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  4. A First-in-Human Randomized Study to Assess the Safety, Tolerability, Pharmacokinetics, and Neutralization Profile of Two Investigational Long-Acting Anti-SARS-CoV-2 Monoclonal Antibodies
 
research article

A First-in-Human Randomized Study to Assess the Safety, Tolerability, Pharmacokinetics, and Neutralization Profile of Two Investigational Long-Acting Anti-SARS-CoV-2 Monoclonal Antibodies

Moullan, Norman
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Asiago, Josephat
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Stecco, Kathryn
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January 14, 2024
Infectious Diseases and Therapy

Introduction: COVID-19 remains a significant risk for the immunocompromised given their lower responsiveness to vaccination or infection. Therefore, passive immunity through long-acting monoclonal antibodies (mAbs) offers a needed approach for pre-exposure prophylaxis (PrEP). Our study evaluated safety, anti-SARS-CoV-2 neutralizing activity, nasal penetration, and pharmacokinetics (PK) of two half-life-extended investigational mAbs, AER001 and AER002, providing the first demonstration of upper airway penetration of mAbs with the LS-modification. Methods: This randomized, double-blind, placebo-controlled phase I study enrolled healthy adults (n = 80) who received two long-acting COVID mAbs (AER001 and AER002), AER002 alone, or placebo. The dose ranged from 100 mg (mg) to 1200 mg per mAb component. The primary objective was to describe the safety and tolerability following intravenous (IV) administration. Secondary objectives were to describe PK, anti-drug antibodies (ADA), neutralization activity levels, and safety evaluation through 6 months of follow-up. Results: The majority (97.6%) of the reported adverse events (AE) post administration were of grade 1 severity. There were no serious adverse events (SAE) or ADAs. AER001 and AER002 successfully achieved an extended half-life of 105 days and 97.5 days, respectively. Participants receiving AER001 and AER002 (300 mg each) or AER002 (300 mg) alone showed 15- and 26-fold higher neutralization levels against D614G and omicron BA.1 than the placebo group 24 h post-administration. Single 300 or 1200 mg IV dose of AER001 and AER002 resulted in nasal mucosa transudation of approximately 2.5% and 2.7%, respectively. Conclusion: AER001 and AER002 showed an acceptable safety profile and extended half-life. High serum neutralization activity was observed against D614G and Omicron BA.1 compared to the placebo group. These data support that LS-modified mAbs can achieve durability, safety, potency, and upper airway tissue penetration and will guide the development of the next generation of mAbs for COVID-19 prevention and treatment. Trial registration: EudraCT Number 2022-001709-35 (COV-2022-001).

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Type
research article
DOI
10.1007/s40121-023-00908-9
Author(s)
Moullan, Norman
Asiago, Josephat
Stecco, Kathryn
Hadi, Salah
Albizem, Moetaz
Tieu, Holly
Hock, Björn
Fenwick, Craig
Lin, Kai
Lengsfeld, Thomas
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Date Issued

2024-01-14

Published in
Infectious Diseases and Therapy
Subjects

COVID-19

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Immunocompromised

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Long acting

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Monoclonal antibodies

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Nasal mucosa

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Neutralization

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Pre-exposure prophylaxis

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Transudation

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
LVG  
Available on Infoscience
January 16, 2024
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/202986
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