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Adalimumab is an immunosuppressive drug that belongs to the family of anti-TNF agents. It contains a monoclonal antibody produced by biotechnology. It is designed to bind to tumor necrosis factor (TNF), a substance that is involved in several auto-immune processes. By binding to TNF, adalimumab blocks its activity, reducing the severity of various chronic inflammatory diseases including Rheumatoid Arthritis, Plaque Psoriasis and others.
Often, the high cost of biologic products may preclude access to the treatment to a big portion of the population worldwide. A biosimilar product that provides comparable safety and efficacy at more affordable cost would fulfill a broader medical need.
Humira has been available on the market for several years. Recently, a higher concentration (100 mg/mL) formulation has been introduced in major markets. Alvotech is developing AVT02, that is a proposed biosimilar of adalimumab containing high concentration (100 mg/mL) of active ingredient.
The objective of this clinical trial is to assess the similarity of AVT02 (100 mg/mL) with Humira (100 mg/mL), in terms of tolerability, safety (including immunogenicity) and compare the pharmacokinetics in healthy volunteers.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| AVT02 100 MG/ML | Experimental | Single subcutaneous injection of 40 mg of AVT02 (100MG/ML) |
|
| Adalimumab 100 MG/ML [HUMIRA] | Active Comparator | Single subcutaneous injection of 40 mg of Adalimumab (100MG/ML) [HUMIRA] |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Adalimumab 100 MG/ML [Humira] | Drug | prefilled syringe at a concentration of 100MG/ML and delivering 40MG of adalimumab, as a single dose on day 1 day 1 |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline blood pressure at 1, 2, 3, 4, 5, 6, 7, 8, 9, 64 days post dosing | Measurement of blood pressure (systolic and diastolic in mm Hg) | Predose and 1, 2, 3, 4, 5, 6, 7, 8, 9, 64 days post dosing |
| Change from baseline heart rate at 1, 2, 3, 4, 5, 6, 7, 8, 9, 64 days post dosing | Measure of heart rate (beats per minute) | Predose and 1, 2, 3, 4, 5, 6, 7, 8, 9, 64 days post dosing |
| Change from baseline body temperature at 1, 2, 3, 4, 5, 6, 7, 8, 9, 64 days post dosing | Measurement of oral temperature (Celsius degree) | Predose and 1, 2, 3, 4, 5, 6, 7, 8, 9, 64 days post dosing |
| Change from baseline electrocardiogram at 1, 2, 5, 9, 64 days post dosing | Analysis of 12-lead electrocardiogram | Predose and 1, 2, 5, 9, 64 days post dosing |
| Change from baseline red blood cells at 2, 3, 5, 9, 64 days post dosing | Blood collection to measure red blood cells count, (unit/mm3) | Predose and 2, 3, 5, 9, 64 days post dosing |
| Change from baseline haemoglobin at 2, 3, 5, 9, 64 days post dosing | Blood collection to measure haemoglobin (g/L) | Predose and 2, 3, 5, 9, 64 days post dosing |
| Change from baseline white blood cells at 2, 3, 5, 9, 64 days post dosing | Blood collection to measure white blood cells count, (unit/mm3) |
| Measure | Description | Time Frame |
|---|---|---|
| Area under the plasma concentration-time curve (AUC) | Venous blood samples will be collected for measurement of Area under the plasma concentration-time curve (AUC) of AVT02 and EU Humira | Over 64 days |
| Maximum serum concentration |
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Main Inclusion Criteria:
Main Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Nucleus Network | Melbourne | Victoria | 3004 | Australia |
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| ID | Term |
|---|---|
| D000068879 | Adalimumab |
| ID | Term |
|---|---|
| D061067 | Antibodies, Monoclonal, Humanized |
| D000911 | Antibodies, Monoclonal |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
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Single Centre, Randomised, Single-Blind, Pilot Study
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This study is single blind. Operators are open to treatment allocation. Subjects are blinded to the treatment allocation. In order to keep the blind, subjects are masked during the subcutaneous injection.
| AVT02 100MG/ML | Drug | prefilled syringe at a concentration of 100MG/ML delivering 40MG of AVT02, as a single dose on day 1 day 1 |
|
| Predose and 2, 3, 5, 9, 64 days post dosing |
| Change from baseline platelets at 2, 3, 5, 9, 64 days post dosing | Blood collection to measure platelets count, (unit/mm3) | Predose and 2, 3, 5, 9, 64 days post dosing |
| Change from baseline blood gamma glutamyl transferase at 2, 3, 5, 9, 64 days post dosing | Blood collection to measure gamma glutamyl transferase (UI/L) | Predose and 2, 3, 5, 9, 64 days post dosing |
| Change from baseline blood aspartate aminotransferase at 2, 3, 5, 9, 64 days post | Blood collection to measure aspartate aminotransferase (UI/L) | Predose and 2, 3, 5, 9, 64 days post dosing |
| Change from baseline blood alanine aminotransferase at 2, 3, 5, 9, 64 days post | Blood collection to measure alanine aminotransferase (UI/L) | Predose and 2, 3, 5, 9, 64 days post dosing |
| Change from baseline blood potassium at 2, 3, 5, 9, 64 days post dosing | Blood collection to measure potassium (mmol/L) | Predose and 2, 3, 5, 9, 64 days post dosing |
| Change from baseline blood sodium at 2, 3, 5, 9, 64 days post dosing | Blood collection to measure sodium (mmol/L) | Predose and 2, 3, 5, 9, 64 days post dosing |
| Change from baseline blood calcium at 2, 3, 5, 9, 64 days post dosing | Blood collection to measure calcium (mmol/L) | Predose and 2, 3, 5, 9, 64 days post dosing |
| Change from baseline blood phosphate at 2, 3, 5, 9, 64 days post dosing | Blood collection to measure phosphate (mmol/L) | Predose and 2, 3, 5, 9, 64 days post dosing |
| Change from baseline blood chloride at 2, 3, 5, 9, 64 days post dosing | Blood collection to measure chloride (mmol/L) | Predose and 2, 3, 5, 9, 64 days post dosing |
| Change from baseline blood bicarbonate at 2, 3, 5, 9, 64 days post dosing | Blood collection to measure bicarbonate (mmol/L) | Predose and 2, 3, 5, 9, 64 days post dosing |
| Change from baseline blood creatinine at 2, 3, 5, 9, 64 days post dosing | Blood collection to measure creatinine (micromol/L) | Predose and 2, 3, 5, 9, 64 days post dosing |
| Change from baseline blood bilirubin at 2, 3, 5, 9, 64 days post dosing | Blood collection to measure Bilirubin (micromol/L) | Predose and 2, 3, 5, 9, 64 days post dosing |
| Change from baseline international normalised ratio at 2, 3, 5, 9, 64 days post dosing | Blood collection to measure international normalised ratio | Predose and 2, 3, 5, 9, 64 days post dosing |
| Change from baseline prothrombin time at 2, 3, 5, 9, 64 days post dosing | Blood collection to measure prothrombin time (sec) | Predose and 2, 3, 5, 9, 64 days post dosing |
| Change from baseline partial prothrombin time at 2, 3, 5, 9, 64 days post dosing | Blood collection to measure partial prothrombin time (sec) | Predose and 2, 3, 5, 9, 64 days post dosing |
| Change from baseline activated partial thromboplastin time at 2, 3, 5, 9, 64 days post | Blood collection to measure activated partial thromboplastin time (sec) | Predose and 2, 3, 5, 9, 64 days post dosing |
| Change from baseline thrombin time at 2, 3, 5, 9, 64 days post | Blood collection to measure thrombin time (sec) | Predose and 2, 3, 5, 9, 64 days post dosing |
| Change from baseline urine leucocytes at 2, 3, 5, 9, 64 days post dosing | Urine sample collection to measure leucocytes | Predose and 2, 3, 5, 9, 64 days post dosing |
| Change from baseline urine glucose at 2, 3, 5, 9, 64 days post dosing | Urine sample collection to measure glucose | Predose and 2, 3, 5, 9, 64 days post dosing |
| Change from baseline urine protein at 2, 3, 5, 9, 64 days post dosing | Urine sample collection to measure protein | Predose and 2, 3, 5, 9, 64 days post dosing |
Venous blood samples will be collected for measurement of serum concentration of AVT02 and EU Humira
| Over 64 days |
| Time to maximum serum concentration | Evaluation of time to maximum plasma concentration (Tmax) of AVT02 and Humira. | Over 64 days |
| Terminal half-life | Evaluation of terminal elimination half-life (T1/2) of AVT02 and Humira | Over 64 days |
| Volume of distribution | Evaluation of volume of distribution during the elimination phase (Vz) of AVT02 and Humira | Over 64 days |
| Clearance | Evaluation of total plasma clearance (CL) of AVT02 and Humira | Over 64 days |
| Incidence and titer of anti-drug antibodies to adalimumab | A blood sample will be collected to measure antibodies to AVT02 and Humira | 15, 29 and 64 days after dosing |
| D007162 |
| Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |