Population Pharmacokinetics and Exposure–Response Analysis of Benralizumab in Chinese Adults, Adolescents, and Pediatric Participants with Severe Eosinophilic Asthma
摘要
Benralizumab is approved as add-on subcutaneous therapy in patients aged ≥ 12 years with severe eosinophilic asthma in > 80 countries, including mainland China.
ObjectiveThe study objective was to update benralizumab population pharmacokinetic (popPK) and exposure–response (ER) models in Chinese, Asian (including Chinese), and non-Asian participants.
MethodsBenralizumab popPK/ER models for asthma exacerbation rate and pre-bronchodilator forced expiratory volume in 1 second (FEV1) were updated for three benralizumab trials involving Chinese, Asian (including Chinese), and non-Asian participants. The ER analysis examined correlations between pharmacokinetic quartiles and annual asthma exacerbation rate (AAER) ratios with simulations comparing predicted clinical outcomes.
ResultsUpdated data included 17,465 benralizumab concentrations (n = 2855). The updated model predicted a slight, and not clinically relevant, increase (< 14%) in benralizumab exposure for Chinese versus non-Asian adults. Median exposure increased in Chinese adolescents versus adults owing to body weight differences, but no dose adjustment was needed. Chinese children weighing < 35 kg receiving a 10 mg dose had similar exposure to those weighing ≥ 35 kg receiving a 30 mg dose. In Chinese versus non-Chinese participants, there was no trend concerning AAER ratios across different trough concentration quartiles; the maximal treatment effect significantly increased (+127%; p < 0.001), and there was no statistically significant effect on pre-bronchodilator FEV1. Steady-state simulations showed lower predicted AAER ratios in Chinese (0.38; 95% confidence interval [CI] 0.32–0.45) than in non-Chinese adults (0.64; 95% CI 0.60–0.71), and no relevant differences between Chinese adults (0.46; 95% CI 0.38–0.54) and adolescents (0.46; 95% CI 0.37–0.55).
ConclusionThe benralizumab popPK/ER models showed good predictive performance across Chinese demographics.
Trial registration numberNCT03186209.
Trial registration date6 July 2017.