Safety, tolerability, and pharmacodynamics of an anti-interleukin-1α/β dual variable domain immunoglobulin in patients with osteoarthritis of the knee: a randomized phase 1 study

Osteoarthritis Cartilage. 2017 Dec;25(12):1952-1961. doi: 10.1016/j.joca.2017.09.007. Epub 2017 Sep 28.

Abstract

Objective: To investigate the safety, tolerability, pharmacokinetics, and pharmacodynamics of ABT-981, a human dual variable domain immunoglobulin simultaneously targeting interleukin (IL)-1α and IL-1β, in patients with knee osteoarthritis (OA).

Method: This was a randomized, double-blind, placebo-controlled, single-center study of multiple subcutaneous (SC) injections of ABT-981 in patients with mild-to-moderate OA of the knee (NCT01668511). Three cohorts received ABT-981 (0.3, 1, or 3 mg/kg) or placebo every other week for a total of four SC injections, and one cohort received ABT-981 (3 mg/kg) or placebo every 4 weeks for a total of three SC injections. Assessment of safety and tolerability were the primary objectives. A panel of serum and urine biomarkers of inflammation and joint degradation were evaluated.

Results: A total of 36 patients were randomized (ABT-981, n = 28; placebo, n = 8); 31 (86%) completed the study. Adverse event (AE) rates were comparable between ABT-981 and placebo (54% vs 63%). The most common AE reported with ABT-981 vs placebo was injection site erythema (14% vs 0%). ABT-981 significantly reduced absolute neutrophil count and serum concentrations of IL-1α/IL-1β, high-sensitivity C-reactive protein, and matrix metalloproteinase (MMP)-derived type 1 collagen. Serum concentrations of MMP-derived type 3 collagen and MMP-degraded C-reactive protein demonstrated decreasing trends with ABT-981. Antidrug antibodies were found in 37% of patients but were not associated with the incidence or severity of AEs.

Conclusion: ABT-981 was generally well tolerated in patients with knee OA and engaged relevant tissue targets, eliciting an anti-inflammatory response. Consequently, ABT-981 may provide clinical benefit to patients with inflammation-driven OA.

Keywords: ABT-981; Clinical study; Interleukin-1; Osteoarthritis; Pharmacokinetic; Safety.

Publication types

  • Clinical Trial, Phase I
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aggrecans / drug effects
  • Aggrecans / metabolism
  • C-Reactive Protein / drug effects
  • C-Reactive Protein / metabolism
  • Cartilage Oligomeric Matrix Protein / drug effects
  • Cartilage Oligomeric Matrix Protein / metabolism
  • Citrullination
  • Collagen Type I / drug effects
  • Collagen Type I / metabolism
  • Collagen Type II / drug effects
  • Collagen Type II / metabolism
  • Collagen Type III / drug effects
  • Collagen Type III / metabolism
  • Erythema
  • Female
  • Humans
  • Immunoglobulins / pharmacology
  • Immunoglobulins / therapeutic use*
  • Injection Site Reaction
  • Injections, Subcutaneous
  • Interleukin-1alpha / antagonists & inhibitors*
  • Interleukin-1beta / antagonists & inhibitors*
  • Interleukin-1beta / drug effects
  • Leukocyte Count
  • Male
  • Middle Aged
  • Neutrophils / cytology
  • Osteoarthritis, Knee / drug therapy*
  • Osteoarthritis, Knee / metabolism
  • Peptides / drug effects
  • Peptides / metabolism
  • Severity of Illness Index
  • Vascular Endothelial Growth Factor A / drug effects
  • Vascular Endothelial Growth Factor A / metabolism
  • Vimentin / drug effects
  • Vimentin / metabolism

Substances

  • Aggrecans
  • COMP protein, human
  • Cartilage Oligomeric Matrix Protein
  • Collagen Type I
  • Collagen Type II
  • Collagen Type III
  • IL1A protein, human
  • IL1B protein, human
  • Immunoglobulins
  • Interleukin-1alpha
  • Interleukin-1beta
  • Peptides
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Vimentin
  • collagen type I trimeric cross-linked peptide
  • C-Reactive Protein

Associated data

  • ClinicalTrials.gov/NCT01668511