Abstract
The PK/PD of abatacept, a selective T cell co-stimulation modulator, was examined in rats with collagen-induced arthritis (CIA) using a nonlinear mixed effect modeling approach. Male Lewis rats underwent collagen induction to produce rheumatoid arthritis. Two single-dose groups received either 10 mg/kg intravenous (IV) or 20 mg/kg subcutaneous (SC) abatacept, and one multiple-dose group received one 20 mg/kg SC abatacept dose and four additional 10 mg/kg SC doses. Effects on disease progression (DIS) were measured by paw swelling. Plasma concentrations of abatacept were assayed by enzyme-linked immunosorbent assay. The PK/PD data were sequentially fitted using NONMEM VI. Goodness-of-fit was assessed by objective functions and visual inspection of diagnostic plots. The PK of abatacept followed a two-compartment model with linear elimination. For SC doses, short-term zero-order absorption was assumed with F = 59.2 %. The disease progression component was an indirect response model with a time-dependent change in paw edema production rate constant (k in ) that was inhibited by abatacept. Variation in the PK data could be explained by inter-individual variability in clearance and central compartment volume (V 1 ), while the large variability of the PD data may be the result of paw edema production (k 0 in ) and loss rate constant (k out ). Abatacept has modest effects on paw swelling in CIA rats. The PK/PD profiles were well described by the proposed model and allowed evaluation of inter-individual variability on drug- and DIS-related parameters.
Similar content being viewed by others
References
Klareskog L, Catrina AI, Paget S (2009) Rheumatoid arthritis. Lancet 373(9664):659–672
Gregersen PK, Silver J, Winchester RJ (1987) The shared epitope hypothesis. An approach to understanding the molecular genetics of susceptibility to rheumatoid arthritis. Arthritis Rheum 30(11):1205–1213
Corrigall VM, Panayi GS (2002) Autoantigens and immune pathways in rheumatoid arthritis. Crit Rev Immunol 22(4):281–293
Cromartie WJ, Craddock JG, Schwab JH, Anderle SK, Yang CH (1977) Arthritis in rats after systemic injection of streptococcal cells or cell walls. J Exp Med 146(6):1585–1602
Mueller DL, Jenkins MK, Schwartz RH (1989) Clonal expansion versus functional clonal inactivation: a costimulatory signalling pathway determines the outcome of T cell antigen receptor occupancy. Annu Rev Immunol 7:445–480
Linsley PS, Brady W, Grosmaire L, Aruffo A, Damle NK, Ledbetter JA (1991) Binding of the B cell activation antigen B7 to CD28 costimulates T cell proliferation and interleukin 2 mRNA accumulation. J Exp Med 173(3):721–730
Gaffo A, Saag KG, Curtis JR (2006) Treatment of rheumatoid arthritis. Am J Health Syst Pharm 63(24):2451–2465
Goldsby RA, Kindt TJ, Osborne BA (2000) Kuby immunology, 4th edn. W.H. Freeman & Company, New York, 553 pp
Bristol-Myers Squibb Inc., (2011) Full prescribing information for ORENCIA (abatacept)
FDA (2006) Drug Approval Package Orencia (Abatacept) Injectable (IV). http://www.accessdata.fda.gov/drugsatfda_docs/nda/2005/125118_s0000_OrenciaTOC.cfm
Earp JC, DuBois DC, Molano DS, Pyszczynski NA, Keller CE, Almon RR, Jusko WJ (2008) Modeling corticosteroid effects in a rat model of rheumatoid arthritis I: mechanistic disease progression model for the time course of collagen-induced arthritis in Lewis rats. J Pharmacol Exp Ther 326(2):532–545
Earp JC, DuBois DC, Molano DS, Pyszczynski NA, Almon RR, Jusko WJ (2008) Modeling corticosteroid effects in a rat model of rheumatoid arthritis II: mechanistic pharmacodynamic model for dexamethasone effects in Lewis rats with collagen-induced arthritis. J Pharmacol Exp Ther 326(2):546–554
Lon HK, Liu D, Zhang Q, DuBois DC, Almon RR, Jusko WJ (2011) Pharmacokinetic-pharmacodynamic disease progression model for effect of etanercept in Lewis rats with collagen-induced arthritis. Pharm Res 28(7):1622–1630
Liu D, Lon HK, DuBois DC, Almon RR, Jusko WJ (2011) Population pharmacokinetic-pharmacodynamic-disease progression model for effects of anakinra in Lewis rats with collagen-induced arthritis. J Pharmacokinet Pharmacodyn 38(6):769–786
Earp JC, Dubois DC, Almon RR, Jusko WJ (2009) Quantitative dynamic models of arthritis progression in the rat. Pharm Res 26(1):196–203
Bailer AJ (1988) Testing for the equality of area under the curves when using destructive measurement techniques. J Pharmacokinet Biopharm 16(3):303–309
Nedelman JR, Gibiansky E, Lau DT (1995) Applying Bailer’s method for AUC confidence intervals to sparse sampling. Pharm Res 12(1):124–128
Beal S, Sheiner LB, Boeckmann A, Bauer RJ (2009) NONMEM User’s Guides. (1989–2009). Icon Development Solutions, Ellicott City, MD, USA
Team RDC (2008) R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna
Srinivas NR, Shyu WC, Weiner RS, Warner G, Comereski C, Tay LK, Greene DS, Barbhaiya RH (1997) Assessment of dose proportionality, absolute bioavailability, and immunogenicity response of CTLA4Ig (BMS-188667), a novel immunosuppressive agent, following subcutaneous and intravenous administration to rats. Pharm Res 14(7):911–916
Srinivas NR, Weiner RS, Warner G, Shyu WC, Davidson T, Fadrowski CG, Tay LK, Lee JS, Greene DS, Barbhaiya RH (1996) Pharmacokinetics and pharmacodynamics of CTLA4lg (BMS-188667), a novel immunosuppressive agent, in monkeys following multiple doses. J Pharm Sci 85(1):1–4
Ma Y, Lin BR, Lin B, Hou S, Qian WZ, Li J, Tan M, Ma J, Li BH, Wang H, Wen AD, Guo YJ (2009) Pharmacokinetics of CTLA4Ig fusion protein in healthy volunteers and patients with rheumatoid arthritis. Acta Pharmacol Sin 30(3):364–371
Srinivas NR, Shyu WC, Weiner RS, Tay LK, Greene DS, Barbhaiya RH (1995) Pharmacokinetics of CTLA4Ig (BMS-188667), a novel immunosuppressive agent, following intravenous and subcutaneous administration to mice. J Pharm Sci 84(12):1488–1489
Srinivas NR, Weiner RS, Shyu WC, Calore JD, Tritschler D, Tay LK, Lee JS, Greene DS, Barbhaiya RH (1996) A pharmacokinetic study of intravenous CTLA4Ig, a novel immunosuppressive agent, in mice. J Pharm Sci 85(3):296–298
Hasegawa M, Imai Y, Hiraoka M, Ito K, Roy A (2011) Model-based determination of abatacept exposure in support of the recommended dose for Japanese rheumatoid arthritis patients. J Pharmacokinet Pharmacodyn 38(6):803–832
Roy A, Mould DR, Wang XF, Tay L, Raymond R, Pfister M (2007) Modeling and simulation of abatacept exposure and interleukin-6 response in support of recommended doses for rheumatoid arthritis. J Clin Pharmacol 47(11):1408–1420
Vugmeyster Y, Xu X, Theil FP, Khawli LA, Leach MW (2012) Pharmacokinetics and toxicology of therapeutic proteins: advances and challenges. World J Biol Chem 3(4):73–92
Genovese MC, Covarrubias A, Leon G, Mysler E, Keiserman M, Valente R, Nash P, Simon-Campos JA, Porawska W, Box J, Legerton C 3rd, Nasonov E, Durez P, Aranda R, Pappu R, Delaet I, Teng J, Alten R (2011) Subcutaneous abatacept versus intravenous abatacept: a phase IIIb noninferiority study in patients with an inadequate response to methotrexate. Arthritis Rheum 63(10):2854–2864
Ismael G, Hegg R, Muehlbauer S, Heinzmann D, Lum B, Kim SB, Pienkowski T, Lichinitser M, Semiglazov V, Melichar B, Jackisch C (2012) Subcutaneous versus intravenous administration of (neo)adjuvant trastuzumab in patients with HER2-positive, clinical stage I-III breast cancer (HannaH study): a phase 3, open-label, multicentre, randomised trial. Lancet Oncol 13(9):869–878
Zhuang Y, Xu Z, Frederick B, de Vries DE, Ford JA, Keen M, Doyle MK, Petty KJ, Davis HM, Zhou H (2012) Golimumab pharmacokinetics after repeated subcutaneous and intravenous administrations in patients with rheumatoid arthritis and the effect of concomitant methotrexate: an open-label, randomized study. Clin Ther 34(1):77–90
Schurgers E, Billiau A, Matthys P (2011) Collagen-induced arthritis as an animal model for rheumatoid arthritis: focus on interferon-gamma. J Interferon Cytokine Res 31(12):917–926
Holmdahl R, Lorentzen JC, Lu S, Olofsson P, Wester L, Holmberg J, Pettersson U (2001) Arthritis induced in rats with nonimmunogenic adjuvants as models for rheumatoid arthritis. Immunol Rev 184:184–202
Lon HK, Liu D, Jusko WJ (2012) Pharmacokinetic/pharmacodynamic modeling in inflammation. Crit Rev Biomed Eng 40(4):295–312
Korhonen R, Moilanen E (2009) Abatacept, a novel CD80/86-CD28 T cell co-stimulation modulator, in the treatment of rheumatoid arthritis. Basic Clin Pharmacol Toxicol 104(4):276–284
Maxwell LJ, Singh JA (2010) Abatacept for rheumatoid arthritis: a cochrane systematic review. J Rheumatol 37(2):234–245
Kremer JM, Westhovens R, Leon M, Di Giorgio E, Alten R, Steinfeld S, Russell A, Dougados M, Emery P, Nuamah IF, Williams GR, Becker JC, Hagerty DT, Moreland LW (2003) Treatment of rheumatoid arthritis by selective inhibition of T-cell activation with fusion protein CTLA4Ig. N Engl J Med 349(20):1907–1915
Kremer JM, Dougados M, Emery P, Durez P, Sibilia J, Shergy W, Steinfeld S, Tindall E, Becker JC, Li T, Nuamah IF, Aranda R, Moreland LW (2005) Treatment of rheumatoid arthritis with the selective costimulation modulator abatacept: twelve-month results of a phase iib, double-blind, randomized, placebo-controlled trial. Arthritis Rheum 52(8):2263–2271
Kliwinski C, Kukral D, Postelnek J, Krishnan B, Killar L, Lewin A, Nadler S, Townsend R (2005) Prophylactic administration of abatacept prevents disease and bone destruction in a rat model of collagen-induced arthritis. J Autoimmun 25(3):165–171
Webb LM, Walmsley MJ, Feldmann M (1996) Prevention and amelioration of collagen-induced arthritis by blockade of the CD28 co-stimulatory pathway: requirement for both B7-1 and B7-2. Eur J Immunol 26(10):2320–2328
Davis PM, Nadler SG, Stetsko DK, Suchard SJ (2008) Abatacept modulates human dendritic cell-stimulated T-cell proliferation and effector function independent of IDO induction. Clin Immunol 126(1):38–47
Liu DY, Lon HK, Wang YL, DuBois DC, Almon RR, Jusko WJ (2013) Pharmacokinetics, pharmacodynamics and toxicities of methotrexate in healthy and collagen-induced arthritic rats. Biopharm Drug Dispos 34(4):203–214
Bendele A, McAbee T, Sennello G, Frazier J, Chlipala E, McCabe D (1999) Efficacy of sustained blood levels of interleukin-1 receptor antagonist in animal models of arthritis: comparison of efficacy in animal models with human clinical data. Arthritis Rheum 42(3):498–506
Schett G, Middleton S, Bolon B, Stolina M, Brown H, Zhu L, Pretorius J, Zack DJ, Kostenuik P, Feige U (2005) Additive bone-protective effects of anabolic treatment when used in conjunction with RANKL and tumor necrosis factor inhibition in two rat arthritis models. Arthritis Rheum 52(5):1604–1611
Castro-Rueda H, Kavanaugh A (2008) Biologic therapy for early rheumatoid arthritis: the latest evidence. Curr Opin Rheumatol 20(3):314–319
Salt E, Crofford L (2012) Rheumatoid arthritis: new treatments, better outcomes. Nurse Pract 37(11):16–22 (quiz 23)
Colmegna I, Ohata BR, Menard HA (2012) Current understanding of rheumatoid arthritis therapy. Clin Pharmacol Ther 91(4):607–620
Chan ES, Cronstein BN (2010) Methotrexate–how does it really work? Nat Rev Rheumatol 6(3):175–178
Neurath MF, Hildner K, Becker C, Schlaak JF, Barbulescu K, Germann T, Schmitt E, Schirmacher P, Haralambous S, Pasparakis M, Meyer Zum Buschenfelde KH, Kollias G, Marker-Hermann E (1999) Methotrexate specifically modulates cytokine production by T cells and macrophages in murine collagen-induced arthritis (CIA): a mechanism for methotrexate-mediated immunosuppression. Clin Exp Immunol 115(1):42–55
Summey BT, Yosipovitch G (2006) Glucocorticoid-induced bone loss in dermatologic patients: an update. Arch Dermatol 142(1):82–90
Seriolo B, Paolino S, Sulli A, Ferretti V, Cutolo M (2006) Bone metabolism changes during anti-TNF-alpha therapy in patients with active rheumatoid arthritis. Ann N Y Acad Sci 1069:420–427
Acknowledgments
This work was supported by funding from the UB Center for Protein Therapeutics, NIH Grant GM 24211, a fellowship for Ms. Lon from Amgen, Inc., and fellowship support for Dr. Liu from Hoffman-La Roche Inc.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lon, HK., Liu, D., DuBois, D.C. et al. Modeling pharmacokinetics/pharmacodynamics of abatacept and disease progression in collagen-induced arthritic rats: a population approach. J Pharmacokinet Pharmacodyn 40, 701–712 (2013). https://doi.org/10.1007/s10928-013-9341-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10928-013-9341-1