Comparative immunogenicity assessment of biosimilar natalizumab to its reference medicine: a matching immunogenicity profile

Comparative Immunogenicity of Biosimilar Natalizumab

Overview

Biosimilar natalizumab (biosim-NTZ) is the first biosimilar version of the original natalizumab (ref-NTZ) used to treat relapsing forms of multiple sclerosis (MS). This study aimed to confirm that biosim-NTZ has a similar immunogenicity profile to ref-NTZ.

Study Methods

Two key clinical studies were conducted:

  • Efficacy and Safety Study: 264 patients with relapsing-remitting MS received monthly infusions of either biosim-NTZ or EU-ref-NTZ for 48 weeks. The main focus was on the first 24 weeks.
  • Pharmacokinetic/Pharmacodynamic Study: 450 healthy subjects received a single dose of biosim-NTZ, US-ref-NTZ, or EU-ref-NTZ, followed by an 85-day monitoring period.

Advanced bioanalytical methods were used to detect anti-drug antibodies (ADA) and neutralizing antibodies (NAb) over time.

Key Findings

The results showed:

  • Similar rates of overall ADA (79.4% for biosim-NTZ vs 73.7% for EU-ref-NTZ) and NAb (68.7% vs 66.2%) at 24 weeks.
  • ADA levels remained consistent throughout the study.
  • Switching from EU-ref-NTZ to biosim-NTZ did not affect ADA/NAb levels or clinical outcomes.
  • The single-dose study also showed matching ADA rates and profiles across treatment groups.

Conclusion

The immunogenicity profile of biosim-NTZ is confirmed to be similar to that of ref-NTZ in both healthy subjects and MS patients, using highly sensitive testing methods.

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