart disease (e.g. angina pectoris, myocardial infarction, and chronic ischemic heart disease), hypertensive heart disease, pulmonary heart disease, valvular heart disease (e.g. rheumatic fever and rheumatic heart disease, endocarditis, mitral valve prolapse, and aortic valve stenosis), congenita) heart disease (e.g. valvular and vascular obstructive lesions, atrial or ventricular septal defect, and patent ductus arteriosus), or myocardial disease {e.g. myocarditis, congestive cardiomyopathy, and hypertrophic cariomyopathy).

Patient administration

A pharmaceutical composition of the invention can be administered to a patient. Administration will typically be via a syringe. Thus the invention provides a delivery device (e.g. a syringe) including a pharmaceutical composition of the invention.

Patients will receive an effective amount of the mAb active ingredient i.e. an amount thai is sufficient to detect, treat, ameliorate, or prevent the disease or disorder in question. Therapeutic effects may also include reduction in physical symptoms. The optimum effective amount and concentration of mAb for any particular subject will depend upon various factors, including the patient's age size health and/or gender, the nature and extent of the condition, the activity of the particular mAb, the rate of its clearance by the body, and also on any possible further theraρeutic(s) administered in combination with the mAb. The effective amount delivered for a given situation can be determined by routine experimentation and is within the judgment of a clinician. For purposes of the present invention, an effective dose may be from about 0.01 mg/kg to about 50 mg/kg, or about 0.05 mg/kg to about 10 mg/kg. Known antibody-based pharmaceuticals provide guidance in this respect e.g. HERCEPTIN™ is administered with an initial loading dose of 4 mg/kg body weight and a weekly maintenance dose of 2 mg/kg body weight; R1TUXAN™ is administered weekly at 375 mg/m²; SYNAG1S™ is administered intramuscularly at 15 mg/kg body weight; etc. The invention provides a method for delivering a monoclonal antibody to a mammal, comprising a step of administering to the patient a pharmaceutical composition of the invention.

The invention also provides a method for delivering a monoclonal antibody to a mammal, comprising steps of: (i) reconstituting a lyophilisate of the invention to give an aqueous formulation, and (ii) administering the aqueous formulation to (he patient. Step (it) ideally takes place within 24 hours of step (i) e.g. within 12 hours, within 6 hours, within 3 hours, or within 1 hour. The invention also provides formulations of the invention for use as medicaments e.g. for use in delivering a monoclonal antibody to a mammal, or for use in treating one or more of the diseases and disorders described above.

The mammal is preferably a human but may also be, for example, a horse or a cow or a dog or a cat. The mAb will ideally be chosen to match the target species e.g. a human antibody for human administration, an equine antibody for horses, a canine antibody for dogs, etc. If native host antibodies are not available then transfer of antibody specificity from one species to another can be achieved by transfer of CDR residues (and typically, in addition, one or more framework residues) from a donor antibody into a recipient framework from the host species e.g. as in humanisation. Equinised, bovinised, canitiised and fclinised antibodies are known in the art. The antibody will bind to sclerostin from the target species, but it may also cross-react with sclcrostin from other species- Dosage can be by a single dose schedule or a multiple dose schedule.

Ingredients for forming compositions of the invention (e.g. lyophilisates and reconstiluents) may be supplied in hermetically-scaled containers.

The monoclonal antibody

The invention concerns the formulation of anti-sclerostin monoclonal antibodies. The term "monoclonal" as originally used in relation to antibodies referred to antibodies produced by a single clonal line of immune cells, as opposed to "polyclonal"' antibodies that, while ail recognising the same target protein, were produced by different B cells and would be directed to different epitopes on that protein. As used herein, the word "monoclonal*¹ does not imply any particular cellular origin, but refers to any population of antibodies that display a single binding specificity and affinity for a particular epitope in the same target protein. This usage is normal e.g. the product datasheets for the CDR-grafled humanised antibody SYNAG1S™ expressed in a murine myeloma NSO cell line, for the humanised antibody HEIICΕPT1N™ expressed in a CMO cell line, and for the phage-displayed antibody HUMIRΛ™ expressed in a CHO cell line, all refer to the active ingredients as "monoclonal" antibodies.

Thus a mAb may be produced using any suitable protein synthesis system, including immune cells, non-immune cells, acellular systems, etc. A mAb can thus be produced by a variety of techniques, including conventional monoclonal antibody methodology (e.g. the standard somatic cell hybridization technique of. Kohler & Milstein), by viral or oncogenic transformation of B lymphocytes, by combinatorial synthesis, by phage display, etc.

Antibodies used with the invention can take various forms. For instance, they may be native antibodies, as naturally found in mammals. Native antibodies are made up of heavy chains and light chains. The heavy and light chains are both divided into variable domains and constant domains. The ability of different antibodies to recognize different antigens arises from differences in their variable domains, in both the tight and heavy chains. Light chains of native antibodies in vertebrate species are either kappa (K) or lambda (λ), based on the amino acid sequences of their constant domains. The constant domain of a native antibody's heavy chains will be α, ό, ε, γ or μ. giving rise respectively to antibodies of IgA, IgD, IgK, IgG, or IgM class. Classes may be further divided into subclasses or isotypes e.g. IgGl , IgG2, IgG3, JgG4. IgA, !gA2, etc. Antibodies may also be classified by allotype e.g. a γ heavy chain may have GIm allotype a, f, x or z, G2m allotype n, or G3m allotype bθ, bl, b3. b4. b5, c3, c5, gl. g5, s, t, u, or v; a K light chain may have a Km(I), K.m(2) or Km(3) allotype. A native IgG antibody has two identical Iighl chains (one constant domain Ci and one variable domain Vi ) and two identical heavy chains (three constant domains CnI Q_\2 & C^"Η3 and one variable domain V_H), held together by disulfide bridges. The domain and three-dimensional structures of the different classes of native antibodies are well known.

Where an antibody of the invention has a light chain with a constant domain, it may be a tc or λ light chain. Where an antibody of the invention has a heavy chain with a constant domain, it may be an α, δ, ε, γ or μ heavy chain. 1 leavy chains in the γ class (i.e. IgG antibodies) are preferred.

Antibodies of the invention may be fragments of native antibodies that retain antigen binding activity. For instance, papain digestion of native antibodies produces two identical antigen-binding fragments, called "'Fab'" fragments, each with a single antigen-binding site, and a residual "Fc" fragment without antigen-binding activity. Pepsin treatment yields a "F(abV fragment thai has two antigen-binding sites. "Fv" is the minimum fragment of a native antibody that contains a complete antigen-binding site, consisting of a dimer of one heavy chain and one light chain variable domain. Thus an antibody of the invention may be Fab, Fab¹, F(ab')_2τ Fv, or any other type, of fragment of a native antibody.

An antibody of the invention may be a "single-chain Fv-" ("sclV or "sFv"), comprising a V_H and Vj domain as a single polypeptide chain [2J-23J. Typically the V₍₁ and Vi, domains are joined by a short polypeptide linker [e.g. >I2 amino acids) between the V_H and Vi. domains that enables the scFv to form the desired structure for antigen binding. A typical way of expressing scFv proteins, at least for initial selection, is in the context of a phage display library or other combinatorial library [24-26]. Multiple scFvs can be linked in a single polypeptide chain |27J.

An antibody of the invention may be a "diabody" or "triabody" etc. [28-31], comprising multiple linked Fv (scFv) fragments. By using a linker between the Vn and V₁. domains that is too short to allow them to pair with each other (e.g. <12 amino acids), they are forced instead to pair with the complementary domains of another Fv fragment and thus create two antigen-binding sites. These antibodies may include CN and/or C_L domains.

An antibody of the invention may be a single variable domain or VHH antibody. Antibodies naturally found in cameiids (e.g. camels and llamas) and in sharks contain a heavy chain but no light chain. Thus antigen recognition is determined by a single variable domain, unlike a mammalian native antibody [32-34], The constant domain of such antibodies can be omitted while retaining antigen-binding activity. One way of expressing single variable domain antibodies, at least for initial selection, is in the context of a phage display library or other combinatorial library [35].

An antibody of the invention may be a "'domain antibody'" (dΛb). Such dAbs are based on the variable domains of cither a heavy or light chain of a human antibody and have a molecular weight of approximately 13 kDa (less than one-tenth the size of a full antibody). By pairing heavy and light chain dAbs that recognize different targets, antibodies with dual specificity can be made. dAbs are cleared from the body quickly and so benefit from a sustained release system, but can additionally be sustained in circulation by fusion to a second dAb that binds to a blood protein (e.g. to serum albumin), by conjugation to polymers (e.g. to a polyethylene glycol), or by other techniques. The antibody may have a scaffold which is based on the fibronectin type Ul domain, as disclosed in reference 36 e.g. an adnectin or trinectin. The fibronectin-bascd scaffold is not an immunoglobulin, although the overall fold is closely related to that of the smallest functional antibody fragment. Because of this structure ihe non-immunoglobulin antibody mimics antigen binding properties that are similar in nature and affinity to those of natural antibodies. The FnIIl domain has 7 or 8 beta strands which are distributed between two beta sheets, which themselves pack against each other to form the core of the protein, and further containing loops (analogous to antibody CORs) which connect the beta strands Io each other and are solvent exposed. There are at least three such loops at each edge of the beta sheet sandwich, where the edge is the boundary of the protein perpendicular to the direction of the beta strands. The TnIH loops can be replaced with immunoglobulin CDRs using standard cloning techniques, and can be used in a loop randomization and shuffling strategy in vitro that is similar to the process of affinity maturation of antibodies in viwt. The FnIH scaffold may be based on the tenth module of fibronectin type Hl (i.e. 10Fn3).

Thus the term "antibody^1* as used herein encompasses a range of proteins having diverse structural features, but usually including at least one immunoglobulin domain, having an all-β protein fold with a 2-layer sandwich of anti-parallel β-stιands arranged in two β-sheets.

Antibodies used with the invention may include a single antigen-binding site (e.g. as in a Fab fragment or a scFv) or multiple antigen-binding sites (e.g. as in a P(ab^*)j fragment or a diabody or a native antibody). Where an antibody has more than one antigen-binding site then advantageously it can result in cross-linking of antigens. Where an antibody has more than one antigen-binding site, the antibody may be mono-specific (i.e. all antigen -binding sites recognize the same antigen) or it may be multi-specific (i.e. the antigen- binding sites recognise more than one antigen).

An antibody of the invention may include a non-protein substance e.g. via covalent conjugation. For example, an antibody may include a radio-isotope e.g. the ZEVAUN^"11* and BEXXAR™ products include ⁹⁰Y and ' ^sι 1 isotopes, respectively. As a further example, an antibody may include a cytotoxic molecule e.g. MYLOTARG™ is linked to N~acety!-γ~ealicheamicin, a bacterial toxin. As a further example, an antibody may include a covalently-attached polymer e.g. attachment of polyoxyethylated polyols or polyethylene glycol (PEG) has been reported to increase the circulating half-life of antibodies.

In sonic embodiments, an antibody can include one or more constant domains (e.g. including Cu or C|, domains), As mentioned above, the constant domains may form a K or λ light chain or an α, δ, ε, γ or μ heavy chain. Where an antibody includes a constant domain, it may be a native constant domain or a modified constant domain. A heavy chain may include either three (as in α, γ, ft classes) or four

(as in μ, e classes) constant domains. Constant domains are not involved directly in the binding interaction between an antibody and an anligen, but they can provide various effector functions, including but not limited to: participation of the antibody in antibody-dependent cellular cytotoxicity

(ADCC); CIq binding; complement dependent cytotoxicity; Fc receptor binding; phagocytosis; and down-regulation of cell surface receptors.

The constant domains can form a "Fc region", which is the C-terminal region of a native antibody's heavy chain. Where an antibody of the invention includes a Fc region, it may be a native Fc region or a modified Fc region. A Fc region is important for some antibodies' functions e.g. the activity of HERCEPTIN™ is Fc-dependeiτt. Although the boundaries of the Fc region of a native antibody may vary, the human IgG heavy chain Fc region is usually defined to stretch from an amino acid residue at position Cys226 or Pro230 to the heavy chain's C-terminus. The Fc region will typically be able to bind one or more Fc receptors, such as a FcγRI (CD64)_S a FcγRli (e.g. FcγRIIΛ, FcγRlIBI , FcγRilB2, FcγRllC), a FcγRI H (e.g. FcγRIIIA, FcγRlUB), a FcRn, FcαR (CD89), FcSR, FcμR, a FcεRI (e.g. FcεRlαβγ2 or Fc&RIαtø), FcεRII (e.g. FcεRHA or FcεRllB), etc. The Fc region may also or alternatively be able to bind to a complement protein, such as CIq. Modifications to an antibody's Fc region can be used to change its effector function^) e.g. to increase or decrease receptor binding affinity. For instance, reference 37 reports that effector functions may be modified by mutating Fc region residues 234, 235, 236, 237, 297, 318, 320 and/or 322. Similarly, reference 38 reports thai effector functions of a human IgGl can be improved by mutating Fc region residues (EU Index Kabat numbering) 238, 239, 248, 249, 252, 254, 255. 256, 258, 265, 267, 268, 269, 270, 272, 276, 278, 280, 283, 285, 286, 289, 290, 292, 294, 295, 296, 298, 301, 303, 305, 307, 309, 312, 315, 320. 322, 324, 326, 327, 329, 330, 331, 333, 334, 335, 337, 338, 340, 360, 373, 376, 378, 382. 388, 389, 398, 414, 416, 419, 430, 434, 435, 437. 438 and/or 439. Modification of Fc residues 322, 329 and/or 331 is reported in reference 39 for modifying CIq affinity of human IgG antibodies, and residues 270, 322, 326, 327, 329, 331, 333 and/or 334 are selected for modification in reference 40. Mapping of residues important for human IgG binding to FcRl, FcRII, FcRlII, and FcRn receptors is reported in reference 41 , together with the design of variants with improved FcR-binding properties. Whole Cu domains can be substituted between isotypes e.g. reference 42 discloses antibodies in which the C_Tj3 domain (and optionally the Cn2 domain) of human lgG4 is substituted by the C>|3 domain of human IgGl to provide suppressed aggregate formation. Reference 42 also reports that mutation of arginine at position 409 (EU index Kabat) of human IgG4 to e.g. lysine shows suppressed aggregate formation. Mutation of the Fc region of available monoclonal antibodies Io vary their effector functions is known e.g. reference 43 reports mutation studies for RlTUX AN™ to change Ciq-bϊnding, and reference 44 reports mutation studies for N UMAX™ to change FcR-binding, with mutation of residues 252, 254 and 256 giving a 10-fold increase in FcRn-binding without affecting antigen-binding.

Antibodies will typically be glycosylated. N-linked glycans attached to the C »2 domain of a heavy chain, for instance, can influence CIq and. FcR binding [41], with aglycosylated antibodies having lower affinity for these receptors. The glycan structure can also affect activity e.g. differences in complement-mediated cell death may be seen depending on the number of galactose sugars (0, 1 or 2) at the terminus of a glycan's biantennary chain. An antibody's glycans preferably do not lead to a human immunogenic response after administration.

Antibodies can be prepared in a form free from products with which they would naturally be associated. Contaminant components of an antibody's natural environment include materials such as enzymes, hormones, or other host cell proteins.

Useful antibodies have nanomolar or picomolar affinity constants for (heir target antigens e.g. 10^"9 M₁ 10^Oϋ M, lO^{"! l} M, !0^"'² M, 10^"13 M or tighter). Such affinities can be determined using conventional analytical techniques e.g. using surface plasmon resonance techniques as embodied in BIAcore™ instrumentation and operated according to the manufacturer's instructions. Radio- immunoassay using radiolabeled target antigen (sclerostin) is another method by which binding affinity may be measured.

The monoclonal antibody used with the invention may be a human antibody, a humanized antibody,, a chimeric antibody or (particularly for veterinary purposes) a non-human antibody.

In some embodiments the antibodies arc human niAbs. These can be prepared by various means. For example, human B cells producing an antigen of interest can be immortalized e.g. by infection with

Epstein Barr Virus (EBV), optionally in the presence of a polyclonal B cell activator [45 & 46].

Human monoclonal antibodies can also be produced in non-human hosts by replacing the host's own immune system with a functioning human immune system e.g. into Scid mice or Trimera mice.

Transgenic and transchromosomic mice have been successfully used for generating human monoclonal antibodies, including the "humab mouse" from Medarex and the "xeno-mousc" from

Abgenix [47], collectively referred to herein as "human Ig mice". Phage display has also been successful [48], and led to the MUMIRA™ product. Unlike non-human antibodies, human antibodies will not elicit an immune response directed against their constant domains when administered to humans. Furthermore, the variable domains of these human antibodies are fully human (in particular the framework regions of the variable domains are fully human, in addition to the complementarity determining regions [CDRs]) and so will not elicit an immune response directed against the variable domain framework regions when administered to humans (except, potentially, for any anti-idiotypic response). Human antibodies do not include any sequences that do not have a human origin.

In some embodiments the antibodies are humanised mAbs. CDR-grafted mAbs or chimeric mAbs. These can be prepared by various means. For example, they may be prepared based on the sequence of a non-human (e.g. murine) monoclonal antibody. DNA encoding the non-human heavy and light chain immunoglobulins can be obtained and engineered to contain human immunoglobulin sequences using standard molecular biology techniques. For example, to create a chimeric antibody, the murine variable regions can be linked to human constant regions using methods known in the art. To create a CDR-grafted antibody, the murine CDR regions can be inserted into a human framework [49-54]. To create a humanized antibody, one or more non-CDR variable framework residue(s) is also altered. The Hl, H2 and 113 CDRs may be transferred together into an acceptor Vn domain, but it may also be adequate to transfer only one or two of them [52|. Similarly, one two or all three of the Ll, L2 and L3 CDRs may be transferred into an acceptor V₁. domain. Preferred antibodies will have 1 , 2, 3, 4. 5 or all 6 of the donor CDRs. Where only one CDR is transferred, it will typically not be the L2 CDR, which is usually the shortest of the six. Typically the donor CDRs will all be from the same human antibody, but it is also possible to mix them e.g. to transfer the light chain CDRs from a first antibody and the heavy chain CDRs from a second antibody.

Anti-sclerostin antibodies useful with the present invention may include one or more (1 , 2, 3, 4, 5 or 6) CDRs from BPS804. The CDRs in the heavy chain are SEQ ID NOs: 3, 4 & S. The CDRs in the light chain are SEQ ID NOs: 6, 7 & 8.

In some embodiments the antibodies are non-human mAbs, These can be prepared by various means e.g. the original Kohler & Milstein technique for preparing murine mAbs.

In some embodiments of the invention, the antibody has a variable domain with an isoelectric point (pi) in the range of 5.0 Io 8.0. In some embodiments the antibody is an lgG2. One suitable ami-sclciOStin antibody for use with die invention is BPS804. Thus the anti-sclerostin antibody may have a V_H domain with amino acid SRQ ID NO: 1 and/or a Vi, domain with amino acid SEQ ID NO: 2. The antibody may comprise SEQ ID NOs: 9 and 10.

Further antibodies

Although the invention is presented above in relation to anti-sclerostin antibodies, the formulation disclosed herein is also suitable for use with antibodies which recognise antigens other than sclerostin. Thus the invention provides a lyophilisate comprising a monoclonal antibody, sucrose, a histidine buffer, polysorbate 80 and arginine. This lyophilisate can be reconstituted with an aqueous reconstituent, and the invention also provides an aqueous pharmaceutical composition comprising a monoclonal antibody, sucrose, a hislidine buffer, polysorbate 80 and arginine. The reconstituted composition obtainable from the lyophilisate may have an antibody concentration of at least 25mg/ml (as described above) in which less than 1% of the anli-scleroslin is aggregated (as described above).

The invention also provides a process for preparing a lyophilisate, comprising steps of: (i) preparing an aqueous solution comprising a monoclonal antibody, sucrose, a histidine buffer, polysorbate 80 and free argininc; and (ii) lyophilising the aqueous solution. The invention also provides a process for preparing a composition, comprising a step of mixing a lyophilisate with an aqueous reeonsiiUient, wherein the lyophilisate comprises a monoclonal antibody, sucrose, a histidine buffer, polysorbate 80 and free argininc. Sucrose may be present at a concentration of between 10 and 800 mM e.g. 50-500 mM, 100-400 mM, 2OQ-300 mM. Λ concentration of 270 mM sucrose is useful.

The histidine buffer may be present at a concentration of between 5 and 50 mM e.g. 10-45 mM, 20 40 mM, 25-35 mM. A concentration of 30 mM histidine buffer is useful.

The polysorbate 80 may be present at a concentration of up to 0.5% (by volume) e«g. 0.01 -0.1%, 0.04-0.08%, 0.05-0.07%. A concentration of 0.06% polysorbate 80 is useful.

The arginine may be present at a concentration of between 5 and 250 mM e.g. 10-150 mM_» 20 100 mM, 40-80 mM, 50-70 mM. A concentration of 51 mM arginine-UCI is useful.

The pH of an aqueous mAb formulation prior to lyophilisation may be in the range 5.0-8.0. Typical ^constituents for the lyophilised mAb include sterile water or buffer, as described above.

General

The practice of the present invention will employ, unless otherwise indicated, conventional methods of chemistry, biochemistry, molecular biology, immunology, pharmacy, posology and pharmacology, wiihin the skill of the art. Such techniques are explained fully in the literature. See, e.g. references 55-61, etc. The term "comprising" encompasses "including" as well as ''consisting" e.g. a composition "comprising" X may consist exclusively of X or may include something additional e.g. X 4 Y.

The term "about" in relation to a numerical value x is optional and means, for example, Λ±10%.

The word "substantially" does not exclude "completely" e.g. a composition which is "substantially free" from Y may be completely free from Y. Where necessary., the word "substantially" may be omitted from a definition of the invention.

BRIEF DESCRIPTION OF DRAWINGS

There are no drawings. MODES FOR CARRYING OUT THE INVENTION

Antibody 'BPS804' recognises sclcrostin and is disclosed as 'MOR.05813^* in reference 10. U Is a human lgG2λ mAb obtained via phage display. Its heavy and light chains are SEQ II) NOs: 9 and 10.

Λ high concentration iyophilised formulation of UPS804 was desired and so formulation studies were performed. A Iyophilised formulation comprising a sugar, a buffering agent and a surfactant was stable at 2-8'C and could maintain high antibody concentrations after rcconstJtution. Addition of arginine-HCI to the formulation reduced aggregation.

Three formulations (FI, F2, F3) of BPS804 at 100 mg/vial were evaluated for stability in a first study. Each formulation had, prior to iyophilisation, 33.3 mg/ml BPS804, pH 5,3. and a fill volume of 3.6 ml. The three formulations included buffer, sugar, surfactant and free amino acid as follows:

The lyophilisates were reconstituted with WFI to giving a reconstituted volume of 1.2ml (20% overage; 1/3 the original aqueous volume). Thus the reconstituted compositions were as follows, all containing I OOmg/ml antibody:

The three reconstituted formulations were tested for stability (i) prior to Iyophilisation, (ii) after immediate post-lyophilisation reconstitution, and (iii) after rcconslitution following storage at 2-8°C or 40⁰C for four weeks. Stability was evaluated by % aggregates (measured by SEC-I-PLC) and by clarity (assessed by visual inspection after overnight storage at 2-8'C), Aggregation results from SBC-HLPC were as follows:

Visual clarity was as follows:

Thus F3 showed (he lowest aggregation of BPS804 after reconsthution, measured both by SiϊC- MPLC and by visual appearance.

Based on these results a second study was performed with a higher antibody concentration using formulations Fl and F3. The pre-lyophilisation antibody concentration was increased to 50 mg/ml but other components were as before. Reconstitution with WFI to a 1 ,2 ml volume was again used. Thus the reconstituted compositions were as follows, all containing lSOmg/ml antibody:

Buffer Sugar Surfactant Amino acid

Fl' 30 m.M histkiine 270 mM sucrose 0.06% polysαrbate 80

F3^» 3O mM histidine 270 mM sucrose 0.06% polysorbate 80 51 mM arginine-HC

The same stability tests were performed and results were as follows:

Again, therefore, the F3 formulation gave the best stability.

It will be understood that the invention witl be described by way of example only, and that modifications may be made whilst remaining within the scope and spirit of the invention.

REFERENCES

[l] WO2008/092894.

|2] WO2005/014650.

[3] WO2006/1 19062.

[4] WO2006/1 19l07.

[5] WO2008Λ>61013.

|6] WO2008/l 15732

[7| WO2008/133722.

[8] WO2006/102070,

[9] Li ϋt ah (2008) J Bone Miner Res 2008: 10.1359/jbmr,081206 l10) WO2009/047356.

( 1 1 } Rcy & May (2004) Freeze-Drymg/Lyophilάation Of Pharmaceutical & Biological Products ISBN 0824748689.

[12] WO92/15331.

113] US patent application 2008/0286280.

[14] WO03/041637. | 16] WO2008/029908.

[17J WO2007/074880.

[I 8] WO03/009817.

[ 19J WO98/022136.

120] Gcnnaro (2000) Remington: The Science and Practice of Pharmacy. 20th edition, ISBN: 0683306472.

[21] Worn & Pluckthun (2001) ./ MoI Biol. 30S(5):989-1010.

122] WO93/I6I85

[23] Adams & Schier (1999) J Immunol Methods. 231 (1 -2):249-όO.

[24] Hallborn & Carisson (2002) Biotechmques SuρρI:30-7.

{25] Pini & Bracci (2000) Curr Protein PcφtSci 1(2): 155-69.

[26] Walter et al. (2001 ) Comb Chem High Throughput Screen. 4(2): 193-205.

[27] Gruber et al ( 1994) J Immunol 152(1 1 ):5368-74.

[28] US-5591828

[29) WO 9371 1 161.

[30] HoI linger el al. (1993) Proc. Natl. Acad Sci. USA 90:6444-6448.

[31 ] Hudson & Kortt (1999) J Immunol Methods 231 : 177-89.

[32] Muyldermans (2001) J #røtøc/røø/ 74(4):277«302.

[33] Dumoulin d al. (2002) Protein ScL 1 l(3):5OO-15.

[34] Sidhu c/ tf/. (2004) J MoI Biol. 338(2):299-310.

[35] Kotz et βl. (2004) Eur J Biochem. 271(9): 1623-9.

[36] US patent 6,818,418.

[37] US patent 5,624,821.

[38] US patent 6,737,056.

[39] US patent 6,538, 124.

[40] US patent 6,528,624.

[41 J Shields et al. (2001 ) J Biol Chem 276:6591 -604.

[42] WO2006/033386.

[43] ldusogie et al (2000) J Immunol 164(8):4178-84.

[44] Dall'acqua ei al. (2006) J Biol Chem 28I(33):23514-24.

[45] WO2004/076677.

[46] Traggiai et al (2004) Nat Med 10(8):871-5.

[47] Cireen ( 1999) J Immunol Methods. 231 ( 1 -2): 1 1 -23.

[48] Mancini et al (2004) New Microbiol 27(4):315-28.

[49] Ewert et al. (2004) Methods 34(2): 184-99.

[50] Riechmann ^ a/. (1988) Nature 332:323-327.

[51] O'Brien & Jones (2003) Methods Mot Biol 207:81-100.

[52] Iwahashi et al. (1999) MoI Immunol. 36(15- 16): 1079-91.

[53] Lo (2004) Methods MoI Biol. 248:135-59.

[54] Verhoeyeπ et al. (1988) Science 239: 1534-1536.

[55] Methods In Enzymohgy (S. Colcwick and N, Kaplan, eds., Academic Press, Inc.)

[56] Handbook of Experimental Immunology, VoIs. i-l V (D.M. Weir and CC. Blackwell, eds, 1986, Blackweli Scientific Publications) [57] Sambrook et at. (2001) Molecular Cloning: A Laboratory Manual, 3rd edition (Cold Spring Harbor Laboratory Press).

[58J Handbook of Surface and Colloidal Chemistry (Birdi, K.S. ed., CIlC Press, 1997)

[59) Ausubet et ah (eds) (2002) Short protocols in molecular biology, 5th edition (Current Protocols).

[60] Molecular Biology Techniques: An Intensive laboratory Course, (Ream et al._t eds., 1998, Academic Press)

[61] PCR (Introtluctiou to Biotechniques Series), 2nd ed. (Newton & Graham eds., 1997, Springer Veriag)

SEQUENCE LISTING

SEQ ID NO: I

QVQLVi-SGGGLWPGGSLKI₁SCAASGFTFRSHWLSIV⁷VROAPGKOLEWVSNiNyDGSSTyYADvSVKGiU-¹Ti SRDNSKN

TLYLQMMSLRAKDTAVYYCARDTYLHFDYWGQGTLVTVSS SEQ ID NO: 2

DIALTQPASVSGSPGQSIT₁TSCTGTSSDVGDINDVSWYOQHPGKAPKLMIYDVNNRPSGVSNRP¹SGSXSGNTASiJTl

SGLQAEDSIADYYCQSYAGSYLSEVFGGUTKLTVIJGQ

SEQ ID NO: 3

GFTFRSHWL8 SEQ ID NO: 4

WVSNrN⁽YDGSSTYYADSVKG

SEQ ID NO: S

DTYLHFDY

SEQ ID NO: 6 TGTSSDVGDINDVS

SEQ ID NO: ?

LMTYDVNNRPS

SEQ ID NO: 8

QSYAGSYLSE

SEQ ID NO: 9

KΛV^^'LPFlJ^AAQSVQAQVQLVΞSGGGLVQlTϊGSLRLSCAASGFTFSSi^LS^^ROAPGKGL^vWSKlNYDGSST YYADSVKGRPTTSRDNSKm¹LYLQ-^SLRAEaTAVYYCARDTYLHFDY WGQGTLWΛ?SSASTKGPSVFP1ΛPCSRST SBSTAALGCLVKDYFPBPVTVSWNSGALTSGVIiTFPAVLQSSGLYSLSSNAm/PSSNFGTQTYTCmmKKPSiJTKVD KTVHiRKCCVSCPPCPAPPVAGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVQFNWYVTJGVEVHNAKTKPRI?. EOFNSTFRVVSVLTVVfIQDWLNGKEYKCKVSNXGLPAPrSKTISKTXGQPREPQWTI₁PPSHSEm^KNQVSLTCLVK GFYPSDlAVSWESKGQPHNNYKTTPPM.DSDGSFJ-'LYSKLTVϋKSRWΩQGNVFSCSVMH EALHNHYTQKSLSLSPGK

SEQ ID NO: 10

MSVLTQVLALLLLWLTGTRCDIMJTQPASVSGSPGQSITISCTGTSSDVGDINDVSWYQQHPGKAPKLMIYDVNNRP SGVSNRFSGSKSG-^!TASLTISGLQAEDS:ADYYCQSYACSYLSEVFGGGTKLTVT..GQPKAAPSVTLF^^JPSSEELQA^!K ATLVCLISDFYPGAV'rVAiVKADSSPVKAGVETTTPSKQSNNKyAASSYLSLTPSQWKSHRSYSCQVTHEGSTVEKTV APTSCS

Claims

I , A lyophiiisate comprising an anti-sclerostin monoclonal antibody, wherein the lyophilisate can be reconstituted with an aqueous recoiistituent (o provide an aqueous composition in which the antibody has a concentration of at least 25mg/ml. 2. A lyophilisate comprising an anti-sclerostin monoclonal antibody, wherein the lyophilisatc can be reconstituted with an aqueous reconstitυcnt to provide an aqueous composition in which less than 1% of the anti-sclerostin is aggregated.

3. A lyophilisate comprising: an anti-sclerostin monoclonal antibody; a sugar; a buffering agent; and a surfactant. 4. The lyophilisate of claim 2, also including a free amino acid.

5. The lyophilisatc of claim 1, claim 3 or claim 4, wherein the lyophilisatc can be reconstituted with an aqueous reeonstitueπl to provide an aqueous composition in which less than 1% of the anti- sclerostin is aggregated.

6. The lyophilisate of claim 2, claim 3 or claim 4, wherein the lyophilisate can be reconstituted with an aqueous reconstituent to provide an aqueous composition in which the antibody has a concentration of at least.25mg/ml.

7. The lyophilisate of claim 2 or claim 3, comprising one, two or three of: a sugar; a buffering agent; and a surfactant.

8. The lyophilisate of claim 7, also including a free amino acid. 9. The lyophilisate of any preceding claim, wherein the lyophilisates can be reconstituted to give an aqueous composition with an anti-sclerostin antibody concentration of at least 125 mg/ml.

10. The lyophilisate of any preceding claim, comprising sucrose.

I I. The lyophilisate of claim 10, comprising 200-300 inM sucrose.

12. The lyophilisate of any preceding claim, comprising a hislidine buffer. 13. The lyophilisate of claim 12, comprising 25-35 niM histidine buffer,

14. The lyophilisate of any preceding claim, comprising polysorbate 80.

15. The lyophilisate of claim 14, comprising 0.01 to 0.1% polysorbate 80. J 6. The lyophilisate of any preceding claim, comprising arginine.

17. The lyophiiisate of claim 15, comprising 40-80 mM arginine. 18. The lyophilisate of any preceding claim, comprising sucrose, a histidine buffer, polysorbate 80 and arginine.

20 The lyophiltsate of any preceding claim, wherein the anti-selerøstin antibody includes: (i) one or more heavy chain CDRs selected from the group consisting of SEQ ID NOs: 3, 4 & 5; and/or (ii) one or more light chain CDRs selected from the group consisting of SKQ ID NOs: 6, 7 & 8. The lyophilisate of any preceding claim, wherein the anti-sclerostin antibody has a Vn domain with amino acid SEQ ID NO: 1 and/or a V₁, domain with amino acid SKQ ID NO: 2. An aqueous pharmaceutical composition obtainable by reconstilution of the lyophilisate of any preceding claim with an aqueous recααstituent. A process for preparing the lyophilisate of any one of claims 1 to 20, comprising steps of: (i) preparing an aqueous solution comprising an anti-sciεrostin monoclonal antibody, a sugar, a buffering agent, a surfactant, and optionally a free amino acid; and (ii) tyophilising the aqueous solution. A process for preparing a pharmaceutical composition, comprising a step of mixing the lyophilisate of any one of claims I to 20 with an aqueous reconstitucnt. A deliver)' device including lite pharmaceutical composition of claim 21 or claim 23. A method for delivering an anti-sclerostin monoclonal antibody to a mammal, comprising a step of administering to the patient a pharmaceutical composition of claim 21 or claim 23. The composition of claim 2J or claim 23 for use in treating a disease or disorders in which bone mineral density is abnormally and/or pathologically high relative to healthy subjects. The composition of claim 21 or claim 23 for use in treating a disease or disorders in which bone mineral density is abnormally and/or pathologically low relative to healthy subjects. The composition of claim 21 or claim 23 for use in treating osteoporosis.