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Relationship of the Calcitonin Gene‐Related Peptide Monoclonal Antibody Galcanezumab Pharmacokinetics and Capsaicin‐Induced Dermal Blood Flow in Healthy Subjects
Author(s) -
FiedlerKelly Jill,
Raddad Eyas,
Hoon Jan,
Ludwig Elizabeth A.,
Passarell Julie,
Kielbasa William,
Collins Emily C.
Publication year - 2021
Publication title -
clinical pharmacology in drug development
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.711
H-Index - 22
eISSN - 2160-7648
pISSN - 2160-763X
DOI - 10.1002/cpdd.929
Subject(s) - pharmacokinetics , calcitonin gene related peptide , pharmacology , calcitonin , volume of distribution , medicine , pharmacodynamics , absorption (acoustics) , monoclonal antibody , ic50 , capsaicin , peptide , chemistry , antibody , neuropeptide , biochemistry , immunology , in vitro , receptor , physics , acoustics
Galcanezumab, a humanized monoclonal antibody targeting calcitonin gene‐related peptide, was recently approved for migraine prophylaxis. The pharmacokinetic/pharmacodynamic (PK/PD) relationship between galcanezumab concentration and inhibition of capsaicin‐induced dermal blood flow (CIDBF) was evaluated using first‐in‐human data following 6 single subcutaneous doses (1 to 600 mg) or multiple (4) 150‐mg doses every 2 weeks in 7 cohorts (7 actively treated subjects and 2 placebo‐treated healthy subjects). Galcanezumab pharmacokinetics were best described by a 1‐compartment model with delayed first‐order absorption/linear elimination. Apparent estimates (between‐subject variability) of clearance, volume of distribution, absorption rate constant, and lag time were 0.0106 L/h (27%CV), 11.2 L (21%CV), 0.0192 h –1 (89%CV), and 0.202 hours, respectively. Estimated elimination half‐life was about 30 days. An effect compartment link model described the concentration‐effect relationship; estimated maximum inhibitory effect was 70.5%, and 50% maximum inhibitory effect concentration (IC 50 ) was 1060 ng/mL. Galcanezumab showed dose‐ and concentration‐dependent potent and durable inhibition of CIDBF. Simulated effect compartment concentrations were maintained above IC 50 after 12 weeks of dosing. Near‐maximal CIDBF inhibition occurred with 150 mg biweekly for 12 weeks lasting ≥24 weeks or with ≥30 mg every 2 weeks or 195 mg every 13 weeks. Quantitative modeling of galcanezumab PK/PD supported dose selection for the phase 2 proof‐of‐concept study.