Article
作者: Wang, Guang ; Hong, Dun ; Wang, Chuansuo ; Wang, Xinjia ; Cheng, Zhifeng ; Liu, Yonghua ; Shang, Xianwen ; Xue, Qingyun ; Xiao, Xinhua ; Fu, Liujun ; Shen, Lin ; Yang, Tao ; Zhang, Xiaomei ; Zhou, Huimin ; Li, Yukun ; Guo, Shuren ; Zhang, Xinchao ; Liu, Lijun ; Cheng, Jinluo ; You, Li ; Zhang, Shimin ; Hua, Fei ; Tang, Xin ; Zhang, Hao ; Deng, Chunying ; Huo, Yanan ; Xiao, Jianzhong ; Cheng, Xigao ; Shen, Jie ; Dong, Jin ; Wang, Li ; Zhang, Yawei ; Jiang, Chengyan ; Lei, Chen ; Guan, Xiaoling ; Gu, Jiemei ; Zhang, Panjun ; Hu, Ling ; Chen, Jianting ; Du, Xiaohong ; Ding, Yue ; Xu, Youjia ; Yuan, Lingqing ; Li, Qifu ; Xu, Jin ; Pan, Tianrong ; Li, Lixin ; Wang, Kai ; Yao, Qi ; Zhang, Zhenlin ; Zhang, Ying ; Liu, Wei
Objectives:This study assessed the efficacy, safety, pharmacokinetics (PK), and immunogenicity profiles of a denosumab biosimilar (LY06006) in Chinese postmenopausal osteoporotic women with a high risk of fracture.
Methods:In this multicenter, randomized, double-blind, placebo-controlled, phase 3 trial, 448 postmenopausal women aged 50-85 years with osteoporosis were enrolled at 49 centers in China and were randomly assigned (3:1) to receive 60 mg of the denosumab biosimilar (LY06006) or placebo subcutaneously every 6 months for 1 year. Lumbar spine bone mineral density (BMD) change was the primary endpoint.
Results:Of the 448 randomized patients, 409 (LY06006, n = 311; placebo, n = 98) completed the study. All 448 (100.0%) subjects were included in the intent-to-treat (ITT) trial, 427 (95.3%) were included in the full analysis set (FAS), 408 (91.1%) were included in the per protocol set (PPS), 446 (99.6%) were included in the safety set (SS), and 336 (75.0%) were included in the pharmacokinetics concentration set (PKCs). For the primary endpoint, a 4.71% (95% CI, 3.81%, 5.60%) treatment difference in percent change in lumbar spine BMD from baseline to month 12 was observed in the LY06006 group compared with the placebo group (P < 0.0001). For the secondary endpoints, LY06006 was associated with increased lumbar spine BMD levels measured at month 6, BMD levels at the femoral neck, total hip, and trochanter measured at months 6 and 12 and reduced serum C-terminal telopeptide of type 1 collagen (CTX) and procollagen type 1 N-peptide (P1NP) levels at months 1, 6, and 12. Safety analysis was based on the safety analysis set (SS), and 264 (78.6%) subjects in the LY06006 group and 83 (75.5%) in the placebo group experienced adverse events (AEs). Most events were mild or moderate and not related to the study drugs.
Conclusion:In postmenopausal women with a high risk of fracture, LY06006 increased the BMD and decreased bone resorption; thus, LY06006 might be an effective treatment for osteoporosis. LY06006 was generally safe and well tolerated without unexpected adverse reactions, similar to the reference drug Prolia®. The characteristics of effectiveness and safety were similar to those reported in previous studies.
The translational potential of this article:In this multi-center, randomized, double-blind, placebo-controlled phase 3 study, LY06006 showed substantially efficacy to increase BMD and well tolerance without unexpected adverse reactions, which is comparable to the reference drug Prolia ®. The presented results are encouraging and can offer some valuable evidence for the clinical practice.