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Study summary · research use only

Evaluation of the immunogenicity of the synthetic α-melanocyte-stimulating hormone (α-MSH) analogue afamelanotide ([Nle4-D-Phe7]-α-MSH, Scenesse®) in erythropoietic protoporphyria patients by ELISA detecting both anti-afamelanotide and anti-α-MSH antibodies

Clinical trial · human · Skin pharmacology and physiology · 2015 · DOI 10.1159/000362174 · PMID 25402764

Plain-language summary

Paraphrased from the published abstract below — not a verdict on whether anything works.

In this study, the authors developed an ELISA to monitor anti-drug antibodies (ADA) against the alpha-melanocyte-stimulating hormone (alpha-MSH) analogue afamelanotide and against alpha-MSH in erythropoietic protoporphyria (EPP) patients. The abstract describes covalent antigen binding to reduce background and reports ELISA sensitivities of 608 and 1,390 ng/ml for ADA against afamelanotide and alpha-MSH respectively. It states no immunoreactivity was found in 23 of 26 EPP patients exposed to the drug for up to 6 years, while pre-existing immunoreactivity against afamelanotide and alpha-MSH was found in 3 patients whose titres did not change during administration. The authors describe afamelanotide as not eliciting ADA during long-term administration.

Abstract

Afamelanotide is an α-melanocyte-stimulating hormone (α-MSH) agonist with proven efficacy in photodermatoses such as erythropoietic protoporphyria (EPP). This peptide drug, repeatedly administered over prolonged time, may induce anti-drug antibodies (ADA). Here, we describe a new ELISA method developed to monitor the occurrence of ADA against afamelanotide as well as against α-MSH. Covalent binding instead of absorption of antigen onto the microtitre wells prevented antigen leakage and enabled extensive washings followed by lower background. The cut-off between antibody-negative and -positive sera was determined. Inhibition of the antigen-antibody reaction by excess soluble antigen tested for specificity. The sensitivity of the ELISA was 608 and 1,390 ng/ml of specific ADA against afamelanotide and α-MSH, respectively. This ELISA method enabled us to investigate the occurrence of ADA during long-term administration of afamelanotide. No immunoreactivity was found in 23 of the 26 EPP patients exposed to the drug for up to 6 years. Pre-existing immunoreactivity against afamelanotide as well as α-MSH was found in 3 patients, whose titres did not change during afamelanotide administration. The new ELISA is suitable to determine ADA against afamelanotide and α-MSH. Afamelanotide did not elicit ADA during long-term administration in patients with EPP.

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