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Kynamro: how was the first human dose set?

mipomersen · APOB (ASO)
First-in-human starting dose
Applicant estimated safe starting dose from nonclinical results; method not specified
“In addition, on the basis of these non-clinical studies the applicant estimated an acceptable safe starting dose for humans based on the results observed.”
✓ VerifiedEMA assessment report, p. 29Source ↗
NOAEL / key findings
1-year monkey NOAEL 10 mg/kg/week (vascular intimal hyperplasia at 30); kidney NOAEL 3 mg/kg/week; liver, kidney, thrombocytopenia
“In a chronic monkey study, multi-focal intimal hyperplasia with mixed inflammatory infiltrates was evident in vascular beds in 2 of 6 monkeys treated for 12 months with 30 mg/kg/week with a no-observed-adverse-effect-level (NOAEL) of 10 mg/kg/week”
✓ VerifiedFDA pharmacology/toxicology review, p. 13Source ↗

Same question, other oligonucleotides

Zanvastro

zilganersen · GFAP (ASO)
Starting-dose rationale not stated; FDA capped clinical IT dose at 25 mg (~1/10 mouse/monkey NOAEL), later 50 mg Q12W

Amondys 45

casimersen · DMD exon 45 (PMO)
Not stated in public reviews

Amvuttra

vutrisiran · TTR (siRNA)
Not stated in public reviews

Dawnzera

donidalorsen · Prekallikrein / KLKB1 (ASO)
Not stated in public reviews

Exondys 51

eteplirsen · DMD exon 51 (PMO)
Not stated in public reviews

Givlaari

givosiran · ALAS1 (siRNA)
Not stated in public reviews

Izervay

avacincaptad pegol · C5 (aptamer)
Not stated in public reviews

Leqvio

inclisiran · PCSK9 (siRNA)
Not stated in public reviews

Macugen

pegaptanib · VEGF-165 (aptamer)
Not stated in public reviews

Onpattro

patisiran · TTR (siRNA)
Not stated in public reviews

Oxlumo

lumasiran · HAO1 (siRNA)
Not stated in public reviews

Qalsody

tofersen · SOD1 (ASO)
Not stated in public reviews

Qfitlia

fitusiran · Antithrombin / SERPINC1 (siRNA)
Not stated in public reviews

Redemplo

plozasiran · APOC3 (siRNA)
Not stated in public reviews

Rivfloza

nedosiran · LDHA (siRNA)
Not stated in public reviews

Rytelo

imetelstat · Telomerase (oligo)
Not stated in public reviews

Spinraza

nusinersen · SMN2 (ASO)
Not stated in public reviews

Tegsedi

inotersen · TTR (ASO)
Not stated in public reviews

Tryngolza

olezarsen · APOC3 (ASO)
Not stated in public reviews

Viltepso

viltolarsen · DMD exon 53 (PMO)
Not stated in public reviews

Vyondys 53

golodirsen · DMD exon 53 (PMO)
Not stated in public reviews

Wainua

eplontersen · TTR (ASO)
Not stated in public reviews

Waylivra

volanesorsen · APOC3 (ASO)
Not stated in public reviews

Summary across all 24 oligonucleotides →