Nonclinical precedent Request an invite

Cinqair

reslizumab
monoclonal antibodyIL-5Humanized IgG4-kappa anti-IL-5 monoclonal antibodySevere eosinophilic asthma, add-on maintenance
Species
MonkeyMouse
Longest study
26 wk
Genotox
Conducted Conducted
Carcinogenicity
Conducted Conducted
Repro
Conducted Conducted
First dose
Partial / alternative Partly stated

Speciesopen answer page →

Species
Mouse and cynomolgus monkey
“Pivotal nonclinical studies were conducted in CD-1 mice and Cynomolgus monkeys; both were identified as relevant species in a series of pharmacology studies.”
✓ VerifiedFDA pharmacology/toxicology review, p. 2Source ↗
Why that species
Similar binding affinity to human, monkey and mouse IL-5 (KD 24, 20 and 31 pM)
“Reslizumab binds with similar affinity to human, monkey, and mouse IL-5 (KD = 24, 20, and 31 pM; respectively, as determined by BIAcore biosensor assays).”
✓ VerifiedFDA pharmacology/toxicology review, p. 30Source ↗
Surrogate molecule
No surrogate; the clinical antibody was tested in mice, rabbits and cynomolgus monkeys
“The nonclinical program for reslizumab included studies conducted in mice, rabbits, and monkeys, which were all considered pharmacologically relevant species based on data from in vivo eosinophilia models in sensitized animals”
✓ VerifiedFDA pharmacology/toxicology review, p. 30Source ↗

Study lengthopen answer page →

Longest pivotal study
26 weeks
“In toxicology studies up to 6 months duration, no target organs of toxicity were identified in either mice or monkeys at an IV dose up to 25 mg/kg once every 4 weeks.”
✓ VerifiedFDA pharmacology/toxicology review, p. 2Source ↗
Pivotal GLP studies
6-month IV studies in mice and cynomolgus monkeys, up to 25 mg/kg once every 4 weeks
“In toxicology studies up to 6 months duration, no target organs of toxicity were identified in either mice or monkeys at an IV dose up to 25 mg/kg once every 4 weeks.”
✓ VerifiedFDA pharmacology/toxicology review, p. 2Source ↗
Route in tox
IV
“Repeat-dose GLP toxicology studies were conducted in CD-1 mice, CByB6F1- Tg(HRAS)2Jic mice, and cynomolgus monkeys using the IV route of administration.”
✓ VerifiedFDA pharmacology/toxicology review, p. 48Source ↗

Skipped studiesopen answer page →

Genotoxicity
Not applicable for a protein; Ames and in vitro chromosomal aberration assays negative
“Genetic toxicity studies were not applicable for this therapeutic biologic protein though reslizumab was negative in two in vitro assays.”
✓ VerifiedFDA pharmacology/toxicology review, p. 2Source ↗
Carcinogenicity
Tg.rasH2 transgenic mouse study up to 500 mg/kg IV every two weeks: no drug-related neoplasms
“A transgenic mouse (Tg.rasH2) carcinogenicity study was conducted with dose concurrence by the Executive Carcinogenicity Assessment Committee (ECAC). No drug-related neoplasms were found after dosing up to 500 mg/kg IV once every two weeks.”
✓ VerifiedFDA pharmacology/toxicology review, p. 2Source ↗
Reproductive & developmental
No effects on fertility or development up to 50 mg/kg IV; about 6-fold exposure margin in mouse studies
“No effects on fertility or development parameters were identified at doses up to 50 mg/kg IV; exposure margins of approximately 6-fold were available in the mouse studies.”
✓ VerifiedFDA pharmacology/toxicology review, p. 3Source ↗
Safety pharmacology
Rat and monkey studies at 100 and 25 mg/kg: no cardiovascular, CNS or gastrointestinal effects
“Reslizumab administered iv at a dose of 100 mg/kg (600 mg/m2) to rats (DS-2014-080) and 25 mg/kg (300 mg/m2) to monkeys (SN96333) did not elicit effects on the most important parameters related to organ functions (cardiovascular, CNS, or gastrointestinal).”
✓ VerifiedEMA assessment report, p. 20Source ↗

First doseopen answer page →

First-in-human starting dose
Phase 1 single-dose escalation in severe asthma at 0.03 to 1.0 mg/kg; derivation of starting dose not described
“This product has been used in Europe in an initial phase 1 single dose, dose escalation trial for treatment of 32 subjects with severe asthma (I96-350). Doses ranged from 0.03 mg/kg to 1.0 mg/kg.”
✓ VerifiedFDA pharmacology/toxicology review, p. 125Source ↗
NOAEL / key findings
NOAEL 25 mg/kg (highest dose) in mice and monkeys; no target organs; about 3-fold exposure margin
“The NOAELs of 25 mg/kg provided a safety margin of approximately 3-fold compared to the recommended clinical dose based on systemic exposure comparisons.”
✓ VerifiedFDA pharmacology/toxicology review, p. 2Source ↗

Risksopen answer page →

Immune & cytokine safety
ADA in 3 monkeys in pivotal study; one at 25 mg/kg had repeated hypersensitivity-type infusion reactions
“Immunogenicity noted in 3 animals in the pivotal toxicity study (1 at 5 mg/kg, 2 at 25 mg/kg); 1 of the 25 mg/kg animals had repeated infusion reactions c/w hypersensitivity”
✓ VerifiedFDA pharmacology/toxicology review, p. 126Source ↗
Biodistribution & persistence
Human TCR binding only in spinal cord, brain and optic nerve; no binding in other tissues
“In human tissue, binding was observed in spinal cord, brain and optic nerve. No binding was seen to peripheral nerves, or any other human tissue examined.”
✓ VerifiedEMA assessment report, p. 19Source ↗
Modality-specific risk
Lack of eosinophil recovery, parasitic infection risk, CNS toxicity from tissue binding, hypersensitivity
“Lack of recovery of eosinophils, increased risk of parasitic infections, nonspecific CNS toxicity due to potential tissue binding, hypersensitivity responses.”
✓ VerifiedFDA pharmacology/toxicology review, p. 125Source ↗

Similar precedents