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Title: A Safety and Pharmacodynamics Study of Temelimab, an anti-HERV-W-Env Monoclonal Antibody, in Type 1 Diabetes Patients.
Austin Authors: Curtin, Francois;Champion, Bernard;Davoren, Peter;Duke, Sally;Ekinci, Elif I ;Gilfillan, Chris;Morbey, Claire;Nathow, Thomas;O'Moore-Sullivan, Trisha;O'Neal, David;Roberts, Adam;Stranks, Stephen;Stuckey, Bronwyn;Vora, Parind;Malpass, Sam;Lloyd, David;Maëstracci-Beard, Nicole;Buffet, Bénédicte;Kornmann, Gabrielle;Bernard, Corinne;Porchet, Hervé;Simpson, Richard
Affiliation: GeNeuro SA, chemin Pré-Fleuri 3, CH, Switzerland
Keogh Institute for Medical Research, Nedlands, WA, Australia
Southern Star Research Pty Ltd, Australia
GeNeuro SA, chemin Pré-Fleuri 3, CH, Switzerland
Department of Pharmacology, University of Pretoria, Pretoria, South Africa
Division of Clinical Pharmacology and Toxicology, Rue Perret-Gentil, University of Geneva, Geneva, Switzerland
Lyell McEwin Hospital, Division of Medicine, Elizabeth, Australia
Faculty of Medicine and Health Sciences, Suite 407, Level 4, Department of Clinical Medicine, Macquarie University, Australia
Southern Adelaide Diabetes & Endocrine Services, Australia
Department of Endocrinology, Barwon Health, Geelong, Victoria, Australia
Department of Medicine, St. Vincent's Hospital, Fitzroy, Victoria, Australia
Mater Hospital, South Brisbane, Australia
Ipswich Research Institute, Ipswich, Australia
AIM Centre, Australia
Eastern Clinical Research Unit, Eastern Health and Monash University Level 2, Box Hill, Victoria, Australia
Medicine (University of Melbourne)
Department of Diabetes, Endocrinology and Metabolism, Royal North Shore Hospital, St Leonards, NSW, Australia
Gold Coats Hospital, Diabetes and Endocrinology, Southport, Australia
Issue Date: 19-Feb-2020
Date: 2020-02-19
Publication information: Diabetes, Obesity & Metabolism 2020; online first: 19 February
Abstract: Type 1 diabetes (T1D) is characterized by a loss of β-cell function resulting in insulin deficiency. The pathogenic human endogenous retrovirus type W envelope (pHERV-W-Env) protein is associated with T1D and may play a role in the loss of β-cells. Temelimab is a monoclonal antibody neutralizing pHERV-W-Env and we report its first study in T1D patients. This double blind placebo-controlled randomized clinical trial recruited adult T1D patients within 4 years post-diagnosis and remaining C-peptide secretion. Sixty four patients were randomized (2:1) to monthly temelimab 6 mg/kg or placebo during 24 weeks followed by a 24-week open-label extension during which all patients received temelimab. The primary objective was the safety and tolerability of temelimab. The secondary objective was to assess pharmacodynamics (PD) response such as C-peptide levels, insulin use, glycated hemoglobin (HbA1c), hypoglycemia and auto-antibodies. Temelimab was well tolerated without any group difference in the frequency or severity of adverse events. Concerning exploratory endpoints, there was no difference in the levels of C-peptide, insulin use or HbA1c between treatment groups at Weeks 24 and 48. The frequency of hypoglycemia events was reduced with temelimab (p=0.0004) at Week 24 and the level of anti-insulin antibodies was lower with temelimab (p<0.01), the other auto-antibodies did not differ between groups. Temelimab appeared safe in T1D patients. Pharmacodynamics signals (hypoglycemia and anti-insulin antibodies) under temelimab were observed. Markers of β-cell functions were not modified by treatment. These results need to be further explored in younger T1D patients with earlier disease onset. This article is protected by copyright. All rights reserved.
DOI: 10.1111/dom.14010
ORCID: 0000-0002-4570-1850
Journal: Diabetes, Obesity & Metabolism
PubMed URL: 32077207
Type: Journal Article
Subjects: HERV
Phase II study
disease modifying drug
endogenous retrovirus
monoclonal antibody
type 1 diabetes
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