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Raghu G, Mouded M, Chambers DC, Martinez FJ, Richeldi L, Lancaster LH, Hamblin MJ, Gibson KF, Rosas IO, Prasse A, Zhao G, Serenko M, Novikov N, McCurley A, Bansal P, Stebbins C, Arefayene M, Ibebunjo S, Violette SM, Gallagher D, Behr J. A Phase IIb Randomized Study of an Anti-αvβ6 Monoclonal Antibody in Idiopathic Pulmonary Fibrosis. Am J Respir Crit Care Med 2022; 206:1128-1139. [PMID: 35771569 DOI: 10.1164/rccm.202112-2824oc] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Treatment options for idiopathic pulmonary fibrosis (IPF) are limited. OBJECTIVES To evaluate the efficacy and safety of BG00011, an anti-αvβ6 IgG1 monoclonal antibody, in the treatment of patients with IPF. METHODS In a phase IIb randomized, double-blind, placebo-controlled trial, patients with IPF (forced vital capacity [FVC] ≥50% predicted, on or off background therapy) were randomized 1:1 to once-weekly subcutaneous BG00011 56 mg or placebo. Primary endpoint was FVC change from baseline at Week 52. Due to early trial termination (imbalance in adverse events [AEs] and lack of clinical benefit), endpoints were evaluated at Week 26 as an exploratory analysis. MEASUREMENTS AND MAIN RESULTS 106 patients were randomized and received ≥1 dose of BG00011 (n = 54) or placebo (n = 52). At Week 26, there was no significant difference in FVC change from baseline (SE) between patients who received BG00011 (n = 20) or placebo (n = 23), -0.056 L (0.0593) vs. -0.097 L (0.0600), respectively; P=0.268. However, after Week 26, patients in the BG00011 group showed a worsening trend. Eight of 18 (44.4%) who received BG00011 and 4 of 22 (18.2%) who received placebo showed worsening of fibrosis on high-resolution computed tomography at end of treatment. IPF exacerbation/or progression was reported in 13 patients (all in the BG00011 group). Serious AEs occurred more frequently in BG00011 patients, including four deaths. CONCLUSIONS The results do not support the continued clinical development of BG00011. Further research is warranted to identify new treatment strategies that modify inflammatory and fibrotic pathways in IPF Clinical trial registration available at www. CLINICALTRIALS gov, ID: NCT03573505.
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Affiliation(s)
- Ganesh Raghu
- University of Washington Medical Center, 21617, Division of Pulmonary and Critical Care Medicine, Seattle, Washington, United States;
| | - Majd Mouded
- Biogen Inc, 2191, Cambridge, Massachusetts, United States
| | - Daniel C Chambers
- The Prince Charles Hospital, 67567, Queensland Lung Transplant Program, Brisbane, Queensland, Australia
| | - Fernando J Martinez
- NewYork-Presbyterian Hospital, 25065, Department of Pulmonary Critical Care Medicine, New York, New York, United States.,Weill Cornell Medical College, 12295, New York, New York, United States
| | - Luca Richeldi
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 18654, Roma, Italy
| | - Lisa H Lancaster
- Vanderbilt University, 5718, Department of Medicine, Nashville, Tennessee, United States
| | - Mark J Hamblin
- University of Kansas Medical Center, 21638, Division of Pulmonary, Critical Care & Sleep Medicine, , Kansas City, Kansas, United States
| | - Kevin F Gibson
- University of Pittsburgh School of Medicine, 12317, Division of Pulmonary, Allergy and Critical Care Medicine, Pittsburgh, Pennsylvania, United States
| | - Ivan O Rosas
- Brigham and Women's Hospital, 1861, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Boston, Massachusetts, United States
| | - Antje Prasse
- Hannover Medical School, 9177, Department of Pneumology, Hannover, Germany
| | - Guolin Zhao
- Biogen Inc, 2191, Cambridge, Massachusetts, United States
| | | | | | - Amy McCurley
- Biogen Inc, 2191, Cambridge, Massachusetts, United States
| | | | | | | | | | | | | | - Jürgen Behr
- University Hospital Munich, 27192, Department of Internal Medicine V, Munchen, Germany
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