A randomized phase-I pharmacokinetic trial comparing the potential biosimilar tocilizumab (QX003S) with the reference product (Actemra®) in Chinese healthy subjects

• Published in: Annals of medicine (Helsinki) Vol. 53; no. 1; pp. 375 - 383
• Main Authors: Zhang, Hong, Li, Xiaojiao, Liu, Jingrui, Li, Cuiyun, Wu, Min, Zhu, Xiaoxue, Sun, Jixuan, Fang, Min, Ding, Yanhua
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 01.01.2021; Taylor & Francis Group
• Subjects: biosimilar; immunogenicity; inter-subject variability; pharmacokinetics; Pharmacology; Tocilizumab; pharmacokinetics; inter-subject variability; Tocilizumab; immunogenicity; biosimilar
• DOI: 10.1080/07853890.2021.1887925
• ISSN: 0785-3890; 1365-2060

QX003S is a biosimilar candidate for the reference tocilizumab, Actemra®. We investigated the tolerance, variability, and pharmacokinetics (PK) of QX003S biosimilar in healthy Chinese male subjects. A randomised, double-blind, two-arm, parallel study was performed to examine the bioequivalence of QX003S (8 mg/kg) with that of Actemra® as a reference drug. QX003S (N = 40) and Actemra® (N = 40) groups exhibited similar PK properties. The inter-subject variability ranged from 14.95% to 18.78%. The 90% confidence intervals of the ratios for C max , AUC 0-t andAUC 0-∞ in both groups were within the range of 80-125%. After administration, the number of subjects who tested positive for anti-drug antibodies (ADA) in the QX003S group and Actemra® groups was 6 (14.3%) and 14 (34.1%), respectively. Adverse reactions occurred in 100% and 97.6% subjects in the QX003S and Actemra® groups, respectively. The most common adverse reactions were decrease in fibrinogen level and neutrophil and leukocyte counts. The PK characteristics and immunogenicity exhibited by QX003S were similar to that of the reference product, Actemra®. The safety profile was similar in the two treatment groups with mild-moderate adverse effects. Trial Registration The trial is registered at Chinese Clinical Trial website ( http://www.chinadrugtrials.org.cn/index.html#CTR20190002 ) Key points This was the first clinical report of a new proposed tocilizumab biosimilar, QX003S. This phase-I randomized, controlled study compared pharmacokinetics, variability,immunogenicity, and safety of QX003S vs. the approved tocilizumab product (Actemra@). The results demonstrate bioequivalence between BAT1806 and the reference products (Actemra@), as well as comparable immunogenicity, safety and tolerability profiles.