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Open Access Research article

A randomized, double-blind study of AMG 108 (a fully human monoclonal antibody to IL-1R1) in patients with osteoarthritis of the knee

Stanley B Cohen1*, Susanna Proudman2, Alan J Kivitz3, Francis X Burch4, John P Donohue5, Deborah Burstein6, Yu-Nien Sun7, Christopher Banfield8, Michael S Vincent9, Liyun Ni10 and Debra J Zack9

Author Affiliations

1 Rheumatology, Metroplex Clinical Research Center, 8144 Walnut Hill Lane, Dallas, TX 75231, USA

2 FRACP, Bone Densitometry Research, Royal Adelaide Hospital, North Terrace, Adelaide SA 5000, Australia

3 Arthritis and Osteoporosis, Altoona Center for Clinical Research, 175 Meadowbrook Lane, Duncansville, PA 16635-8445, USA

4 San Antonio Center for Clinical Research, 7940 Floyd Curl Drive, San Antonio, TX 78229, USA

5 Rheumatologic and Immunologic Disease, Cleveland Clinic, 2950 Cleveland Clinic Boulevard, Florida, Weston, FL 33331, USA

6 Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Drive, Boston, MA 02115, USA

7 Inflammation Research, Amgen, Inc., One Amgen Center Drive, Thousand Oaks, CA 91320, USA

8 Medical Sciences Early Development, Amgen, Inc., One Amgen Center Drive, Thousand Oaks, CA 91320, USA

9 Global Development, Amgen, Inc., One Amgen Center Drive, Thousand Oaks, CA 91320, USA

10 Global Biostatistical Science, Amgen, Inc., One Amgen Center Drive, Thousand Oaks, CA 91320, USA

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Arthritis Research & Therapy 2011, 13:R125  doi:10.1186/ar3430

Published: 29 July 2011

Abstract

Introduction

AMG 108 is a fully human, immunoglobulin subclass G2 (IgG2) monoclonal antibody that binds the human interleukin-1 (IL-1) receptor type 1, inhibiting the activity of IL-1a and IL-1b. In preclinical studies, IL-1 inhibition was shown to be beneficial in models of osteoarthritis (OA). The purpose of this two-part study was to evaluate the safety and pharmacokinetics (PK; Part A) and clinical effect (Part B) of AMG 108 in a double-blind, placebo-controlled, multiple-dose study in patients with OA of the knee.

Methods

In Part A, patients received placebo or AMG 108 subcutaneously (SC; 75 mg or 300 mg) or intravenously (IV; 100 mg or 300 mg) once every 4 weeks for 12 weeks; in Part B, patients received placebo or 300 mg AMG 108 SC, once every 4 weeks for 12 weeks. The clinical effect of AMG 108 was measured in Part B by using the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index pain score.

Results

In Part A, 68 patients were randomized, and 64 received investigational product. In Part B, 160 patients were randomized, and 159 received investigational product. AMG 108 was well tolerated. Most adverse events (AEs), infectious AEs, serious AEs and infections, as well as withdrawals from the study due to AEs occurred at similar rates in both active and placebo groups. One death was reported in an 80-year-old patient (Part A, 300 mg IV AMG 108; due to complications of lobar pneumonia). AMG 108 serum concentration-time profiles exhibited nonlinear PK. The AMG 108 group in Part B had statistically insignificant but numerically greater improvement in pain compared with the placebo group, as shown by the WOMAC pain scores (median change, -63.0 versus -37.0, respectively).

Conclusions

The safety profile of AMG 108 SC and IV was comparable with placebo in patients with OA of the knee. Patients who received AMG 108 showed statistically insignificant but numerically greater improvements in pain; however, minimal, if any, clinical benefit was observed.

Trial Registration

This study is registered with ClinicalTrials.gov with the identifier NCT00110942.