A bispecific antibody approach for the potential prophylactic treatment of inherited bleeding disorders

Nat Cardiovasc Res. 2024 Feb;3(2):166-185. doi: 10.1038/s44161-023-00418-4. Epub 2024 Feb 8.

Abstract

Inherited bleeding disorders such as Glanzmann thrombasthenia (GT) lack prophylactic treatment options. As a result, serious bleeding episodes are treated acutely with blood product transfusions or frequent, repeated intravenous administration of recombinant activated coagulation factor VII (rFVIIa). Here we describe HMB-001, a bispecific antibody designed to bind and accumulate endogenous FVIIa and deliver it to sites of vascular injury by targeting it to the TREM (triggering receptor expressed on myeloid cells)-like transcript-1 (TLT-1) receptor that is selectively expressed on activated platelets. In healthy nonhuman primates, HMB-001 prolonged the half-life of endogenous FVIIa, resulting in its accumulation. Mouse bleeding studies confirmed antibody-mediated potentiation of FVIIa hemostatic activity by TLT-1 targeting. In ex vivo models of GT, HMB-001 localized FVIIa on activated platelets and potentiated fibrin-dependent platelet aggregation. Taken together, these results indicate that HMB-001 has the potential to offer subcutaneous prophylactic treatment to prevent bleeds in people with GT and other inherited bleeding disorders, with a low-frequency dosing regimen.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antibodies, Bispecific* / immunology
  • Antibodies, Bispecific* / pharmacology
  • Antibodies, Bispecific* / therapeutic use
  • Blood Platelets / drug effects
  • Blood Platelets / immunology
  • Blood Platelets / metabolism
  • Disease Models, Animal
  • Factor VIIa
  • Female
  • Hemorrhage / drug therapy
  • Hemorrhage / prevention & control
  • Humans
  • Macaca fascicularis
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Platelet Activation / drug effects
  • Platelet Aggregation / drug effects
  • Thrombasthenia / drug therapy
  • Thrombasthenia / immunology

Substances

  • Antibodies, Bispecific
  • Factor VIIa