Immunogenicity to therapeutic proteins: impact on PK/PD and efficacy

AAPS J. 2012 Jun;14(2):296-302. doi: 10.1208/s12248-012-9340-y. Epub 2012 Mar 10.

Abstract

The development of therapeutic proteins requires the understanding of the relationship between the dose, exposure, efficacy, and toxicity of these molecules. Several intrinsic and extrinsic factors contribute to the challenges for measuring therapeutic proteins in a precise and accurate manner. In addition, induction of an immune response to therapeutic protein results in additional complexities in the analysis of the pharmacokinetic profile, toxicity, safety, and efficacy of this class of molecules. Assessment of immunogenicity of therapeutic proteins is a required aspect of regulatory filings for a licensing application and for the safe and efficacious use of these compounds. A systematic strategy and well-defined criteria for measuring anti-drug antibodies (ADA) have been established, to a large extent, through coordinated efforts. These recommendations are based on risk assessment and include the determination of ADA content (concentration/titer), affinity, immunoglobulin isotype/subtype, and neutralization capacity. This manuscript reviews the requirements necessary for understanding the nature of an ADA response in order to discern the impact of immunogenicity on pharmacokinetics/pharmacodynamics and efficacy.

Publication types

  • Review

MeSH terms

  • Animals
  • Antibody Formation*
  • Biological Products / immunology*
  • Biological Products / pharmacokinetics*
  • Biological Products / therapeutic use
  • Clinical Trials as Topic / methods
  • Humans
  • Immunogenetic Phenomena / drug effects*
  • Immunogenetic Phenomena / immunology*
  • Pharmaceutical Preparations / metabolism
  • Pharmacokinetics
  • Proteins / immunology*
  • Proteins / pharmacokinetics*
  • Proteins / therapeutic use
  • Treatment Outcome

Substances

  • Biological Products
  • Pharmaceutical Preparations
  • Proteins