Tuesday, June 18, 2013

Pateclizumab at the EULAR 2013

Pateclizumab is an anti-lymphotoxin-alpha monoclonal antibody (the artist formely known as MLTA3698A). I hadn’t seen anything at the EULAR 2012 in Berlin. As I hadn't seen anything at the ACR 2012 in Washington, I thought to wait until the EULAR 2013 before I'd erase pateclizumab from my list of interests.
Now there have been two studies on Pateclizumab at the EULAR 2013 in Madrid.

A. E. Herman and colleagues presented a study [FRI0170]: "Pharmacodynamic biomarkers demonstrate overlapping and distinct biological pathways for lymphotoxin-αlpha and tumor necrosis factor-alpha in patients with rheumatoid arthritis". Within their conclusion you find this sentence: "LTα blockade demonstrated significant reduction in levels of CCL19, as well as CXCL13, suggesting an impact on T and B cell migration and/or lymphogenesis. However, the decrease in chemokines observed with LTα blockade was associated with only modest reduction in clinical activity (5)."
Not too overwhelming, I'd say.

But there has been a second study by W. Kennedy and colleagues [SAT0110]: "Efficacy and safety of pateclizumab (antilymphotoxin-alpha) in dmard-ir patients: results of a randomized, double-blind, placebo-controlled head-to-head phase 2 study with adalimumab". In their conclusion the authors state: "Pateclizumab treatment of DMARD-IR RA patients was associated with modest improvement in the signs and symptoms of RA, and was inferior to adalimumab after 12 weeks of treatment."

I don't think that pateclizumab will make it to the market as the demand for modest improvement isn't too big with better alternative options already in use. I'm a bit disappointed as two years ago I thought targeting lymphotoxin-αlpha could be an interesting approach. I guess we'll have to wait if pateclizumab is abandoned silently.

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