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Jensen VFH, Schefe LH, Jacobsen H, Mølck AM, Almholt K, Sjögren I, Dalsgaard CM, Kirk RK, Benie AJ, Petersen BO, Kyhn MS, Overgaard AJ, Bjørnsdottir I, Stannard DR, Offenberg HK, Egecioglu E. Normal Neurodevelopment and Fertility in Juvenile Male Rats Exposed to Polyethylene Glycol Following Dosing With PEGylated rFIX (Nonacog Beta Pegol, N9-GP): Evidence from a 10-Week Repeat-Dose Toxicity Study. Int J Toxicol 2022; 41:455-475. [DOI: 10.1177/10915818221121054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
N9-GP/Rebinyn®/Refixia® is an approved PEGylated (polyethylene glycol-conjugated) recombinant human factor IX intended for prophylactic and/or on-demand treatment in adults and children with haemophilia B. A juvenile neurotoxicity study was conducted in male rats to evaluate effects on neurodevelopment, sexual maturation, and fertility following repeat-dosing of N9-GP. Male rats were dosed twice weekly from Day 21 of age with N9-GP or vehicle for 10 weeks, followed by a dosing-free recovery period for 13 weeks and terminated throughout the dosing and recovery periods. Overall, dosing N9-GP to juvenile rats did not result in any functional or pathological effects, as measured by neurobehavioural/neurocognitive tests, including motor activity, sensory function, learning and memory as well as growth, sexual maturation, and fertility. This was further supported by the extensive histopathologic evaluation of brain tissue. Exposure and distribution of polyethylene glycol was investigated in plasma, choroid plexus, cerebrospinal fluid, and brain sections. PEG did not cross the blood brain barrier and PEG exposure did not result in any effects on neurodevelopment. In conclusion, dosing of N9-GP to juvenile rats did not identify any effects on growth, sexual maturation and fertility, clinical and histological pathology, or neurodevelopment related to PEG exposure and supports the prophylactic use of N9-GP in children.
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Affiliation(s)
- Vivi F. H. Jensen
- Department of Safety Sciences & Imaging, Novo Nordisk A/S, Måløv, Denmark
| | - Line H. Schefe
- Department of DMPK (Drug Metabolism and Pharmacokinetics) and Non-clinical Project Management, Novo Nordisk A/S, Måløv, Denmark
| | - Helene Jacobsen
- Department of DMPK (Drug Metabolism and Pharmacokinetics) and Non-clinical Project Management, Novo Nordisk A/S, Måløv, Denmark
| | - Anne-Marie Mølck
- Department of Safety Sciences & Imaging, Novo Nordisk A/S, Måløv, Denmark
| | - Kasper Almholt
- Department of Safety Sciences & Imaging, Novo Nordisk A/S, Måløv, Denmark
| | - Ingrid Sjögren
- Department of Safety Sciences & Imaging, Novo Nordisk A/S, Måløv, Denmark
| | | | - Rikke K Kirk
- Department of Safety Sciences & Imaging, Novo Nordisk A/S, Måløv, Denmark
| | - Andrew J. Benie
- Department of Biophysics & Formulation 1, Novo Nordisk A/S, Måløv, Denmark
| | - Bent O. Petersen
- Department of Biophysics & Formulation 1, Novo Nordisk A/S, Måløv, Denmark
| | - Mette S. Kyhn
- Department of Non-clinical and Clinical Assay Sciences, Novo Nordisk A/S, Måløv, Denmark
| | - Anne J. Overgaard
- Department of Non-clinical and Clinical Assay Sciences, Novo Nordisk A/S, Måløv, Denmark
| | - Inga Bjørnsdottir
- Department of DMPK (Drug Metabolism and Pharmacokinetics) and Non-clinical Project Management, Novo Nordisk A/S, Måløv, Denmark
| | | | - Hanne K. Offenberg
- Department of DMPK (Drug Metabolism and Pharmacokinetics) and Non-clinical Project Management, Novo Nordisk A/S, Måløv, Denmark
| | - Emil Egecioglu
- Department of DMPK (Drug Metabolism and Pharmacokinetics) and Non-clinical Project Management, Novo Nordisk A/S, Måløv, Denmark
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Wu W, Zhou J, Wu C, Zhou Q, Li X, Zhang Y, Zuo C, Yin J, Hou L, Wang S, Gao H, Luo T, Jin L, Zhong E, Wang Y, Luo X. PEGylated Recombinant Human Growth Hormone Jintrolong ® Exhibits Good Long-Term Safety in Cynomolgus Monkeys and Human Pediatric Growth Hormone Deficiency Patients. Front Endocrinol (Lausanne) 2022; 13:821588. [PMID: 35909512 PMCID: PMC9336684 DOI: 10.3389/fendo.2022.821588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 06/02/2022] [Indexed: 11/22/2022] Open
Abstract
Jintrolong® is a long-acting PEGylated recombinant human growth hormone (PEG-rhGH) developed for weekly injection in patients with pediatric growth hormone deficiency (PGHD). Although PEG modification of therapeutic proteins is generally considered safe, concerns persist about the potential for adverse vacuolation in tissues with long-term exposure to PEG-included therapies, particularly in children. We assessed the safety of Jintrolong® in cynomolgus monkeys with an examination of vacuolation in the brain choroid plexus (CP) and reported long-term clinical safety data obtained from children with PGHD. The toxicity of Jintrolong® was assessed following the 52-week administration with doses at 0.3, 1, or 3 mg/kg/week. The levels of vacuolation of CP in animals were dose-dependent and at least partially reversible after a 104- or 157-week recovery period. Vacuolation in the CP epithelium did not lead to obvious subcellular structural or cell functional abnormalities. Compared with the clinical dose of 0.2 mg/kg/week Jintrolong® in PGHD patients, exposure in monkeys under NOAEL 3 mg/kg/week exhibited safety margins greater than 120.5, the predicted minimum dose to induce vacuolation in monkeys is equivalent to 1.29 mg/kg/week in humans, which is 6.45-fold higher than the clinical dose. The safety data acquired in clinical trials for Jintrolong® were also analyzed, which included phase III (360 patients), phase IV (3,000 patients) of 26-week treatment, and a follow-up study with treatment lasting for 3 years. There was no statistically significant difference in the incidence of adverse reactions between the Jintrolong® group and the daily rhGH control group (no PEG), and no new adverse effects (AE) were observed in the Jintrolong® group at the clinical therapeutic dose of 0.2 mg/kg/week.
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Affiliation(s)
- Wei Wu
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Juan Zhou
- Center for Nonclinical Research and Translational Medicine, Changchun GeneScience Pharmaceuticals Co., Ltd., Changchun, China
| | - Chuandong Wu
- Department of Toxicology, JOINN Laboratories (Suzhou) Co., Ltd., Suzhou, China
| | - Qian Zhou
- Center for Nonclinical Research and Translational Medicine, Changchun GeneScience Pharmaceuticals Co., Ltd., Changchun, China
| | - Xiaoyu Li
- Center for Nonclinical Research and Translational Medicine, Changchun GeneScience Pharmaceuticals Co., Ltd., Changchun, China
| | - Yanlin Zhang
- Department of Toxicology, JOINN Laboratories (Suzhou) Co., Ltd., Suzhou, China
| | - Conglin Zuo
- Department of Toxicology, JOINN Laboratories (Suzhou) Co., Ltd., Suzhou, China
| | - Jun Yin
- Department of Toxicology, JOINN Laboratories (Suzhou) Co., Ltd., Suzhou, China
| | - Ling Hou
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shuyang Wang
- Department of Pathology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Hongyang Gao
- Electron Microscope Core Laboratory, Shanghai Medical College, Fudan University, Shanghai, China
| | - Tianhong Luo
- Center for Nonclinical Research and Translational Medicine, Changchun GeneScience Pharmaceuticals Co., Ltd., Changchun, China
| | - Lei Jin
- Center for Nonclinical Research and Translational Medicine, Changchun GeneScience Pharmaceuticals Co., Ltd., Changchun, China
| | - Enhong Zhong
- Center for Nonclinical Research and Translational Medicine, Changchun GeneScience Pharmaceuticals Co., Ltd., Changchun, China
| | - Yingwu Wang
- School of Life Science, Jilin University, Changchun, China
- *Correspondence: Xiaoping Luo, ; Yingwu Wang,
| | - Xiaoping Luo
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Xiaoping Luo, ; Yingwu Wang,
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Kaufman L, Gore K, Zandee JC. Data Standardization, Pharmaceutical Drug Development, and the 3Rs. ILAR J 2017; 57:109-119. [PMID: 28053065 DOI: 10.1093/ilar/ilw030] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 10/09/2016] [Indexed: 11/13/2022] Open
Abstract
Despite the efforts, cost, and extensive use of animals for nonclinical research, only a small number of studies have methodically compared findings from animal toxicology studies to those from human clinical trials. Impediments to understanding the translation of nonclinical safety have included the lack of easy access to data and the need for extensive data curation given the diverse terminologies, formats, and data platforms in use. SEND and SDTM study data standards, developed by CDISC and about to become mandated by FDA, can address this and other drug development issues by facilitating access to data in ways that are not currently feasible. A consistent data standard across clinical and nonclinical will discourage the development of data silos, which easily become obstacles to data sharing and maximizing the value of animal and human data. The confluence of rapid scientific advances, increasingly larger quantities of diverse data, technological advances in data mining, and the FDA's requirements for standardized study data create new opportunities for the advancement of drug development and for refinement in the way we use animals.
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Affiliation(s)
- Laura Kaufman
- Laura Kaufman, PhD, DABT, is an independent consultant based out of New Jersey. Katrina Gore, BSc, MSc, is the founder of KDL Gore Solutions Ltd, Hertfordshire, England. Joyce Chandler Zandee, MS, is Chief Operating Officer at Integrated Nonclinical Development Solutions, Inc, Ann Arbor, Michigan
| | - Katrina Gore
- Laura Kaufman, PhD, DABT, is an independent consultant based out of New Jersey. Katrina Gore, BSc, MSc, is the founder of KDL Gore Solutions Ltd, Hertfordshire, England. Joyce Chandler Zandee, MS, is Chief Operating Officer at Integrated Nonclinical Development Solutions, Inc, Ann Arbor, Michigan
| | - Joyce Chandler Zandee
- Laura Kaufman, PhD, DABT, is an independent consultant based out of New Jersey. Katrina Gore, BSc, MSc, is the founder of KDL Gore Solutions Ltd, Hertfordshire, England. Joyce Chandler Zandee, MS, is Chief Operating Officer at Integrated Nonclinical Development Solutions, Inc, Ann Arbor, Michigan
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