CYTOKINES, IMMUNOGLOBULINS AND IGG SUBCLASSES IN PATIENTS WITH IGG MYELOMAS
IMMUNITAT UND INFEKTION
Authors: KLOUCHE, M; WILHELM, D; KIRCHNER, H
Abstract
Cytokines play an essential role in normal and malignant B-cell proliferation and isotype-switching. Therefore we determined serum levels of different B-cell activating cytokines including IFN gamma, IL-4 and IL-10, IgG subclasses, further immunoglobulins and the soluble B-cell activation marker sCD23 in 68 patients with recently diagnosed and previously untreated IgG myelomas in comparison with age- and sex-matched healthy controls. Our results demonstrated that 16% of the myeloma patients had elevated IL-10 levels up to 1000 pg/ml and 8% showed increased IFN gamma serum concentrations. By contrast, only 7% of the controls showed detectable IL-10 levels and 3% had measurable IFN gamma levels. While in men 67% of the paraproteins were of the kappa light chain type, we found an equal occurrence of kappa and lambda light chains in women. In addition, the distribution of IgG subclasses differed in men and women. In comparison with the controls, no alteration of sCD23 was detected in myeloma patients. We found an apparent correlation of elevated IL-10 levels and the IgG1 subclass.
Population Pharmacokinetic Modeling of Guselkumab, a Human IgG1 Monoclonal Antibody Targeting IL-23, in Patients with Moderate to Severe Plaque Psoriasis
JOURNAL OF CLINICAL PHARMACOLOGY
Authors: Yao, Zhenling; Hu, Chuanpu; Zhu, Yaowei; Xu, Zhenhua; Randazzo, Bruce; Wasfi, Yasmine; Chen, Yang; Sharma, Amarnath; Zhou, Honghui
Abstract
Psoriasis is a common inflammatory skin disorder that requires chronic treatment and is associated with multiple comorbidities. Guselkumab, a human immunoglobulin-G1-lambda monoclonal antibody, binds to interleukin-23 with high specificity and affinity and is effective in treating moderate to severe plaque psoriasis. As part of the guselkumab psoriasis clinical trial program, using a confirmatory approach, a population pharmacokinetics (PopPK) model was established using 13014 PK samples from 1454 guselkumab-treated patients across 3 phase 2/3 trials. Observed serum guselkumab concentrations were adequately described by a 1-compartment linear PK model with first-order absorption and elimination. The final PK model was robust and stable, with apparent clearance (CL/F), apparent volume of distribution (V/F), and absorption rate constant (ka) estimates of 0.516L/day, 13.5L, and 1.11day(-1), respectively. A model-derived elimination half-life of 18.1days indicated achievement of steady-state serum guselkumab concentrations within 12-14 weeks. The primary covariate contributing to the observed PK variability was body weight, which accounted for only 28% (CL/F) and 32% (V/F) of the interindividual proportion of variance. Diabetes was identified to marginally reduce guselkumab exposure, owing to 12% higher CL/F in diabetic versus nondiabetic patients, but its contribution was not clinically relevant. None of the other covariates tested (eg, age, sex, ethnicity, immune response to guselkumab, or concomitant medications) had a clinically relevant effect on guselkumab exposure.