Biogen (Germany)

BackgroundThis epidemiologic cohort study documented clinical and serological data in MS patients over several vaccination cycles against severe respiratory syndrome coronavirus-2 (SARS-CoV-2) in a real-world setting.MethodsAdult patients with MS were included during a period of 26 months from July 2021 if SARS-CoV-2 vaccination was planned, or first dose was given, or vaccination was completed within the last 6 weeks, or vaccination was completed >6 weeks ago and a booster dose was planned within the next 90 days. Humoral immune response to authorized SARS-CoV-2 vaccines was investigated during each vaccination cycle at baseline and approximately 1 and 6 months after vaccination. Immune response was defined as an anti-SARS-CoV-2 spike protein IgG titer >100 BAU/ml above pre-vaccination level and, separately, by the presence of SARS-CoV-2 neutralizing antibodies (NAb) approximately 1 month after the last vaccination.ResultsOf 159 patients enrolled, 140 (88.1%) were being treated with a DMT. Most patients (67.9%, n = 108) entered the study after complete initial SARS-CoV-2 vaccination (up to two doses) and before the 1st booster dose. Approximately 1 month after the 1st booster vaccination, response was seen in 68.1% of the patients (n = 79/116) based on anti-S1-IgG increase and in 72.1% (n = 88/122) based on NAb seropositivity. Persisting immune response approximately 6 months after vaccination was observed in 71.8% (n = 51/71) and in 93.7% (n = 74/79) of the responders, respectively. Adequate humoral immune response and persistence of response was less frequent in patients on anti-CD20 antibodies or sphingosine-1-phosphate receptor (S1PR) modulators compared to patients on other DMTs or DMT-untreated patients. Breakthrough infections with the SARS-CoV-2 virus were reported in 58 patients (36.5%). Seven patients (4.4%) experienced an MS relapse during the study period.ConclusionsWith the exception of anti-CD20 antibodies and S1PR modulators, DMTs did not impair humoral response to any of the authorized SARS-CoV-2 vaccines. Persistence of humoral immune response was seen over a period of at least 3 months in the majority of initial responders but was decreased in the anti-CD20 antibodies/S1PR modulator subgroup.Clinical trial registrationThis epidemiological study is registered in the German Clinical Trials Register (DRKS00025893).

The consideration of patient preference for a certain drug route of administration (RoA) plays an important role in promoting patient adherence in chronic diseases. Natalizumab is an established treatment for relapsing-remitting multiple sclerosis (RRMS) and can be administered as intravenous (IV) infusion or subcutaneous (SC) injection developed to enable a shorter and easier administration versus IV RoA. Primary objective is to compare patients' preference for RoA and satisfaction with SC versus IV natalizumab at baseline and subsequent visits up to 12 months. Secondary objectives include drug utilization, clinical outcomes, safety, and treatment satisfaction in a usual care setting. SISTER (Subcutaneous: Non-Interventional Study for Tysabri Patient Preference - Experience from Real World) is an ongoing, prospective, observational study where natalizumab is utilized according to local label. RRMS patients are included in three natalizumab cohorts: Patients switching from current IV to SC administration (switcher) and patients newly starting natalizumab on either SC or IV route (starter SC/IV). This interim analysis includes 262 patients (184 switchers, 39 SC starters, and 39 IV starters), median observation period was 9 months. 80.8% IV starters and 93.9% SC starters reported at baseline that they prefer the assigned RoA. Although initial satisfaction with chosen RoA was maintained over time from baseline through Month 12 in all three cohorts, the wish for change of the current RoA after 6 and 12 months was more frequently expressed among IV starters than in either SC cohort. Consistently, six patients (23.1%) starting with IV changed their RoA from IV to SC route.Mean global treatment satisfaction according to TSQM-II score at baseline remained high in the switcher group and increased through Month 12 in both IV and SC starter cohorts. Based on current data, there is a trend toward patients' preference for the natalizumab SC route over the IV route, which provides valuable insights into patients' preference for natalizumab RoA in routine care and complements available data from clinical studies with real-world data on SC natalizumab. This observational (non-interventional) study was registered in the local German PEI register for non-interventional studies (NIS-No. 611) and in the international CTgov register (NCT05304520).

Abstract Stable/efficient low‐energy emitters for photon down‐conversion in bio‐hybrid light‐emitting diodes (Bio‐HLEDs) are still challenging, as the archetypal fluorescent protein (FP) mCherry has led to the best deep‐red Bio‐HLEDs with poor stabilities: 3 h (on‐chip)/160 h (remote). Capitalizing on the excellent refolding under temperature/pH/chemical stress, high brightness, and high compatibility with polysaccharides of phycobiliproteins (smURFP), first‐class low‐energy emitting Bio‐HLEDs are achieved. They outperform those with mCherry regardless of using reference polyethylene oxide (on‐chip: 24 h vs. 3 h) and new biopolymer hydroxypropyl cellulose (HPC; on‐chip: 44 h vs. 3 h) coatings. Fine optimization of smURFP‐HPC‐coatings leads to stable record devices (on‐chip: 2600 h/108 days) compared to champion devices with perylene diimides (on‐chip: <700 h) and artificial FPs (on‐chip: 35 h). Finally, spectroscopy/computational/thermal assays confirm that device degradation is related to the photo‐induced reduction of biliverdin to bilirubin. Overall, this study pinpoints a new family of biogenic emitters toward superior protein‐based lighting.

BackgroundThe non-interventional PROPER study generated real-world evidence on clinical outcomes following transition in routine practice from reference adalimumab to the EMA-approved SB5 biosimilar adalimumab in patients with immune-mediated inflammatory disease.MethodsAdults with rheumatoid arthritis (RA), axial spondyloarthritis (axSpA), psoriatic arthritis (PsA), Crohn’s disease (CD), or ulcerative colitis (UC) were enrolled at 63 sites across Europe. Eligible patients received ≥ 16 weeks of routine treatment with reference adalimumab before transitioning to SB5, and were followed for 48 weeks post-transition. The primary objective was to evaluate candidate predictors (clinically relevant baseline variables with incidence ≥ 15% by indication cohort) associated with persistence on SB5 at 48 weeks post-initiation. Key primary outcome measures were persistence on SB5 (estimated by Kaplan–Meier methodology) and clinical characteristics and disease activity scores at the time of transition to SB5 treatment (baseline).ResultsA total of 955 eligible patients were enrolled (RA, n = 207; axSpA, n = 127; PsA, n = 162; CD, n = 447; UC, n = 12), of whom 932 (97.6%) completed follow-up and 722 (75.6%) were still receiving SB5 at week 48. Kaplan–Meier estimates (95% confidence interval, CI) of persistence on SB5 at week 48 for RA, axSpA, PsA, and CD were 0.86 (0.80–0.90), 0.80 (0.71–0.86), 0.81 (0.74–0.86), and 0.72 (0.67–0.76), respectively. The single candidate predictor associated with probability of SB5 discontinuation before week 48 was female sex [RA, axSpA, and CD cohorts; HR (95% CI): 3.53 (1.07–11.67), 2.38 (1.11–5.14), and 2.21 (1.54–3.18), respectively]. Disease activity scores remained largely unchanged throughout the study, with proportions by cohort in remission at baseline versus week 48 being 59.2% versus 57.2%, 81.0% versus 78.0%, 94.7% versus 93.7%, and 84.0% versus 85.1% for patients with RA, axSpA, PsA, and CD, respectively. Similarly, the SB5 dosing regimen remained unchanged for the majority of patients from baseline to week 48, the most common regimen being 40 mg every 2 weeks. In total, 232 patients (24.3%) reported at least one adverse drug reaction, and most events were mild; eight patients (3.9%) in the RA cohort experienced nine serious adverse events (SAEs; two possibly related to SB5); eight patients (4.9%) in the PsA cohort experienced nine SAEs (one possibly related to SB5); 22 patients (4.9%) in the CD cohort experienced 27 SAEs (four possibly related to SB5); and no SAEs were observed in the UC cohort.ConclusionsWith the exception of female sex in RA, axSpA, and CD, none of the candidate predictors were associated with SB5 discontinuation. Persistence on SB5 was high, treatment effectiveness was maintained, and no safety signals were detected.Trial RegistrationThis trial is registered with ClinicalTrials.gov: NCT04089514.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40259-023-00616-3.

(−)-Camphor can occur naturally as a constituent of essential oils of several plants, including Cinnamomum camphora, or it can be obtained chemically from optically pure α-pinene, which itself must be isolated from plants. Camphor is well known for its characteristic pungent odor and health benefits. While (+)-camphor can be isolated from various natural sources, (−)-camphor is more difficult to obtain. In our work, we demonstrate facile enantioselective kinetic resolution of renewable isobornyl esters for the synthesis of the valuable (−)-camphor. More information can be found in the Communication by M. Hofer, R. Kourist et al.

Apart from biologics, no systemic drugs are approved in Europe for children with moderate-to-severe psoriasis. Retrospective observational studies have shown promising results for fumaric acid esters (FAE) in this setting. To show superiority of FAE over placebo in terms of treatment response after 20weeks in children and adolescents aged 10-17years. In a multicentre, randomized, double-blind, placebo-controlled phase IIIb study, patients aged 10-17years with moderate-to-severe plaque psoriasis requiring systemic therapy were randomized 2:1 to receive FAE (n=91) or placebo (n=43) over 20weeks, followed by an open-label FAE treatment phase. The coprimary endpoints were≥75% improvement in Psoriasis Area and Severity Index (PASI 75) and Physician's Global Assessment (PGA) score of 0 or 1 (clear or almost clear) at week 20. The study was registered with EudraCT number 2012-000035-82. At week 20, 55% [95% confidence interval (CI) 0·44-0·65] of FAE-treated patients achieved a PASI 75 response vs. 19% (95% CI 0·08-0·33) in the placebo group (absolute difference 36%, 95% CI 0·20-0·53; P<0·001). In total, 42% (95% CI 0·32-0·53) in the FAE group vs. 7% (95% CI 0·01-0·19) in the placebo group achieved a PGA score of 0 or 1 at week 20 (absolute difference 35%, 95% CI 0·21-0·49; P<0·001). During the double-blind period, drug-related adverse events occurred more frequently in patients receiving FAE compared with placebo (76% vs. 47%). Gastrointestinal disorders were the most common adverse events. FAE administered over a period of 20weeks demonstrated a better response than placebo; the difference was statistically significant and clinically meaningful. Application up to 40weeks was generally well tolerated. However, further studies are required.

Objective: The primary objective of this trial was to assess the transfer of drospirenone to breast milk after daily administration of an oral test preparation containing 4 mg of drospirenone at the steady state. The secondary objective of the trial was to assess the safety of the preparation based on safety clinical and laboratory measurements (at the beginning and at the end of the trial) and reporting of adverse events and/or adverse drug reactions. Patients and Methods: This was an open label, non-comparative single center study. Drospirenone 4mg per day was the first postpartum contraceptive for the study participants who were no longer breastfeeding yet were still lactating. It was administered for 7 (seven) days to achieve steady-state concentration. All participants were volunteers who planned to use oral contraceptives as their family planning method in the future. Results: A total number of 12 volunteers completed the trial according to the protocol and the samples of all the 12 study completers were analyzed. The average concentration-time curve of drospirenone in plasma 24 h after the administration of the last dose (AUC(0-24h)) was 635.33 ng*h/mL and 120 h after the single repeat dose administration (AUC(0-120h) was 1180.57 ng*h/mL, respectively. The average Cmax was 48.64 ng/mL. The average concentration-time curve of drospirenone in milk 24 h after the administration of the last dose (AUC(0-24h)) was 134.35 ng*h/mL and 120 h after the single repeat dose administration (AUC(0-120h) was 227.17 ng*h/mL respectively. The average Cmax was 10.34 ng/mL. Conclusion: On average 18.13% of plasma drospirenone made it to breast milk and the highest concentration of drospirenone in breast milk was 17.55% of that in plasma. The total quantity of drospirenone passing to breast milk is on average 4478 ng during a 24 h period representing 0.11% of the maternal daily dose. Thus, at the recommended doses, no effects on breastfed newborns/infants are anticipated with drospirenone 4 mg.

Process intensification and integration is crucial regarding an ever increasing pressure on manufacturing costs and capacities in biologics manufacturing. For virus production in perfusion mode, membrane-based alternating tangential flow filtration (ATF) and acoustic settler are the commonly described cell retention technologies. While acoustic settlers allow for continuous influenza virus harvesting, the use of commercially available membranes for ATF systems typically results in the accumulation of virus particles in the bioreactor vessel. Accordingly, with one single harvest at the end of a cultivation, this increases the risk of lowering the product quality. To assess which cell retention device would be most suitable for influenza A virus production, we compared various key performance figures using AGE1.CR.pIX cells at concentrations between 25 and 50 × 106 cells/mL at similar infection conditions using either an ATF system or an acoustic settler. Production yields, process-related impurities, and aggregation of viruses and other large molecules were evaluated. Taking into account the total number of virions from both the bioreactor and the harvest vessel, a 1.5–3.0-fold higher volumetric virus yield was obtained for the acoustic settler. In addition, fewer large-sized aggregates (virus particles and other molecules) were observed in the harvest taken directly from the bioreactor. In contrast, similar levels of process-related impurities (host cell dsDNA, total protein) were obtained in the harvest for both retention systems. Overall, a clear advantage was observed for continuous virus harvesting after the acoustic settler operation mode was optimized. This development may also allow direct integration of subsequent downstream processing steps.Key points• High suspension cell density, immortalized avian cell line, influenza vaccine.

Wattle seed (Acacia spp.) is a well-known staple food within indigenous communities in Australia. A detailed investigation of the overall nutritional and sensory profile of four abundant and underutilized Acacia species—A. coriacea, A. cowleana, A. retinodes and A. sophorae—were performed. Additionally, molecular weight of protein extracts from the wattle seeds (WS) was determined. The seeds are rich in protein (23–27%) and dietary fibre (33–41%). Relatively high fat content was found in A. cowleana (19.3%), A. sophorae (14.8%) and A. retinodes (16.4%) with oleic acid being the predominant fatty acid. The seeds contained high amounts of essential amino acids (histidine, lysine, valine, isoleucine and leucine). A. coriacea is rich in iron (43 mg/kg), potassium (10 g/kg) and magnesium (1.7 g/kg). Pentose (xylose/arabinose), glucose, galactose and galacturonic acids were the major sugars found in the four species. Raw seeds from A. sophorae, A. retinodes and A. coriacea have the highest protein molecular weight, between 50–90 kDa, 80 kDa and 50–55 kDa, respectively. There was variation in the sensory profile of the WS species. This study showed that the four WS species have good nutritional value and could be included in human diet or used in food formulations.

To evaluate the proportion of blood samples diagnosed with reticulocytosis without anaemia in cats and dogs and report the aetiology and mortality rate of affected animals. Retrospective multicentre study including haematological examination of 3956 cats and 11,087 dogs admitted to seven German veterinary clinics (2012 to 2014). The proportion of blood samples with reticulocytosis without anaemia was calculated, and after exclusion of multiple measurements of the same animal, clinical data were evaluated. Animals with reticulocytosis without anaemia were classified as healthy or diseased, and diseased patients were assigned to 12 disease groups. Pretreatment (i.e. non-steroidal anti-inflammatory drugs, glucocorticoids, dipyrone) was recorded. The proportion of blood samples with reticulocytosis without anaemia was 3·1% (124/3956) in cats and 4·4% (492/11,087) in dogs. Overall, 1·8% (2/111) of cats and 1·5% (7/458) of dogs with reticulocytosis without anaemia were healthy. Blood loss/anaemia, cardiac/respiratory disorders, gastrointestinal disorders and inflammatory disorders as well as cancer were the most frequent underlying diseases. Pretreatment was noted in 39·5% (43/111) of cats and 42·4% (194/458) of dogs. The mortality rate was 37·8% (42/111) in cats and 29·7% (136/458) in dogs with reticulocytosis without anaemia; the median survival time in non-survivors was 1day (range: 0 to 376 days in cats, 0 to 444 days in dogs). In both species, reticulocytosis without anaemia was observed in a low proportion of blood samples (dogs>cat). Though a bias towards sick animals is possible in our sample, reticulocytosis without anaemia was mainly seen in diseased animals and associated with a mortality rate of approximately one-third of patients.