Trial Outcomes & Findings for Comparative Immunogenicity Study of Multiple Doses of Proposed Pegfilgrastim Biosimilar, INTP5 of Intas Pharmaceuticals Ltd., India Against Neulasta of Amgen Inc., USA in Healthy, Adult Human Subjects. (NCT NCT04015232)

NCT ID: NCT04015232

Last Updated: 2019-10-04

Results Overview

Immunogenicity (anti-drug antibody; ADA) data is presented for all subjects' samples collected and a descriptive analysis is provided for immunogenicity (ADA) data. Percentage incidence within + 10% of the expected ADA positivity incidence of Test (6% ADA in Test is anticipated from literature) is not considered clinically significant. Evaluation of immunogenicity is carried out in a tiered fashion: 1. Screening assay to assess if samples were positive or negative for anti-PegG-CSF. 2. Confirmatory assays for samples that were positive in the screening assay. The confirmatory assays assessed if antibodies were specific for INTP5, Neulasta, PEG and/or filgrastim. 3. Titer assay was performed to determine titer of the anti-PEG-GCSF antibody samples. 4. Neutralizing antibody (NAb) assay for those samples that were positive in the confirmatory assays to assess the neutralizing capability of the antibody to inhibit pegfilgrastim activity.

Recruitment status

COMPLETED

Study phase

PHASE1

Target enrollment

200 participants

Primary outcome timeframe

Samples (8 mL each) were withdrawn at screening, at pre-dose and at 336 (D-15, Week 2), 504 (D-22, Week 3, within 60 minutes before 2nd dose), 840 (D-36, Week 5), 1176 (D-50, Week 7), 1680 (D-71, Week 10) and 2016 (D-85, Week 12) hours after first dose.

Results posted on

2019-10-04

Participant Flow

Participant milestones

Participant milestones
Measure
INTP5 Biosimilar Product
INTP5 subcutaneously at a dose of 6 mg/0.6 mL. INTP5: A pegfilgrastim biosimilar to US Neulasta.
US Neulasta Reference Product
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
Overall Study
STARTED
100
100
Overall Study
COMPLETED
89
93
Overall Study
NOT COMPLETED
11
7

Reasons for withdrawal

Reasons for withdrawal
Measure
INTP5 Biosimilar Product
INTP5 subcutaneously at a dose of 6 mg/0.6 mL. INTP5: A pegfilgrastim biosimilar to US Neulasta.
US Neulasta Reference Product
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
Overall Study
Withdrawal by Subject
7
4
Overall Study
Protocol Violation
1
0
Overall Study
Medical Grounds
3
3

Baseline Characteristics

Comparative Immunogenicity Study of Multiple Doses of Proposed Pegfilgrastim Biosimilar, INTP5 of Intas Pharmaceuticals Ltd., India Against Neulasta of Amgen Inc., USA in Healthy, Adult Human Subjects.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
INTP5 Biosimilar Product
n=100 Participants
INTP5 subcutaneously at a dose of 6 mg/0.6 mL. INTP5: A pegfilgrastim biosimilar to US Neulasta.
US Neulasta Reference Product
n=100 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
Total
n=200 Participants
Total of all reporting groups
Age, Continuous
31.5 years
STANDARD_DEVIATION 6.82 • n=5 Participants
34.3 years
STANDARD_DEVIATION 6.05 • n=7 Participants
32.9 years
STANDARD_DEVIATION 6.58 • n=5 Participants
Sex: Female, Male
Female
40 Participants
n=5 Participants
40 Participants
n=7 Participants
80 Participants
n=5 Participants
Sex: Female, Male
Male
60 Participants
n=5 Participants
60 Participants
n=7 Participants
120 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
100 Participants
n=5 Participants
100 Participants
n=7 Participants
200 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
White
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Region of Enrollment
India
100 Participants
n=5 Participants
100 Participants
n=7 Participants
200 Participants
n=5 Participants
Height
160.2 cm
STANDARD_DEVIATION 8.48 • n=5 Participants
160.1 cm
STANDARD_DEVIATION 8.68 • n=7 Participants
160.2 cm
STANDARD_DEVIATION 8.56 • n=5 Participants
Weight
61.3 kg
STANDARD_DEVIATION 8.31 • n=5 Participants
62.6 kg
STANDARD_DEVIATION 7.49 • n=7 Participants
61.9 kg
STANDARD_DEVIATION 7.92 • n=5 Participants
BMI
23.95 kg/m^2
STANDARD_DEVIATION 3.069 • n=5 Participants
24.51 kg/m^2
STANDARD_DEVIATION 3.266 • n=7 Participants
24.23 kg/m^2
STANDARD_DEVIATION 3.173 • n=5 Participants

PRIMARY outcome

Timeframe: Samples (8 mL each) were withdrawn at screening, at pre-dose and at 336 (D-15, Week 2), 504 (D-22, Week 3, within 60 minutes before 2nd dose), 840 (D-36, Week 5), 1176 (D-50, Week 7), 1680 (D-71, Week 10) and 2016 (D-85, Week 12) hours after first dose.

Immunogenicity (anti-drug antibody; ADA) data is presented for all subjects' samples collected and a descriptive analysis is provided for immunogenicity (ADA) data. Percentage incidence within + 10% of the expected ADA positivity incidence of Test (6% ADA in Test is anticipated from literature) is not considered clinically significant. Evaluation of immunogenicity is carried out in a tiered fashion: 1. Screening assay to assess if samples were positive or negative for anti-PegG-CSF. 2. Confirmatory assays for samples that were positive in the screening assay. The confirmatory assays assessed if antibodies were specific for INTP5, Neulasta, PEG and/or filgrastim. 3. Titer assay was performed to determine titer of the anti-PEG-GCSF antibody samples. 4. Neutralizing antibody (NAb) assay for those samples that were positive in the confirmatory assays to assess the neutralizing capability of the antibody to inhibit pegfilgrastim activity.

Outcome measures

Outcome measures
Measure
INTP5 Biosimilar Product
n=94 Participants
INTP5 subcutaneously at a dose of 6 mg/0.6 mL. INTP5: A pegfilgrastim biosimilar to US Neulasta.
US Neulasta Reference Product
n=100 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 1
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 2
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
Immunogenicity Screening Incidence to Detect the Presence of Anti-PegG-CSF Antibodies.
Positive for Anti-Drug-Antibody
10 Participants
9 Participants
Immunogenicity Screening Incidence to Detect the Presence of Anti-PegG-CSF Antibodies.
Positive in Neutralizing Anti-Drug-Antibody
0 Participants
0 Participants
Immunogenicity Screening Incidence to Detect the Presence of Anti-PegG-CSF Antibodies.
No Anit-Drug Antibody Confirmed Positive Results
84 Participants
91 Participants

SECONDARY outcome

Timeframe: Venous blood samples (4 mL each) were withdrawn at pre-dose and at 8, 16, 24 (Day 2), 48 (Day 3), 72 (Day 4), 96 (Day 5), 120 (Day 6), 144 (Day 7), 240 (Day 11), 336 (Day 15) and 504 (Day 22) hours following 1st and 2nd dose, administration.

Population: All the 19 ADA confirmed positive subjects were included in the PK analysis: 10 subjects from INTP5 and 9 subjects from US-Neulasta.

Pharmacokinetic (PK) properties of the test and reference formulations were assessed by measuring serum Pegfilgrastim concentration. Maximum measured serum concentration, calculated from the serum concentration vs. time profile of the individual subjects.

Outcome measures

Outcome measures
Measure
INTP5 Biosimilar Product
n=10 Participants
INTP5 subcutaneously at a dose of 6 mg/0.6 mL. INTP5: A pegfilgrastim biosimilar to US Neulasta.
US Neulasta Reference Product
n=10 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 1
n=9 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 2
n=9 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
PK Endpoints: Pegfilgrastim C[Max]
483.230 ng/mL
Standard Deviation 175.1787
346.018 ng/mL
Standard Deviation 150.4879
368.569 ng/mL
Standard Deviation 223.3380
371.778 ng/mL
Standard Deviation 263.4440

SECONDARY outcome

Timeframe: Venous blood samples (4 mL each) were withdrawn at pre-dose and at 8, 16, 24 (Day 2), 48 (Day 3), 72 (Day 4), 96 (Day 5), 120 (Day 6), 144 (Day 7), 240 (Day 11), 336 (Day 15) and 504 (Day 22) hours following 1st and 2nd dose, administration.

Population: All the 19 ADA confirmed positive subjects were included in the PK analysis: 10 subjects from INTP5 and 9 subjects from US-Neulasta

Area under the serum concentration vs. time curve, calculated by linear trapezoidal rule from measured data points from the time zero to the time of last quantified concentration.

Outcome measures

Outcome measures
Measure
INTP5 Biosimilar Product
n=10 Participants
INTP5 subcutaneously at a dose of 6 mg/0.6 mL. INTP5: A pegfilgrastim biosimilar to US Neulasta.
US Neulasta Reference Product
n=10 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 1
n=9 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 2
n=9 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
PK Endpoints: Pegfilgrastim AUC[0-t]
22417.938 ng.h/mL
Standard Deviation 9922.2648
13640.695 ng.h/mL
Standard Deviation 6709.2752
16610.870 ng.h/mL
Standard Deviation 11255.1296
15255.327 ng.h/mL
Standard Deviation 11050.7580

SECONDARY outcome

Timeframe: Venous blood samples (4 mL each) were withdrawn at pre-dose and at 8, 16, 24 (Day 2), 48 (Day 3), 72 (Day 4), 96 (Day 5), 120 (Day 6), 144 (Day 7), 240 (Day 11), 336 (Day 15) and 504 (Day 22) hours following 1st and 2nd dose, administration.

Population: All the 19 ADA confirmed positive subjects were included in the PK analysis: 10 subjects from INTP5 and 9 subjects from US-Neulasta

Area under the serum concentration versus time curve from time zero to infinity. Where AUC\[0-infinity\]= AUC\[0-t\] + Ct/lambda-z, Ct is the last measurable concentration and lamda-z is the terminal rate constant. AUC\[0-infinity\] is the sum of measurable and extrapolated parts.

Outcome measures

Outcome measures
Measure
INTP5 Biosimilar Product
n=10 Participants
INTP5 subcutaneously at a dose of 6 mg/0.6 mL. INTP5: A pegfilgrastim biosimilar to US Neulasta.
US Neulasta Reference Product
n=10 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 1
n=9 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 2
n=9 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
PK Endpoints: Pegfilgrastim AUC[0-∞]
22436.497 ng.h/mL
Standard Deviation 9922.4383
13637.403 ng.h/mL
Standard Deviation 6699.9736
16630.861 ng.h/mL
Standard Deviation 11253.7406
15280.376 ng.h/mL
Standard Deviation 11058.1142

SECONDARY outcome

Timeframe: Venous blood samples (4 mL each) were withdrawn at pre-dose and at 8, 16, 24 (Day 2), 48 (Day 3), 72 (Day 4), 96 (Day 5), 120 (Day 6), 144 (Day 7), 240 (Day 11), 336 (Day 15) and 504 (Day 22) hours following 1st and 2nd dose, administration.

Population: All the 19 ADA confirmed positive subjects were included in the PK analysis: 10 subjects from INTP5 and 9 subjects from US-Neulasta

The time of observing the peak concentration, calculated from the serum concentration vs. time profile of the individual subjects.

Outcome measures

Outcome measures
Measure
INTP5 Biosimilar Product
n=10 Participants
INTP5 subcutaneously at a dose of 6 mg/0.6 mL. INTP5: A pegfilgrastim biosimilar to US Neulasta.
US Neulasta Reference Product
n=10 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 1
n=9 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 2
n=9 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
PK Endpoints: Pegfilgrastim T[Max]
22.405 h
Standard Deviation 3.3758
20.800 h
Standard Deviation 5.5936
22.226 h
Standard Deviation 3.5298
23.111 h
Standard Deviation 2.6667

SECONDARY outcome

Timeframe: Venous blood samples (4 mL each) were withdrawn at pre-dose and at 8, 16, 24 (Day 2), 48 (Day 3), 72 (Day 4), 96 (Day 5), 120 (Day 6), 144 (Day 7), 240 (Day 11), 336 (Day 15) and 504 (Day 22) hours following 1st and 2nd dose, administration.

Population: All the 19 ADA confirmed positive subjects were included in the PK analysis: 10 subjects from INTP5 and 9 subjects from US-Neulasta

Terminal rate constant: First order rate constant associated with the terminal (log-linear) portion of the curve. This was estimated via linear regression of time vs. log concentration. This parameter was calculated by linear least squares regression analysis using last three or more nonzero plasma concentration values.

Outcome measures

Outcome measures
Measure
INTP5 Biosimilar Product
n=10 Participants
INTP5 subcutaneously at a dose of 6 mg/0.6 mL. INTP5: A pegfilgrastim biosimilar to US Neulasta.
US Neulasta Reference Product
n=10 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 1
n=9 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 2
n=9 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
PK Endpoints: Pegfilgrastim λz (Lambda-z)
0.021 1/h
Standard Deviation 0.0071
0.025 1/h
Standard Deviation 0.0142
0.022 1/h
Standard Deviation 0.0058
0.019 1/h
Standard Deviation 0.0074

SECONDARY outcome

Timeframe: Venous blood samples (4 mL each) were withdrawn at pre-dose and at 8, 16, 24 (Day 2), 48 (Day 3), 72 (Day 4), 96 (Day 5), 120 (Day 6), 144 (Day 7), 240 (Day 11), 336 (Day 15) and 504 (Day 22) hours following 1st and 2nd dose, administration.

Population: All the 19 ADA confirmed positive subjects were included in the PK analysis: 10 subjects from INTP5 and 9 subjects from US-Neulasta

Goodness of fit statistic for the terminal phase, adjusted for the number of points used in the estimation of λz (lambda-z). R\^2 is the coefficient of determination and can range from 0 to 1, with higher values indicating greater predictability.

Outcome measures

Outcome measures
Measure
INTP5 Biosimilar Product
n=10 Participants
INTP5 subcutaneously at a dose of 6 mg/0.6 mL. INTP5: A pegfilgrastim biosimilar to US Neulasta.
US Neulasta Reference Product
n=10 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 1
n=9 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 2
n=9 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
PK Endpoints: Pegfilgrastim R^2 Adjusted
0.968 Coefficient of Determination
Standard Deviation 0.0379
0.876 Coefficient of Determination
Standard Deviation 0.133
0.974 Coefficient of Determination
Standard Deviation 0.0245
0.879 Coefficient of Determination
Standard Deviation 0.2339

SECONDARY outcome

Timeframe: Venous blood samples (4 mL each) were withdrawn at pre-dose and at 8, 16, 24 (Day 2), 48 (Day 3), 72 (Day 4), 96 (Day 5), 120 (Day 6), 144 (Day 7), 240 (Day 11), 336 (Day 15) and 504 (Day 22) hours following 1st and 2nd dose, administration.

Population: All the 19 ADA confirmed positive subjects were included in the PK analysis: 10 subjects from INTP5 and 9 subjects from US-Neulasta

The residual area in percentage determined by the formula, \[(AUC\[0-infinity\]-AUC\[0-t\])/AUC\[0-infinity\]\] x 100.

Outcome measures

Outcome measures
Measure
INTP5 Biosimilar Product
n=10 Participants
INTP5 subcutaneously at a dose of 6 mg/0.6 mL. INTP5: A pegfilgrastim biosimilar to US Neulasta.
US Neulasta Reference Product
n=10 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 1
n=9 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 2
n=9 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
PK Endpoints: Pegfilgrastim AUC[_%Extrap_Obs]
0.115 percentage of AUC
Standard Deviation 0.1106
0.644 percentage of AUC
Standard Deviation 1.4428
0.230 percentage of AUC
Standard Deviation 0.2672
0.266 percentage of AUC
Standard Deviation 0.2664

SECONDARY outcome

Timeframe: Venous blood samples (4 mL each) were withdrawn at pre-dose and at 8, 16, 24 (Day 2), 48 (Day 3), 72 (Day 4), 96 (Day 5), 120 (Day 6), 144 (Day 7), 240 (Day 11), 336 (Day 15) and 504 (Day 22) hours following 1st and 2nd dose, administration.

Population: All the 19 ADA confirmed positive subjects were included in the PK analysis: 10 subjects from INTP5 and 9 subjects from US-Neulasta

The terminal half-life calculated using the formula 0.693/(lambda-z)

Outcome measures

Outcome measures
Measure
INTP5 Biosimilar Product
n=10 Participants
INTP5 subcutaneously at a dose of 6 mg/0.6 mL. INTP5: A pegfilgrastim biosimilar to US Neulasta.
US Neulasta Reference Product
n=10 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 1
n=9 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 2
n=9 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
PK Endpoints: Pegfilgrastim t[1/2]
36.721 h
Standard Deviation 11.0052
36.612 h
Standard Deviation 19.6215
34.172 h
Standard Deviation 8.8669
40.616 h
Standard Deviation 14.6054

SECONDARY outcome

Timeframe: Venous blood samples (2 mL each) were withdrawn at pre-dose and at 8, 16, 24 (Day 2), 48 (Day 3), 72 (Day 4), 96 (Day 5), 120 (Day 6), 144 (Day 7), 240 (Day 11), 336 (Day 15) and 504 (Day 22) following 1st and 2nd dose administration.

Population: Outcome Measure Data Table is breaks participants into negative-ADA or positive-ADA, totaling the overall number of participants by arm

Maximum measured absolute neutrophil count (ANC).

Outcome measures

Outcome measures
Measure
INTP5 Biosimilar Product
n=89 Participants
INTP5 subcutaneously at a dose of 6 mg/0.6 mL. INTP5: A pegfilgrastim biosimilar to US Neulasta.
US Neulasta Reference Product
n=89 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 1
n=93 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 2
n=93 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
PD Endpoints for Baseline Non-adjusted ANC: E[Max]
ADA-NEGATIVE
40.72 x10^3cells/uL
Standard Deviation 10.862
44.63 x10^3cells/uL
Standard Deviation 11.077
38.34 x10^3cells/uL
Standard Deviation 9.925
40.62 x10^3cells/uL
Standard Deviation 8.963
PD Endpoints for Baseline Non-adjusted ANC: E[Max]
ADA-POSITIVE
42.89 x10^3cells/uL
Standard Deviation 10.512
46.53 x10^3cells/uL
Standard Deviation 9.093
38.38 x10^3cells/uL
Standard Deviation 8.211
44.96 x10^3cells/uL
Standard Deviation 16.409

SECONDARY outcome

Timeframe: Venous blood samples (2 mL each) were withdrawn at pre-dose and at 8, 16, 24 (Day 2), 48 (Day 3), 72 (Day 4), 96 (Day 5), 120 (Day 6), 144 (Day 7), 240 (Day 11), 336 (Day 15) and 504 (Day 22) following 1st and 2nd dose administration.

Population: Outcome Measure Data Table is breaks participants into negative-ADA or positive-ADA, totaling the overall number of participants by arm

Area under the ANC versus time curve from time zero to the last measurable concentration as calculated by linear trapezoidal method.

Outcome measures

Outcome measures
Measure
INTP5 Biosimilar Product
n=89 Participants
INTP5 subcutaneously at a dose of 6 mg/0.6 mL. INTP5: A pegfilgrastim biosimilar to US Neulasta.
US Neulasta Reference Product
n=89 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 1
n=93 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 2
n=93 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
PD Endpoints for Baseline Non-adjusted ANC: T[Max]
ADA-NEGATIVE
64.710 h
Standard Deviation 11.1076
59.587 h
Standard Deviation 14.9170
63.182 h
Standard Deviation 15.8763
64.637 h
Standard Deviation 20.5772
PD Endpoints for Baseline Non-adjusted ANC: T[Max]
ADA-POSITIVE
72.003 h
Standard Deviation 0.0072
67.453 h
Standard Deviation 15.7091
64.002 h
Standard Deviation 12.0014
61.461 h
Standard Deviation 29.9401

SECONDARY outcome

Timeframe: Venous blood samples (2 mL each) were withdrawn at pre-dose and at 8, 16, 24 (Day 2), 48 (Day 3), 72 (Day 4), 96 (Day 5), 120 (Day 6), 144 (Day 7), 240 (Day 11), 336 (Day 15) and 504 (Day 22) following 1st and 2nd dose administration.

Population: Table breaks participants into ADA(-) or ADA(+), totaling the overall number of participants by arm. 5 Subjects having three consecutive missing samples in elimination phase were excluded from the analysis of AUEC0-t reducing the total participants to 88 for INTP5 Dose 1, 88 for INTP5 Dose 2, 92 for Neulasta Dose 1, and 91 for Neulasta Dose 2.

Time to reach the maximum measured absolute neutrophil count (ANC)

Outcome measures

Outcome measures
Measure
INTP5 Biosimilar Product
n=88 Participants
INTP5 subcutaneously at a dose of 6 mg/0.6 mL. INTP5: A pegfilgrastim biosimilar to US Neulasta.
US Neulasta Reference Product
n=88 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 1
n=92 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 2
n=91 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
PD Endpoints for Baseline Non-adjusted ANC: AUEC[0-t]
ADA-NEGATIVE
7107.14 h*ng/mL
Standard Deviation 1481.971
7929.25 h*ng/mL
Standard Deviation 1561.246
6718.70 h*ng/mL
Standard Deviation 1361.957
7359.09 h*ng/mL
Standard Deviation 1455.570
PD Endpoints for Baseline Non-adjusted ANC: AUEC[0-t]
ADA-POSITIVE
7286.53 h*ng/mL
Standard Deviation 1744.737
8539.99 h*ng/mL
Standard Deviation 1522.935
6846.77 h*ng/mL
Standard Deviation 763.675
7761.65 h*ng/mL
Standard Deviation 1658.478

SECONDARY outcome

Timeframe: Venous blood samples (2 mL each) were withdrawn at pre-dose and at 8, 16, 24 (Day 2), 48 (Day 3), 72 (Day 4), 96 (Day 5), 120 (Day 6), 144 (Day 7), 240 (Day 11), 336 (Day 15) and 504 (Day 22) following 1st and 2nd dose administration.

Population: Outcome Measure Data Table is breaks participants into negative-ADA or positive-ADA, totaling the overall number of participants by arm

Maximum measured absolute neutrophil count (ANC).

Outcome measures

Outcome measures
Measure
INTP5 Biosimilar Product
n=88 Participants
INTP5 subcutaneously at a dose of 6 mg/0.6 mL. INTP5: A pegfilgrastim biosimilar to US Neulasta.
US Neulasta Reference Product
n=88 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 1
n=91 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 2
n=89 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
PD Endpoints for Baseline Adjusted ANC: E[Max]
ADA-NEGATIVE
36.50 x10^3cells/uL
Standard Deviation 10.458
40.80 x10^3cells/uL
Standard Deviation 11.038
33.35 x10^3cells/uL
Standard Deviation 9.189
36.56 x10^3cells/uL
Standard Deviation 8.755
PD Endpoints for Baseline Adjusted ANC: E[Max]
ADA-POSITIVE
38.37 x10^3cells/uL
Standard Deviation 9.548
42.50 x10^3cells/uL
Standard Deviation 10.061
34.18 x10^3cells/uL
Standard Deviation 8.503
40.76 x10^3cells/uL
Standard Deviation 17.170

SECONDARY outcome

Timeframe: Venous blood samples (2 mL each) were withdrawn at pre-dose and at 8, 16, 24 (Day 2), 48 (Day 3), 72 (Day 4), 96 (Day 5), 120 (Day 6), 144 (Day 7), 240 (Day 11), 336 (Day 15) and 504 (Day 22) following 1st and 2nd dose administration.

Population: Outcome Measure Data Table is breaks participants into negative-ADA or positive-ADA, totaling the overall number of participants by arm

Area under the absolute neutrophil count (ANC) versus time curve from time zero to the last measurable concentration as calculated by linear trapezoidal method.

Outcome measures

Outcome measures
Measure
INTP5 Biosimilar Product
n=87 Participants
INTP5 subcutaneously at a dose of 6 mg/0.6 mL. INTP5: A pegfilgrastim biosimilar to US Neulasta.
US Neulasta Reference Product
n=87 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 1
n=90 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 2
n=89 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
PD Endpoints for Baseline Adjusted ANC: AUEC[0-t]
ADA-NEGATIVE
4920.26 x10^3cells*h/uL
Standard Deviation 1339.674
5992.49 x10^3cells*h/uL
Standard Deviation 1555.062
4389.55 x10^3cells*h/uL
Standard Deviation 1140.655
5441.01 x10^3cells*h/uL
Standard Deviation 1478.241
PD Endpoints for Baseline Adjusted ANC: AUEC[0-t]
ADA-POSITIVE
4967.86 x10^3cells*h/uL
Standard Deviation 1229.792
6539.58 x10^3cells*h/uL
Standard Deviation 2202.473
4578.32 x10^3cells*h/uL
Standard Deviation 1200.125
5676.92 x10^3cells*h/uL
Standard Deviation 1991.456

SECONDARY outcome

Timeframe: Venous blood samples (2 mL each) were withdrawn at pre-dose and at 8, 16, 24 (Day 2), 48 (Day 3), 72 (Day 4), 96 (Day 5), 120 (Day 6), 144 (Day 7), 240 (Day 11), 336 (Day 15) and 504 (Day 22) following 1st and 2nd dose administration.

Population: Outcome Measure Data Table is breaks participants into negative-ADA or positive-ADA, totaling the overall number of participants by arm

Time to reach the maximum measured absolute neutrophil count (ANC)

Outcome measures

Outcome measures
Measure
INTP5 Biosimilar Product
n=88 Participants
INTP5 subcutaneously at a dose of 6 mg/0.6 mL. INTP5: A pegfilgrastim biosimilar to US Neulasta.
US Neulasta Reference Product
n=88 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 1
n=91 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 2
n=91 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
PD Endpoints for Baseline Adjusted ANC: T[Max]
ADA-NEGATIVE
64.617 h
Standard Deviation 11.1482
59.735 h
Standard Deviation 14.9546
65.553 h
Standard Deviation 15.8887
65.043 h
Standard Deviation 20.6610
PD Endpoints for Baseline Adjusted ANC: T[Max]
ADA-POSITIVE
72.003 h
Standard Deviation 0.0072
67.453 h
Standard Deviation 15.7091
64.002 h
Standard Deviation 12.0014
61.461 h
Standard Deviation 29.9401

SECONDARY outcome

Timeframe: Venous blood samples (2 mL each) were withdrawn at pre-dose and at 8, 16, 24 (Day 2), 48 (Day 3), 72 (Day 4), 96 (Day 5), 120 (Day 6), 144 (Day 7), 240 (Day 11), 336 (Day 15) and 504 (Day 22) following 1st and 2nd dose administration.

Population: Outcome Measure Data Table is breaks participants into negative-ADA or positive-ADA, totaling the overall number of participants by arm

First order rate constant associated with the terminal (log-linear) portion of the curve. This was estimated via linear regression of time vs. log concentration. This parameter was calculated by linear least squares regression analysis using last three or more non-zero plasma concentration values.

Outcome measures

Outcome measures
Measure
INTP5 Biosimilar Product
n=86 Participants
INTP5 subcutaneously at a dose of 6 mg/0.6 mL. INTP5: A pegfilgrastim biosimilar to US Neulasta.
US Neulasta Reference Product
n=87 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 1
n=89 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 2
n=88 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
PD Endpoints for Baseline Adjusted ANC: λz (Lambda-z)
ADA-NEGATIVE
0.01 h
Standard Deviation 0.007
0.01 h
Standard Deviation 0.006
0.01 h
Standard Deviation 0.006
0.01 h
Standard Deviation 0.006
PD Endpoints for Baseline Adjusted ANC: λz (Lambda-z)
ADA-POSITIVE
0.01 h
Standard Deviation 0.006
0.01 h
Standard Deviation 0.003
0.01 h
Standard Deviation 0.004
0.01 h
Standard Deviation 0.005

SECONDARY outcome

Timeframe: Venous blood samples (2 mL each) were withdrawn at pre-dose and at 8, 16, 24 (Day 2), 48 (Day 3), 72 (Day 4), 96 (Day 5), 120 (Day 6), 144 (Day 7), 240 (Day 11), 336 (Day 15) and 504 (Day 22) following 1st and 2nd dose administration.

Population: Outcome Measure Data Table is breaks participants into negative-ADA or positive-ADA, totaling the overall number of participants by arm

The terminal half-life will be calculated as 0.693/(lambda-z)

Outcome measures

Outcome measures
Measure
INTP5 Biosimilar Product
n=86 Participants
INTP5 subcutaneously at a dose of 6 mg/0.6 mL. INTP5: A pegfilgrastim biosimilar to US Neulasta.
US Neulasta Reference Product
n=87 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 1
n=89 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
US Neulasta Dose 2
n=88 Participants
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
PD Endpoints for Baseline Adjusted ANC: t[1/2]
ADA-NEGATIVE
62.25 h
Standard Deviation 28.847
64.13 h
Standard Deviation 26.785
77.23 h
Standard Deviation 86.239
76.02 h
Standard Deviation 59.888
PD Endpoints for Baseline Adjusted ANC: t[1/2]
ADA-POSITIVE
67.03 h
Standard Deviation 41.296
69.72 h
Standard Deviation 25.447
81.74 h
Standard Deviation 29.981
67.02 h
Standard Deviation 22.706

Adverse Events

INTP5 Biosimilar Product

Serious events: 0 serious events
Other events: 32 other events
Deaths: 0 deaths

US Neulasta Reference Product

Serious events: 1 serious events
Other events: 37 other events
Deaths: 1 deaths

Serious adverse events

Serious adverse events
Measure
INTP5 Biosimilar Product
n=100 participants at risk
INTP5 subcutaneously at a dose of 6 mg/0.6 mL. INTP5: A pegfilgrastim biosimilar to US Neulasta.
US Neulasta Reference Product
n=100 participants at risk
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
General disorders
death
0.00%
0/100 • 99 Days
1.0%
1/100 • Number of events 1 • 99 Days

Other adverse events

Other adverse events
Measure
INTP5 Biosimilar Product
n=100 participants at risk
INTP5 subcutaneously at a dose of 6 mg/0.6 mL. INTP5: A pegfilgrastim biosimilar to US Neulasta.
US Neulasta Reference Product
n=100 participants at risk
US Neulasta subcutaneously at a dose of 6 mg/0.6 mL. US Neulasta: FDA approved pegfilgrastim innovator product.
Blood and lymphatic system disorders
Eosinophilia
1.0%
1/100 • Number of events 1 • 99 Days
0.00%
0/100 • 99 Days
Gastrointestinal disorders
Abdominal pain
1.0%
1/100 • Number of events 1 • 99 Days
0.00%
0/100 • 99 Days
Gastrointestinal disorders
Diarrhoea
0.00%
0/100 • 99 Days
2.0%
2/100 • Number of events 2 • 99 Days
Gastrointestinal disorders
Gastritis
1.0%
1/100 • Number of events 1 • 99 Days
0.00%
0/100 • 99 Days
Gastrointestinal disorders
Toothache
1.0%
1/100 • Number of events 1 • 99 Days
0.00%
0/100 • 99 Days
Gastrointestinal disorders
Vomiting
5.0%
5/100 • Number of events 7 • 99 Days
5.0%
5/100 • Number of events 7 • 99 Days
General disorders
Chills
1.0%
1/100 • Number of events 1 • 99 Days
0.00%
0/100 • 99 Days
General disorders
Injection site pain
5.0%
5/100 • Number of events 5 • 99 Days
4.0%
4/100 • Number of events 4 • 99 Days
General disorders
Pyrexia
2.0%
2/100 • Number of events 2 • 99 Days
0.00%
0/100 • 99 Days
Hepatobiliary disorders
Hyperbilirubinaemia
1.0%
1/100 • Number of events 1 • 99 Days
1.0%
1/100 • Number of events 1 • 99 Days
Injury, poisoning and procedural complications
Face injury
1.0%
1/100 • Number of events 1 • 99 Days
0.00%
0/100 • 99 Days
Injury, poisoning and procedural complications
Injury
0.00%
0/100 • 99 Days
3.0%
3/100 • Number of events 3 • 99 Days
Investigations
Eosinophil count increased
1.0%
1/100 • Number of events 1 • 99 Days
0.00%
0/100 • 99 Days
Investigations
Hepatic enzyme increased
0.00%
0/100 • 99 Days
1.0%
1/100 • Number of events 1 • 99 Days
Investigations
Human chorionic gonadotropin increased
0.00%
0/100 • 99 Days
1.0%
1/100 • Number of events 1 • 99 Days
Investigations
Protein urine present
1.0%
1/100 • Number of events 1 • 99 Days
1.0%
1/100 • Number of events 1 • 99 Days
Investigations
Red blood cells urine positive
3.0%
3/100 • Number of events 3 • 99 Days
0.00%
0/100 • 99 Days
Investigations
Urine analysis abnormal
0.00%
0/100 • 99 Days
1.0%
1/100 • Number of events 1 • 99 Days
Investigations
Urine output decreased
1.0%
1/100 • Number of events 1 • 99 Days
0.00%
0/100 • 99 Days
Musculoskeletal and connective tissue disorders
Musculoskeletal pain
16.0%
16/100 • Number of events 17 • 99 Days
15.0%
15/100 • Number of events 16 • 99 Days
Nervous system disorders
Headache
6.0%
6/100 • Number of events 7 • 99 Days
13.0%
13/100 • Number of events 13 • 99 Days
Investigations
Urine abnormality
1.0%
1/100 • Number of events 1 • 99 Days
0.00%
0/100 • 99 Days
Respiratory, thoracic and mediastinal disorders
Dyspnoea
1.0%
1/100 • Number of events 1 • 99 Days
0.00%
0/100 • 99 Days
Skin and subcutaneous tissue disorders
Angioedema
1.0%
1/100 • Number of events 1 • 99 Days
1.0%
1/100 • Number of events 1 • 99 Days
Skin and subcutaneous tissue disorders
Pruritus
0.00%
0/100 • 99 Days
1.0%
1/100 • Number of events 1 • 99 Days
Skin and subcutaneous tissue disorders
Rash generalized
0.00%
0/100 • 99 Days
1.0%
1/100 • Number of events 1 • 99 Days
Skin and subcutaneous tissue disorders
Skin burning sensation
0.00%
0/100 • 99 Days
1.0%
1/100 • Number of events 1 • 99 Days

Additional Information

Dr. Adarsh Kumar Garg, M.B.B.S. Principal Investigator

Lambda Therapeutic Research Ltd.

Phone: +91-79-40202020

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place