We use cookies to improve your experience. By continuing to browse this site, you accept our cookie policy.×

Strategic characterization of anti-drug antibody responses for the assessment of clinical relevance and impact

    Suzanna M Tatarewicz

    *Author for correspondence:

    E-mail Address: suzannat@amgen.com

    Clinical Immunology, Amgen, Thousand Oaks, CA 91320, USA

    Clinical Immunology, Amgen, Thousand Oaks, CA 91320, USA

    ,
    Daniel T Mytych

    Clinical Immunology, Amgen, Thousand Oaks, CA 91320, USA

    Clinical Immunology, Amgen, Thousand Oaks, CA 91320, USA

    ,
    Marta Starcevic Manning

    Clinical Immunology, Amgen, Thousand Oaks, CA 91320, USA

    Clinical Immunology, Amgen, Thousand Oaks, CA 91320, USA

    ,
    Steven J Swanson

    Clinical Immunology, Amgen, Thousand Oaks, CA 91320, USA

    Clinical Immunology, Amgen, Thousand Oaks, CA 91320, USA

    ,
    Michael S Moxness

    Clinical Immunology, Amgen, Thousand Oaks, CA 91320, USA

    Clinical Immunology, Amgen, Thousand Oaks, CA 91320, USA

    &
    Narendra Chirmule

    Clinical Immunology, Amgen, Thousand Oaks, CA 91320, USA

    Clinical Immunology, Amgen, Thousand Oaks, CA 91320, USA

    Published Online:https://doi.org/10.4155/bio.14.114

    All therapeutic proteins have the potential to induce anti-drug antibodies (ADA). Clinically relevant ADA can impact efficacy and/or safety of a biological therapeutic. Immunogenicity assessment strategy evaluates binding and neutralizing ADA, and the need for additional characterization (e.g., epitope, titer and so on) is determined using a risk-based approach. The choice of characterization assays depends on the type, application and immunogenicity of the therapeutic. ADA characterization can impact the interpretation of the risk profile of a given therapeutic, and offers insight into opportunities for risk mitigation and management. This article describes common ADA characterization methods. Strategic assessment and characterization of clinically relevant ADA are discussed, in order to support clinical options for safe and effective patient care and disease management.

    Papers of special note have been highlighted as: • of interest •• of considerable interest

    References

    • 1 Singh SK. Impact of product-related factors on immunogenicity of biotherapeutics. J. Pharm. Sci. 100(2), 354–387 (2011).
    • 2 De Groot AS, Scott DW. Immunogenicity of protein therapeutics. Trends Immunol. 28(11), 482–490 (2007).
    • 3 Committee for Medicinal Products for Human Use. Guideline of Immunogenicity Assessment of Biotechnology-Derived Therapeutic Proteins. EMA, London, UK (2008).
    • 4 US Department Health and Human Services C. FDA Draft Guidance Immunogenicity Assessment. US FDA, Silver Spring, MD, USA (2013). 
    • 5 Shankar G, Devanarayan V, Amaravadi L et al. Recommendations for the validation of immunoassays used for detection of host antibodies against biotechnology products. J. Pharm. Biomed. Anal. 48(5), 1267–1281 (2008).
    • 6 Gupta S, Indelicato SR, Jethwa V et al. Recommendations for the design, optimization, and qualification of cell-based assays used for the detection of neutralizing antibody responses elicited to biological therapeutics. J. Immunol. Methods 321(1–2), 1–18 (2007).
    • 7 Koren E, Smith HW, Shores E et al. Recommendations on risk-based strategies for detection and characterization of antibodies against biotechnology products. J. Immunol. Methods 333(1–2), 1–9 (2008).•• Provides recommendations and risk-based strategy for detection and characterization of anti-drug antibodies (ADA).
    • 8 Shankar G, Pendley C, Stein KE. A risk-based bioanalytical strategy for the assessment of antibody immune responses against biological drugs. Nat. Biotech. 25(5), 555–561 (2007).
    • 9 Hart MH. Differential effect of drug interference in immunogenicity assays. J. Immunol. Methods 372, 196–203 (2011).•• Regulatory guidance for immunogenicity assessment.
    • 10 Mire-Sluis AR, Barrett YC, Devanarayan V et al. Recommendations for the design and optimization of immunoassays used in the detection of host antibodies against biotechnology products. J. Immunol. Methods 289(1–2), 1–16 (2004).
    • 11 Lofgren JA, Dhandapani S, Pennucci JJ et al. Comparing ELISA and surface plasmon resonance for assessing clinical immunogenicity of panitumumab. J. Immunol. 178(11), 7467–7472 (2007).
    • 12 Wang YM, Fang L, Zhou L, Wang J, Ahn HY. A survey of applications of biological products for drug interference of immunogenicity assays. Pharm. Res. 29(12), 3384–3392 (2012).
    • 13 Patton A, Mullenix MC, Swanson SJ, Koren E. An acid dissociation bridging ELISA for detection of antibodies directed against therapeutic proteins in the presence of antigen. J. Immunol. Methods 304(1–2), 189–195 (2005).
    • 14 Moxness M, Tatarewicz S, Weeraratne D et al. Immunogenicity testing by electrochemiluminescent detection for antibodies directed against therapeutic human monoclonal antibodies. Clin. Chem. 51(10), 1983–1985 (2005).
    • 15 Li J, Yea X. Thrombocytopenia caused by the development of antibodies to thrombopoietin. Blood 98, 3241–3248 (2001).
    • 16 Crawford J, Glaspy J, Belani C. A randomized, placebo-controlled, blinded, dose-scheduling trial of pegylated recombinant human megakaryocyte growth and development factor (PEG-rHuMGDF) with Filgrastim support in non-small cell lung cancer (NSCLC) patients treated with paclitaxel and carboplatin during multiple cycles of chemotherapy [abstract]. Proc. Am. Soc. Clin. Oncol. 17, 285 (1998).
    • 17 Schellekens H. Recombinant human erythropoietins, biosimilars and immunogenicity. J. Nephrol. 21(4), 497–502 (2008).
    • 18 Gupta S, Devanarayan V, Finco D et al. Recommendations for the validation of cell-based assays used for the detection of neutralizing antibody immune responses elicited against biological therapeutics. J. Pharm. Biomed. Anal. 55(5), 878–888 (2011).
    • 19 Uetrecht J. Immune mediated adverse drug reactions. Clin. Res. Toxicol. 22, 24–34 (2009).
    • 20 Puxeddu I, Giori L, Rocchi V et al. Hypersensitivity reactions during treatment with infliximab, etanercept, and adalimumab. Ann. Allergy Asthma Immunol. 108(2), 123–124 (2012).
    • 21 Ramos-Casals M, Brito-Zeron P, Munoz S et al. Autoimmune diseases induced by TNF-targeted therapies: analysis of 233 cases. Medicine (Baltimore) 86(4), 242–251 (2007).
    • 22 Tabrizi MA, Roskos LK. Preclinical and clinical safety of monoclonal antibodies. Drug Discov. Today 12(13–14), 540–547 (2007).
    • 23 Shen CH, Talay O, Mahajan VS, Leskov IB, Eisen HN, Chen J. Antigen-bearing dendritic cells regulate the diverse pattern of memory CD8 T-cell development in different tissues. Proc. Natl Acad. Sci. USA 107(52), 22587–22592 (2010).• Reviews key findings associated with ADA to anti-TNFα therapeutics.
    • 24 Subramanyam M. Case study-immunogenicity of natalizumab. In: Immunogenicity of BioPharmaceuticals. Springer, NY, USA, 173–187 (2008).
    • 25 Bartelds GM, Krieckaert CL, Nurmohamed MT et al. Development of antidrug antibodies against adalimumab and association with disease activity and treatment failure during long-term follow-up. JAMA 305(14), 1460–1468 (2011).• Case study of the thorough ADA characterization of natalizumab.
    • 26 Ben-Horin S, Mazor Y, Yanai H et al. The decline of anti-drug antibody titres after discontinuation of anti-TNFs: implications for predicting re-induction outcome in IBD. Aliment Pharmacol. Ther. 35(6), 714–722 (2012).
    • 27 Chirmule N, Jawa V, Meibohm B. Immunogenicity to therapeutic proteins: impact on PK/PD and efficacy. AAPS J. 14, 296–302 (2012).
    • 28 Li J, Yang C, Xia Y et al. Thrombocytopenia caused by the development of antibodies to thrombopoietin. Blood 98(12), 3241–3248 (2001).
    • 29 Baert F, Noman M, Vermeire S et al. Influence of immunogenicity on the long-term efficacy of infliximab in Crohn’s disease. N. Engl. J. Med. 348(7), 601–608 (2003).
    • 30 De Vries MK, Wolbink GJ, Stapel SO et al. Inefficacy of infliximab in ankylosing spondylitis is correlated with antibody formation. Ann. Rheum. Dis. 66(1), 133–134 (2007).
    • 31 Kappos L, Clanet M, Sandberg-Wollheim M et al. Neutralizing antibodies and efficacy of interferon beta-1a: a 4-year controlled study. Neurology 65(1), 40–47 (2005).
    • 32 Xu ZH, Lee H, Vu T et al. Population pharmacokinetics of golimumab in patients with ankylosing spondylitis: impact of body weight and immunogenicity. Int J. Clin. Pharmacol. Ther. 48(9), 596–607 (2010).
    • 33 Chung CH, Mirakhur B, Chan E et al. Cetuximab-induced anaphylaxis and IgE specific for galactose-alpha-1,3-galactose. N. Engl. J. Med. 358(11), 1109–1117 (2008).
    • 34 Vultaggio A. Anti-infliximab IgE and non-IgE antibodies and induction of infusion-related severe anaphylactic reactions. Allergy 65, 657–661 (2010).
    • 35 Thway TM, Magana I, Bautista A, Jawa V, Gu W, Ma M. Impact of anti-drug antibodies in preclinical pharmacokinetic assessment. AAPS J. 15(3), 856–863 (2013).
    • 36 Lobo ED, Hansen RJ, Balthasar JP. Antibody pharmacokinetics and pharmacodynamics. J. Pharm. Sci. 93(11), 2645–2668 (2004).
    • 37 Rehlaender BN, Cho MJ. Antibodies as carrier proteins. Pharm. Res. 15(11), 1652–1656 (1998).
    • 38 Yanover C, Jain N, Pierce G, Howard TE, Sauna ZE. Pharmacogenetics and the immunogenicity of protein therapeutics. Nat. Biotech. 29(10), 870–873 (2011).
    • 39 Lasko TA, Bhagwat JG, Zou KH, Ohno-Machado L. The use of receiver operating characteristic curves in biomedical informatics. J. Biomed. Inform. 38(5), 404–415 (2005).
    • 40 Zou KH, O’Malley AJ, Mauri L. Receiver-operating characteristic analysis for evaluating diagnostic tests and predictive models. Circulation 115(5), 654–657 (2007).
    • 41 Mendelsohn NJ, Messinger YH, Rosenberg AS, Kishnani PS. Elimination of antibodies to recombinant enzyme in Pompe’s disease. N. Engl. J. Med. 360(2), 194–195 (2009).
    • 42 Lacana E, Yao LP, Pariser AR, Rosenberg A. The role of immune tolerance induction in restoration of the efficacy of ERT in Pompe disease. Am. J. Med. Genet. C 160(C), 30–39 (2012).
    • 43 Banugaria SG, Prater SN, Ng YK et al. The impact of antibodies on clinical outcomes in diseases treated with therapeutic protein: lessons learned from infantile Pompe disease. Genet. Med. 13(8), 729–736 (2011).
    • 44 Steenholdt C, Bendtzen K, Brynskov J, Thomsen OØ, Ainsworth MA. Cut-off levels and diagnostic accuracy of infliximab trough levels and anti-infliximab antibodies in Crohn’s disease. Scand. J. Gastroenterol. 46(3), 310–318 (2011).• Example of ADA with impact on clinical outcomes in diseases treated with therapeutic protein.
    • 45 Kantor AB, Herzenberg LA. Origin of murine B cell lineages. Ann. Rev. Immunol. 11(1), 501–538 (1993).
    • 46 Stavnezer J. Immunoglobulin class switching. Curr. Opin. Immunol. 8(2), 199–205 (1996).
    • 47 Jefferis R, Kumararatne DS. Selective IgG subclass deficiency: quantification and clinical relevance. Clin. Exp. Immunol. 81(3), 357–367 (1990).
    • 48 Clinical and Laboratory Standards Institute. Design and Validation of Immunoassays for Assessment of Human Allergenicity of New Biotherapeutic Drugs; Approved Guideline. 2010. CLSI document I/LA34-A. Clinical and Laboratory Standards Institute, Wayne, PA, USA (2010).
    • 49 Alugupalli KR. A distinct role for B1b lymphocytes in T cell-independent immunity. Curr. Top. Microbiol. Immunol. 9, 105–130 (2008).
    • 50 Haas KM, Poe JC, Steeber DA, Tedder TF. B-1a and B-1b cells exhibit distinct developmental requirements and have unique functional roles in innate and adaptive immunity to S. pneumoniae. Immunity 23(1), 7–18 (2005).
    • 51 Hsu MC, Toellner KM, Vinuesa CG, Maclennan IC. B cell clones that sustain long-term plasmablast growth in T-independent extrafollicular antibody responses. Proc. Natl Acad. Sci. USA 103(15), 5905–5910 (2006).
    • 52 Barger TE, Wrona D, Goletz TJ, Mytych DT. A detailed examination of the antibody prevalence and characteristics of anti-ESA antibodies. Nephrol. Dial. Transplant. 27(10), 3892–3899 (2012).
    • 53 Tatarewicz SM, Wei X, Gupta S, Masterman D, Swanson SJ, M M. Development of a maturing T-cell-mediated immune response in patients with idiopathic Parkinson’s disease receiving r-met-HuGDNF via continuous intraputaminal infusion. J. Clin. Immunol. 27(6), 620 (2007).
    • 54 O’sneil BH, Allen R, Spigel DR et al. High incidence of cetuximab-related infusion reactions in Tennessee and North Carolina and the association with atopic history. J. Clin. Oncol. 25(24), 3644–3648 (2007).
    • 55 Commins SP, Platts-Mills TA. Anaphylaxis syndromes related to a new mammalian cross-reactive carbohydrate determinant. J. Allergy Clin. Immunol. 124(4), 652–657 (2009).
    • 56 Vultaggio A, Matucci A, Nencini F, Pratesi S, Maggi E. Skin testing and infliximab-specific antibodies detection as a combined strategy for preventing infusion reaction. Intern. Emerg. Med. 7(2), 77–79 (2012).
    • 57 Weeraratne DK, Kuck AJ, Chirmule N, Mytych DT. Measurement of anti-erythropoiesis-stimulating agent IgG4 antibody as an indicator of antibody-mediated pure red cell aplasia. Clin. Vaccine Immunol. 20(1), 46–51 (2013).
    • 58 Van Schouwenburg PA. IgG4 production against adalimumab during long term treatment of RA patients. J. Clin. Immunol. 32, 1000–1006 (2012).
    • 59 Svenson M, Geborek P, Saxne T, Bendtzen K. Monitoring patients treated with anti-TNF-α biopharmaceuticals: assessing serum infliximab and anti-infliximab antibodies. Rheumatology 46(12), 1828–1834 (2007).
    • 60 Gottlieb AB, Evans R, Li S et al. Infliximab induction therapy for patients with severe plaque-type psoriasis: a randomized, double-blind, placebo-controlled trial. J. Am. Acad. Dermatol. 51(4), 534–542 (2004).
    • 61 Wagner CL, Schantz A, Barnathan E et al. Consequences of immunogenicity to the therapeutic monoclonal antibodies ReoPro and Remicade. Dev. Biol. (Basel) 112, 37–53 (2003).
    • 62 Jamnitski A, Bartelds GM, Nurmohamed MT et al. The presence or absence of antibodies to infliximab or adalimumab determines the outcome of switching to etanercept. Ann. Rheum. Dis. 70, 284–288 (2011).
    • 63 Lundkvist M, Engdahl E, Holmén C et al. Characterization of anti-natalizumab antibodies in multiple sclerosis patients. Mult. Scler. J. 19(6), 757–764 (2013).
    • 64 Whelan SF, Hofbauer CJ, Horling FM et al. Distinct characteristics of antibody responses against factor VIII in healthy individuals and in different cohorts of hemophilia A patients. Blood 121(6), 1039–1048 (2013).
    • 65 Monteiro R. The role of IgA and IgA Fc receptors as anti-inflammatory agents. J. Clin. Immunol. 30(1), 61–64 (2010).
    • 66 Onda M, Nagata S, Fitzgerald DJ et al. Characterization of the B cell epitopes associated with a truncated form of Pseudomonas exotoxin (PE38) used to make immunotoxins for the treatment of cancer patients. J. Immunol. 177(12), 8822–8834 (2006).
    • 67 Van Regenmortel MH. What is a B-cell epitope? Methods Mol. Biol. 524, 3–20 (2009).
    • 68 Ponomarenko J, Bui HH, Li W et al. ElliPro: a new structure-based tool for the prediction of antibody epitopes. BMC Bioinformat. 9, 514 (2008).
    • 69 Yao B, Zheng D, Liang S, Zhang C. Conformational B-cell epitope prediction on antigen protein structures: a review of current algorithms and comparison with common binding site prediction methods. PLoS ONE 8(4), e62249 (2013).
    • 70 Onda M. Reducing the immunogenicity of protein therapeutics. Curr. Drug Targets 10(2), 131–139 (2009).
    • 71 Haste Andersen P, Nielsen M, Lund O. Prediction of residues in discontinuous B-cell epitopes using protein 3D structures. Protein Sci. 15(11), 2558–2567 (2006).
    • 72 Hager-Braun C, Tomer KB. Determination of protein-derived epitopes by mass spectrometry. Expert Rev. Proteomics 2(5), 745–756 (2005).
    • 73 Nagata S, Pastan I. Removal of B cell epitopes as a practical approach for reducing the immunogenicity of foreign protein-based therapeutics. Adv. Drug Deliv. Rev. 61(11), 977–985 (2009).
    • 74 Mytych DT, Barger TE, King C et al. Development and characterization of a human antibody reference panel against erythropoietin suitable for the standardization of ESA immunogenicity testing. J. Immunol. Methods 382(1–2), 129–141 (2012).
    • 75 Nagata S, Numata Y, Onda M et al. Rapid grouping of monoclonal antibodies based on their topographical epitopes by a label-free competitive immunoassay. J. Immunol. Methods 292(1–2), 141–155 (2004).
    • 76 Hoofring SA, Lopez R, Hock MB et al. Immunogenicity testing strategy and bioanalytical assays for antibody–drug conjugates. Bioanalysis 5(9), 1041–1055 (2013).
    • 77 Tatarewicz SM, Juan G, Swanson SJ, Moxness MS. Epitope characterization of pre-existing and developing antibodies to an aglycosylated monoclonal antibody therapeutic of G1m17,1 allotype. J. Immunol. Methods 382(1–2), 93–100 (2012).
    • 78 Jamnitski A, Bartelds GM, Nurmohamed MT et al. The presence or absence of antibodies to infliximab or adalimumab determines the outcome of switching to etanercept. Ann. Rheum. Dis. 70(2), 284–288 (2011).
    • 79 Vincent FB, Morand EF, Murphy K, Mackay F, Mariette X, Marcelli C. Antidrug antibodies (ADAb) to tumour necrosis factor (TNF)-specific neutralising agents in chronic inflammatory diseases: a real issue, a clinical perspective. Ann. Rheum. Dis. 72(2), 165–178 (2012).