A Phase 2 Randomized, Double-Blind, Placebo-Controlled Trial of the Monoclonal Antibody MHAA4549A in Patients With Acute Uncomplicated Influenza A Infection
Lim, Jeremy J. (Early Clinical Development, Genentech, Inc)
Dar, Sadia (Clinical Research Solutions, LLC)
Venter, Dirk (Henderson Medical Centre)
Horcajada, Juan Pablo (Institut Hospital del Mar d'Investigacions Mèdiques)
Kulkarni, Priya (Early Clinical Development, Genentech, Inc)
Nguyen, Allen (Early Clinical Development, Genentech, Inc)
McBride, Jacqueline M. (Early Clinical Development, Genentech, Inc)
Deng, Rong (Early Clinical Development, Genentech, Inc)
Galanter, Joshua (Early Clinical Development, Genentech, Inc)
Chu, Tom (Early Clinical Development, Genentech, Inc)
Newton, Elizabeth M. (Early Clinical Development, Genentech, Inc)
Tavel, Jorge A. (Early Clinical Development, Genentech, Inc)
Peck, Melicent C. (Early Clinical Development, Genentech, Inc)
Universitat Autònoma de Barcelona

Data:	2021
Resum:	MHAA4549A, a human monoclonal antibody targeting the influenza A hemagglutinin stalk, neutralizes influenza A virus in animal and human volunteer challenge studies. We investigated the safety and tolerability, efficacy, and pharmacokinetics of MHAA4549A in outpatients with acute, uncomplicated influenza A infection. This was a phase 2, randomized, double-blind, placebo-controlled trial of single intravenous (IV) doses of 3600 mg or 8400 mg of MHAA4549A or IV placebo in adult outpatients testing positive for influenza A. Patients were enrolled across 35 sites in 6 countries. Randomization and dosing occurred within ≤72 hours of symptom onset; the study duration was 14 weeks. The primary end point was the nature and frequency of adverse events (AEs). Secondary end points included median time to alleviation of all influenza symptoms, effects on nasopharyngeal viral load and duration of viral shedding, and MHAA4549A serum pharmacokinetics. Of 125 randomized patients, 124 received study treatment, with 99 confirmed positive for influenza A by central testing. The frequency of AEs between the MHAA4549A and placebo groups was similar; nausea was most common (8 patients; 6. 5%). MHAA4549A serum exposure was confirmed in all MHAA4549A-treated patients and was dose-proportional. No hospitalizations or deaths occurred. Between the MHAA4549A and placebo groups, no statistically significant differences occurred in the median time to alleviation of all symptoms, nasopharyngeal viral load, or duration of viral shedding. While MHAA4549A was safe and well tolerated with confirmed exposure, the antibody did not improve clinical outcomes in patients with acute uncomplicated influenza A infection. D/C/F/TAF is the reference for combination therapy based on protease inhibitors but has not been compared with regimens containing integrase inhibitors as initial ART. We could not demonstrate D/C/F/TAF noninferiority relative to DTG/ABC/3TC, although both regimens were similarly well tolerated.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Antiviral agents ; Influenza A virus ; MHAA4549A ; Monoclonal antibody
Publicat a:	Open Forum Infectious Diseases, Vol. 9 (december 2021) , ISSN 2328-8957

DOI: 10.1093/ofid/ofab630
PMID: 35106315

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