Departments of Drug Metabolism and Pharmacokinetics (P.Z.-A., E.M.,
L.J.B., C.S.H., L.A.P.T., C.B.D.) and Safety Assessment (T.K.H.),
SmithKline Beecham, King of Prussia, Pennsylvania
The pharmacokinetics (PK) of SB-240563 have been investigated after
i.v. and s.c. administration to cynomolgus monkeys. Approximately linear PK was observed following i.v. administration over a 6000-fold dose range (0.05-300 mg/kg). After i.v. dosing, SB-240563
concentration declined in a biexponential manner with a mean terminal
half-life of 13 ± 2 days. The plasma clearance and volume of
distribution at steady state were ~0.2 ml/h/kg and 70 ml/kg,
respectively. Following s.c. administration, SB-240563 was completely
absorbed into the systemic circulation. Because interleukin-5 is known to stimulate production, activation, and maturation of eosinophils, eosinophil counts were measured to assess pharmacologic activity of
SB-240563. The maximal response (81-96% decrease in eosinophil count
relative to baseline) following a single s.c. administration occurred
at 3 weeks postdosing. Suppression of eosinophil count also was
observed following multiple monthly administrations of SB-240563 to
monkeys. The pharmacokinetic/pharmacodynamic relationship was generally
well described with an indirect pharmacologic response model with an
estimated IC50 value of 1.43 µg/ml. The combination of a
low IC50 value for reduction of circulating eosinophils and a long terminal half-life suggests the possibility of an infrequent dosing regimen for SB-240563 for treatment of diseases associated with
increased eosinophil function such as asthma.
 |
Introduction |
SB-240563
is a humanized monoclonal antibody (IgG1) with specificity for human
interleukin-5 (IL-5). IL-5 is a cytokine produced primarily by T
lymphocytes and mast cells (Takatsu et al., 1988
; Galli et al., 1994
).
By binding to the IL-5 receptor on eosinophils, IL-5 plays an essential
role in the differentiation and functional maturation of eosinophils
(Dent et al., 1990
; Sanderson, 1990
; Tominaga et al., 1991
;
Takatsu et al., 1994
). In addition to IL-5, other cytokines such as
IL-3 and granulocyte macrophage-colony stimulating factor influence the
development and maturation of eosinophils in the bone marrow, and
postmitotic functional activation of eosinophils in tissues (Saito et
al., 1988
; Clutterbuck et al., 1989
; Goodall et al., 1993
). Even though
IL-3 and granulocyte macrophage-colony stimulating factor play a role
in the proliferation and commitment of progenitors to the eosinophil
lineage, IL-5 is necessary and sufficient for eosinophil development
(Sanderson, 1990
, 1991
). IL-5 is overexpressed in many
eosinophil-associated diseases (Owen et al., 1989
, 1990
; Sanderson,
1992
) and development of profound eosinophilia has been observed in
IL-5 transgenic mice (Dent et al., 1990
; Tominaga et al., 1991
). Thus,
IL-5 appears to play essential roles in promoting the production and
function of eosinophils in vivo. This cytokine also has been shown to
enhance survival of mature eosinophils (Tai et al., 1991
).
Activated eosinophils release proinflammatory molecules and cytotoxic
agents that are not only toxic to helminthic parasites but also can
cause tissue damage in allergic inflammations such as asthma (Lopez et
al., 1988
; Bousquet et al., 1990
; Reed, 1994
). Antibodies to IL-5 have
been shown to block peripheral eosinophilia in recombinant IL-2-treated
mice (Yamaguchi et al., 1990
) and to be beneficial in reducing
eosinophil recruitment into the lung in murine models of allergic
disease (Hamelmann et al., 1997
).
In this article, the pharmacokinetics (PK) of SB-240563 following
single or repeated i.v./s.c. administrations of the drug to monkeys has
been described. Additionally, the bioavailability of SB-240563 and its
effect on eosinophils following s.c. administration are discussed. The
monkey was chosen as the appropriate preclinical species because
SB-240563 cross-reacts with monkey IL-5 but not with recombinant rat or
guinea pig IL-5. The presented data have been collated from four
different preclinical studies conducted with SB-240563.
 |
Materials and Methods |
Chemicals.
SB-240563 is a Chinese hamster ovary-derived IgG1
humanized monoclonal antibody directed to human IL-5. Drug was supplied as a sterile solution in phosphate-buffered saline. The concentration of SB-240563 solutions (original or diluted) were confirmed by UV
absorption spectrometry. The mouse monoclonal antibody to human IL-5
was purchased from Zymed Laboratories Inc. (South San Francisco, CA).
The ruthenium label was from IGEN, Inc. (Rockville, MD). Streptavidin-coated microbeads (2.8-µm paramagnetic polystyrene beads) were purchased from DYNAL, Inc. (Great Neck, NY). Assay buffer
for the Origen analyzer was purchased from IGEN, Inc. Tween 20 was
purchased from Sigma Chemical Co. (St. Louis, MO). All other chemicals
were of reagent grade or better.
Electrochemiluminescent (ECL) Immunoassay.
Plasma
concentrations of SB-240563 were determined with an ECL immunoassay.
Briefly, plasma samples were diluted to within the calibration range
and reacted with biotin-conjugated human IL-5 and paramagnetic
microbeads conjugated to streptavidin. The microbeads were then reacted
with a ruthenium-labeled mouse monoclonal antibody to human IgG1 (Fc
CH2 region), and the ECL response was recorded on an Origen
analyzer. The lower limit of quantification of the assay was 50 ng/ml.
Reproducibility and accuracy of the assay were determined by spiking
control monkey plasma with SB-240563 and analyzing replicates (n = 6, stored frozen as authentic plasma samples at
20°C or below). These samples were stable for at least the time
period spanning the collection and analysis of authentic plasma
samples. The within-run and between-run coefficients of variation
ranged from 2.3 to 9.5% and 1.9 to 5.6%, respectively, in the
concentration range of 10 to 5000 ng/ml. Average assay accuracy ranged
from 93.7 to 111%.
Animal Husbandry.
Cynomolgus monkeys weighing ~2 to 5 kg
were used. Animals were housed in stainless steel cages in a controlled
environment (68-76°F; 40-70% relative humidity) on a 12-h
light/dark cycle in the Department of Laboratory Animal Sciences at
SmithKline Beecham. Approximately six to eight biscuits of Purina
certified monkey chow or monkey diet 5038 (PMI Feeds, Inc., St. Louis,
MO) were provided to each monkey twice a day and filtered tap water was
available ad libitum from an automatic watering system. Additionally, a
daily allotment of fresh fruit was offered to each monkey. On the day
of dosing, food was withdrawn at least 1 h before drug administration and then again provided 6 h after drug administration.
Dose Administration and Blood Samples.
In a single dose i.v.
study, two dose levels of 3 and 300 mg/kg (0.2 ml/kg bolus and 20 ml/kg
at 10 ml/min, respectively) were administered on study day 1. Two
cynomolgus monkeys (one male and one female) were used for each dose
group. Blood samples were obtained before and immediately after dose
administration, and at 3- and 6-h postdosing on day 1. Additional
samples were collected on days 3, 8, 15, and 28.
In a repeat-dose study where two monthly doses were given, four dose
levels (0.05, 0.5, 5.0, and 50.0 mg/kg with a 2.0 ml/kg dose volume)
were injected i.v. on days 1 and 29. Four cynomolgus monkeys (two males
and two females) were used for each dose group. Blood samples were
obtained before dose administration and at 5-min and 3- and 6-h
postdosing. Additional samples were collected on days 2, 7, 13, 27, 29 (5 min before administration of the second dose), 30, 35, 41, 56, 77, 99, and 120.
In a 6-month repeat-dose study, six cynomolgus monkeys (three males and
three females) were injected with 10 mg/kg (injection volume of
0.5-1.0 ml given at two injection sites each) monthly doses of
SB-240563 via the s.c. route. Blood samples for PK analysis were
obtained before each dose administration, and at 24 h and 1 week
following the first and fifth doses of SB-240563. Eosinophil count was
measured before each dose administration.
In a separate crossover i.v./s.c. study, four female cynomolgus monkeys
each received a 1 mg/kg dose of SB-240563 that was administered as an
i.v. bolus (total injection volume of 0.6 ml). Approximately 3 months
after the administration of the i.v. dose, these monkeys each received
a second 1 mg/kg dose of SB-240563 administered s.c.. For the i.v. arm
of this study, blood sample collection was performed at the following
times postdosing: 0 (predose), 0.1, 0.5, 1, 2, 4, 6, 8, 24, 72, and
120 h, and at 1, 2, 3, 4, 5, 6, 7, and 8 weeks. For the s.c. arm
of the study, blood sample collection was performed at the following
times postdosing: 0 (predose), 2, 4, 6, 8, 24, 48, 72, and 96 h,
and at 1, 2, 3, 4, 5, 6, and 8 weeks. Additional blood samples were
collected for hematology before dose administration and ~10-weeks
postdosing for the i.v. arm, and before dosing and at 1-, 3-, 5-, 8-, and 14-weeks postdosing for the s.c. arm.
Pharmacokinetics and Pharmacodynamics (PD).
Noncompartmental
PK analysis of SB-240563 plasma concentration-time data was performed
using traditional methods (Chiou, 1978
). The following PK parameters
are reported: maximum observed plasma concentration
(Cmax), the time to reach
Cmax (Tmax), the
area under the plasma concentration-time curve from time zero to
infinity [AUC(0-inf)] and apparent terminal elimination
half-life (T1/2). In addition, the following
parameters were calculated from data obtained following i.v.
administration of SB-240563: plasma clearance (CL) and volume of
distribution at steady state (Vss).
Compartmental analysis of concentration-time data obtained following
i.v. administration was performed with a two-compartment model in the
curve-fitting program MODFIT (Allen, 1990
).
Bioavailability of SB-240563 following s.c. administration in the
crossover study was computed as follows:
|
(1)
|
To assess the effect of SB-240563 on eosinophils, eosinophil
count data obtained following a single s.c. administration were plotted
versus time. A time lag was evident between the measured maximal
SB-240563 concentration and the observed maximal decrease in eosinophil
count data. This delayed effect is consistent with the mechanism of
action of SB-240563, i.e., its effect on eosinophils via binding to
IL-5. Therefore, the PK/PD relationship was described with an indirect
response model with inhibition of the production of response
(eosinophils) via the inhibition of kin
(eq. 2) (Dayneka et al., 1993
):
|
(2)
|
where R is the measured response (eosinophil count),
kin is the zero-order constant for
production of response, kout is the first-order rate constant for loss of response,
IC50 is the concentration that produces 50% of
maximal inhibition in the eosinophil production rate, and Cp
is the predicted SB-240563 plasma concentration. The above-mentioned PD
model assumes that kin and
kout completely account for production and
loss of response. Equation 2 assumes maximal response is one or
complete suppression (i.e., 100% reduction in eosinophil count).
Inclusion of an Imax term, the maximal
inhibitory capability of the drug (Sharma and Jusko, 1996
), did not
improve the quality of the fit and Imax was
estimated as one.
Before the PK/PD analysis, a one-compartment model with first-order
absorption was fitted to the observed SB-240563 concentration-time data
with nonlinear regression analysis (WinNonlin, version 1.1; Apex, NC).
The PK parameters obtained from this exercise were used to
predict drug concentrations (Cp) for the PD model. The indirect response model was fitted to the eosinophil time course data
obtained following a single s.c. dosing with nonlinear regression analysis. For these analyses, uniform weighting and the Gauss-Newton (Levenberg and Hartley) minimization algorithm were used. The goodness
of fit was judged by examination of the predicted values, residual
plots, and precision of parameter estimates (%S.E.).
The mean PK parameters obtained from the modeling exercise (Table
1) were used to simulate (WinNonlin Pro.,
version 1.5; Apex, NC) an average concentration-time profile following
multiple s.c. injections of a 10 mg/kg dose. Additionally, the mean
parameters obtained following the PK/PD modeling of the single-dose
data (Table 2) were used to simulate
(WinNonlin Pro., version 1.5; Apex, NC) an average eosinophil
count-time profile following multiple dosing of SB-240563.
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TABLE 1
Estimated individual PK parameters (%S.E.) with a one-compartment
model with first-order input after s.c. administration of a 1-mg/kg
dose of SB-240563
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|
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TABLE 2
Individual and mean (S.D.) PD parameters (%S.E.) for the indirect PD
response model applied to eosinophil count data obtained following s.c.
administration of 1 mg/kg of SB-240563 to female monkeys
|
|
 |
Results |
Following i.v. administration, SB-240563 exhibited approximately
dose-proportional PK over the dose range from 0.05 to 300 mg/kg. After
the injection, concentrations declined in a biexponential manner with
an average initial half-life of 12.9 ± 9.4 h (Figs. 1 and 2).
The second phase of the concentration-time profile accounted for the
majority of AUC (
86%). SB-240563 concentration-time profiles were
similar between male and female monkeys (Fig. 1). The mean CL and
Vss were relatively constant across the
examined dose groups (0.05-300 mg/kg) and ranged from 0.157 to 0.217 ml/h/kg and 65.6 to 82.1 ml/kg, respectively (Tables
3-5). The mean overall terminal half-life following i.v. dosing was 13.0 ± 2.2 days.

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Fig. 1.
Mean (n = 2/sex/group) plasma
SB-240563 concentrations (micrograms per milliliter) following the
first- and second i.v.-administered doses of SB-240563 in the
repeat-dose study in cynomolgus monkeys. Filled symbols represent
plasma concentrations from male animals and open symbols represent
plasma concentrations from female animals. Animals were given 0.05 ( , ), 0.5 ( , ), 5 ( , ), or 50 ( , ) mg/kg
SB-240563.
|
|

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Fig. 2.
Mean concentration-time profiles following i.v. ( )
or s.c. ( ) administrations of a single 1 mg/kg dose of SB-240563 to
cynomolgus monkeys.
|
|
After s.c. dosing, maximal concentrations were observed 2- to 4-days
postinjection (Table 4). Following the
absorption phase, SB-240563 concentration appeared to decline in a
mono-exponential manner with an apparent half-life (14.5 ± 3.8 days) similar to that observed after i.v. dosing (Fig. 2 and Table
4). SB-240563 appeared to be completely
absorbed (F = 1.18 ± 0.16) following s.c.
administration (Table 4).
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TABLE 4
Individual and mean (S.D.) PK parameters obtained with noncompartmental
analysis of concentration-time data following i.v. and s.c. dosing of 1 mg/kg of SB-240563 to female monkeys
|
|
Following a single s.c. injection, peripheral eosinophil count
decreased in a time-dependent manner (Fig.
3). The maximum percentage of decrease
(81 to 96%) relative to baseline (just before administration of the
s.c. dose) was observed at 3-weeks postdosing, whereas maximal
concentrations were observed at 2- to 4-days postdosing. Thus, an
inhibitory indirect model with inhibition of production of response
(eosinophil count) was used to describe the data.

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Fig. 3.
Eosinophil count versus time profiles following s.c.
administration of a single 1 mg/kg dose of SB-240563 to cynomolgus
monkeys. , eosinophil data from monkey 1; , data from monkey 2;
, data from monkey 3, and , data from monkey 4.
|
|
A one-compartment PK model with first-order absorption fitted the
concentration-time profiles obtained following s.c. administration reasonably well as indicated by the low standard errors of the parameter estimates (%S.E. < 21%) (Table 1). As evidenced by the
close agreement between the observed and predicted eosinophil counts,
the indirect response model as described by eq. 2 generally described
the PD data well (Fig. 4, A-D). The
standard errors associated with the parameter estimates were <40% in
three of four animals (Table 2). In one animal, the standard errors
were large compared with the remaining animals; nonetheless, the model appeared to adequately describe the data in this animal (Fig. 4D) and
the parameter estimates were similar to those obtained in the other
animals. An IC50 value of 1.43 µg/ml was
observed for reduction in eosinophil count by SB-240563 (Table 2). This value is 2- to 4-fold lower than the observed plasma concentrations during the first month after i.v. or s.c. administration of a 1-mg/kg
dose. During the first 2 months after a single s.c. administration of 1 mg/kg SB-240563, eosinophil counts were suppressed to ~30-70% of
the baseline level (Fig. 3).

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Fig. 4.
Predicted and observed SB-240563 concentration and
eosinophil count following s.c. administration of a single 1 mg/kg dose
of SB-240563 to cynomolgus monkeys. Individual data presented from
monkey 1 (A), monkey 2 (B), monkey 3 (C), and monkey 4 (D). ,
observed SB-240563 plasma concentrations; solid lines represent the
predicted SB-240563 plasma concentrations; , observed eosinophil
counts, and dashed lines represent the predicted eosinophil counts.
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TABLE 5
Mean (S.D.) PK data obtained following administration of repeated i.v.
doses of SB-240563 to cynomolgus monkeys
|
|
Following six monthly repeated administrations of SB-240563 at 10 mg/kg, the observed eosinophil counts were persistently <20% of the
baseline levels over the entire 6-month dosing period (Fig.
5). The estimated PK and PD parameters
obtained from modeling the concentration and eosinophil count data
following a single s.c. administration of drug were used to
simulate concentration and eosinophil count data following s.c.
administration of six monthly 10-mg/kg doses. Although a significant
suppression in eosinophil count was observed following multiple dose
administration, the PD model developed with the single-dose data
predicted a somewhat greater decrease in eosinophil count after
administration of all six doses, including the first dose. This
observation may reflect a higher IC50 value in
the monkeys used in the repeat-dose study.

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Fig. 5.
Predicted and observed SB-240563 concentration and
eosinophil count following repeated s.c. administrations of 10 mg/kg
SB-240563 once monthly for 6 months to cynomolgus monkeys. ,
observed SB-240563 plasma concentrations, solid lines represent the
predicted SB-240563 plasma concentrations (obtained with the PK model
and the mean parameter values presented in Table 1), , observed
eosinophil counts, and dashed lines represent the predicted eosinophil
counts (obtained with the PD model and the mean parameter values
presented in Table 2). The observed data are from all studied
animals.
|
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 |
Discussion |
Following i.v. administration, SB-240563 exhibited relatively low
clearance and volume of distribution. The observed volume of
distribution (66 to 82 ml/kg) was slightly higher than the typical
plasma volume (45 ml/kg) but lower than the typical extracellular fluid
volume (200 ml/kg) in monkeys (Davies and Morris, 1993
). The mean
terminal half-life values were similar following i.v. (~13 day) and
s.c. (14.5 day) administrations. These half-life values are within the
range of values (9-30 days) reported for other monoclonal antibodies
in the monkey (Ehrlich et al., 1987
; Muraszko et al., 1993
; Cavacini et
al., 1994
; Davis et al., 1995
). SB-240563 was completely bioavailable
following s.c. administration.
Consistent with similar results obtained following i.v. administration
of SB-240653 (Hart et al., 1998
), s.c. administration of a relatively
low dose of 1 mg/kg was effective in reducing circulating eosinophils.
The drop in circulating eosinophils does not appear to be due to
redistribution of eosinophils because complete histopathology
assessments were conducted with no remarkable accumulation or absence
of eosinophils in any organs (data not shown). Thus, the drop in
circulating eosinophils appears to represent an absence of or a
decreased signal for eosinophil recruitment from the bone marrow to
areas in the body where they may be needed.
A time delay in the manifestation of maximal effect (decrease) on basal
eosinophil count was noted relative to the observed time for maximal
drug concentrations. The relationship between drug concentrations and
eosinophil count was generally well described with an indirect PD
response model. A steady-state concentration of ~1.5 µg/ml
SB-240563 would decrease and sustain peripheral eosinophil counts by
50% relative to that observed before drug administration. It is worth
noting that the IC50 is a term that not only
reflects the binding equilibrium between the antibody and IL-5 but also
the interaction of IL-5 with its receptor on the eosinophil surface.
The kout represents the rate constant for
the elimination of eosinophils from the body. Based on the estimated
value of kout, the elimination half-life of
eosinophils in monkey blood is 2.1 days (~50 h). In human blood,
eosinophils have a half-life of 18 h (Steinbach et al., 1979
) and
we suspect that their half-life in monkey would be similar to that in
humans. Considering the observed variability (up to 5-fold) in baseline eosinophil count, which is a reflection of variability in
kin and kout,
the estimated half-life of 2 days is a reasonable estimate of the
monkey eosinophil half-life.
The combination of the availability of SB-240563 via the s.c. route,
its long terminal half-life, and low IC50 value
(~1-2 µg/ml) for reduction of circulating eosinophils make this
compound a viable candidate for treatment of diseases associated with
exaggerated eosinophil function, e.g., asthma. The link between
depression of eosinophil count following administration of SB-240563
and pulmonary function tests is currently being investigated in
clinical trials.
Accepted for publication August 18, 1999.
Received for publication March 17, 1999.
IL-5, interleukin 5;
PK, pharmacokinetic(s);
ECL, electrochemiluminescent;
PD, pharmacodynamic(s);
Cmax, maximum plasma concentration;
Tmax, time at which
Cmax occurs;
AUC, area under the plasma
concentration-time curve;
Vss, volume of
distribution at steady state;
CL, clearance;
T1/2, terminal
half-life.