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Model-Based Assessment of the Contribution of Monocytes and Macrophages to the Pharmacokinetics of Monoclonal Antibodies

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Abstract

Purpose

We have hypothesized that a high concentration of circulating monocytes and macrophages may contribute to the fast weight-based clearance of monoclonal antibodies (mAbs) in young children. Exploring this hypothesis, this work uses modeling to clarify the role of monocytes and macrophages in the elimination of mAbs.

Methods

Leveraging pre-clinical data from mice, a minimal physiologically-based pharmacokinetic model was developed to characterize mAb uptake and FcRn-mediated recycling in circulating monocytes, macrophages, and endothelial cells. The model characterized IgG disposition in complex scenarios of site-specific FcRn deletion and variable endogenous IgG levels. Evaluation was performed for predicting IgG disposition with co-administration of high dose IVIG. A one-at-a-time sensitivity analysis quantified the role of relevant cellular parameters on IgG elimination in various scenarios.

Results

The plasma AUC of mAbs was highly sensitive to endothelial cell parameters, but had near-nil sensitivity to monocyte and macrophage parameters, even in scenarios with 90% loss of FcRn expression/activity. In mice with normal FcRn expression, simulations suggest that less than 2% of an IV dose is eliminated in macrophages, while endothelial cells are predicted to dominate mAb elimination.

Conclusions

The model suggests that the role of monocytes and macrophages in IgG homeostasis includes extensive uptake and highly efficient FcRn-mediated protection, but not appreciable degradation when FcRn is present. Therefore, it is very unlikely that a high concentration of circulating monocytes can contribute to explaining the fast weight-based clearance of mAbs in very young children, even if FcRn expression/activity was 90% lower in children than in adults.

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ACKNOWLEDGMENTS AND DISCLOSURES

The authors have no conflicts of interest or sources of competing interest to declare.

Funding

This work was funded in part by Canadian Institutes of Health Research through the Frederick Banting and Charles Best Canada Graduate Scholarship (CGS-D).

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Authors and Affiliations

  1. School of Pharmacy, University of Waterloo, 10A Victoria St S, Kitchener, Ontario, N2G 1C5, Canada

    Paul R. V. Malik, Abdullah Hamadeh & Andrea N. Edginton

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  1. Paul R. V. Malik
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  3. Andrea N. Edginton
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Correspondence to Andrea N. Edginton.

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Malik, P.R.V., Hamadeh, A. & Edginton, A.N. Model-Based Assessment of the Contribution of Monocytes and Macrophages to the Pharmacokinetics of Monoclonal Antibodies. Pharm Res 39, 239–250 (2022). https://doi.org/10.1007/s11095-022-03177-2

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  • DOI: https://doi.org/10.1007/s11095-022-03177-2

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