A novel B-domain O-glycoPEGylated FVIII (N8-GP) demonstrates full efficacy and prolonged effect in hemophilic mice models

Blood. 2013 Mar 14;121(11):2108-16. doi: 10.1182/blood-2012-01-407494. Epub 2013 Jan 18.

Abstract

Frequent infusions of intravenous factor VIII (FVIII) are required to prevent bleeding associated with hemophilia A. To reduce the treatment burden, recombinant FVIII with a longer half-life was developed without changing the protein structure. FVIII-polyethylene glycol (PEG) conjugates were prepared using an enzymatic process coupling PEG (ranging from 10 to 80 kDa) selectively to a unique O-linked glycan in the FVIII B-domain. Binding to von Willebrand factor (VWF) was maintained for all conjugates. Upon cleavage by thrombin, the B-domain and the associated PEG were released, generating activated FVIII (FVIIIa) with the same primary structure and specific activity as native FVIIIa. In both FVIII- and VWF-deficient mice, the half-life was found to increase with the size of PEG. In vivo potency and efficacy of FVIII conjugated with a 40-kDa PEG (N8-GP) and unmodified FVIII were not different. N8-GP had a longer duration of effect in FVIII-deficient mouse models, approximately a twofold prolonged half-life in mice, rabbits, and cynomolgus monkeys; however, the prolongation was less pronounced in rats. Binding capacity of N8-GP on human monocyte-derived dendritic cells was reduced compared with unmodified FVIII, resulting in several-fold reduced cellular uptake. In conclusion, N8-GP has the potential to offer efficacious prevention and treatment of bleeds in hemophilia A at reduced dosing frequency.

Publication types

  • Evaluation Study

MeSH terms

  • Animals
  • CHO Cells
  • Cells, Cultured
  • Cricetinae
  • Cricetulus
  • Disease Models, Animal
  • Factor VIII / administration & dosage
  • Factor VIII / metabolism
  • Factor VIII / therapeutic use*
  • Female
  • Glycosylation
  • Hemophilia A / drug therapy*
  • Hemophilia A / pathology
  • Humans
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Mice, Knockout
  • Models, Biological
  • Polyethylene Glycols / administration & dosage
  • Polyethylene Glycols / metabolism
  • Polyethylene Glycols / therapeutic use*
  • Rabbits
  • Rats
  • Rats, Sprague-Dawley
  • Time Factors
  • Treatment Outcome

Substances

  • N8-GP compound
  • Polyethylene Glycols
  • Factor VIII