Investigation of the influence of nephropathy on monoclonal antibody disposition: A pharmacokinetic study in a mouse model of diabetic nephropathy

Purpose: This study employed a mouse model to evaluate the effects of diabetic nephropathy on the pharmacokinetics of 8C2, a murine monoclonal antibody (mAb). Methods: Streptozotocin (STZ) was administered to mice to induce diabetic nephropathy (125 mg/kg/day∈×∈2). Mice were grouped (n∈=∈8-10) based on time after STZ-treatment (control, 1, 2, 3, 4, or 6 weeks), and injected intravenously with 10 mg/kg 8C2. Blood samples were collected up to 7 days, and 8C2 plasma concentrations were determined via immunoassay. Inulin clearance and urinary albumin excretion rate (UAE) were determined to assess renal function. Results: UAE, inulin clearance, and 8C2 clearance increased significantly following STZ. Comparing control and 6 week STZ-treatment groups, UAE and inulin clearance increased from 25.7∈±∈3.3 to 99.3∈±∈13.7 μg/day, and from 421∈±∈31 to 584∈±∈78 μl/min. 8C2 clearance increased from 121∈±∈12.5 to 228∈±∈61 μl/hr/kg (p∈<∈0.01). 8C2 clearance was highly correlated with UAE (r²: 0.731). Inclusion of UAE as a covariate in population modeling explained significant residual variability in 8C2 clearance. Conclusions: The clearance of 8C2 increased significantly in STZ-treated mice. Population pharmacokinetic modeling suggests that UAE has potential for use in predicting mAb clearance in subjects with diabetic nephropathy, possibly assisting in the individualization of mAb dosing.