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Published in: BioDrugs 3/2014

Open Access 01-06-2014 | Original Research Article

Safety and Pharmacokinetics of Escalating Doses of Human Recombinant Nerve Growth Factor Eye Drops in a Double-Masked, Randomized Clinical Trial

Authors: Mauro P. Ferrari, Flavio Mantelli, Marta Sacchetti, Maria Irene Antonangeli, Franca Cattani, Gaetano D’Anniballe, Francesco Sinigaglia, Pier Adelchi Ruffini, Alessandro Lambiase

Published in: BioDrugs | Issue 3/2014

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Abstract

Background and Objectives

Nerve growth factor (NGF) is a neurotrophin with therapeutic possibilities that extend from the nervous system to the eye. We tested the safety, maximal tolerated dose, pharmacokinetics, and antigenicity of a novel human recombinant NGF (rhNGF) eye-drop formulation in a phase I study.

Methods

This prospective, randomized, double-masked, vehicle-controlled trial, sponsored by Dompé SpA (registered as NCT01744704 at ClinicalTrials.gov), enrolled 74 healthy volunteers (24 females, 50 males, age 40.2 ± 11.8 years). Subjects were randomized in three cohorts to receive (1) a single eye-drop containing 0.0175, 0.175, or 0.7 μg rhNGF; (2) a single ascending dose of rhNGF eye drops three times a day for 1 day (total daily dose 2.1, 6.3, or 18.9 μg), or vehicle; or (3) a multiple ascending dose of rhNGF eye drops three times a day for 5 days (total dose 10.5, 31.5, or 94.5 μg), or vehicle. Outcome measures included blood chemistry, urinalyses, vital signs, electrocardiograms (ECGs), serum NGF antibodies, ocular and systemic adverse events (AEs), visual acuity, tear function, intraocular pressure, fundus oculi, and ocular symptoms.

Results

Administration of rhNGF eye drops did not result in a significant increase of circulating NGF levels and no antidrug antibodies were detected in serum. No serious AEs were recorded, and a few mild, transient ocular AEs related to rhNGF administration were reported only at the highest concentration.

Conclusions

rhNGF eye drops were well tolerated, with no detectable clinical evidence of systemic AEs. These results pave the way for the development of clinical trials on rhNGF in ophthalmology.
Literature
1.
go back to reference Micera A, Lambiase A, Aloe L, Bonini S, Levi-Schaffer F, Bonini S. Nerve growth factor involvement in the visual system: implications in allergic and neurodegenerative diseases. Cytokine Growth Factor Rev. 2004;15:411–7.PubMedCrossRef Micera A, Lambiase A, Aloe L, Bonini S, Levi-Schaffer F, Bonini S. Nerve growth factor involvement in the visual system: implications in allergic and neurodegenerative diseases. Cytokine Growth Factor Rev. 2004;15:411–7.PubMedCrossRef
2.
3.
go back to reference Meakin SO, Shooter EM. The nerve growth factor family of receptors. Trends Neurosci. 1992;15:323–31.PubMedCrossRef Meakin SO, Shooter EM. The nerve growth factor family of receptors. Trends Neurosci. 1992;15:323–31.PubMedCrossRef
4.
go back to reference Yoon SO, Casaccia-Bennefil P, Carter B, Chao MV. Competitive signaling between TrkA and p75 nerve growth factor receptors determines cell survival. J Neurosci. 1998;18:3273–81.PubMed Yoon SO, Casaccia-Bennefil P, Carter B, Chao MV. Competitive signaling between TrkA and p75 nerve growth factor receptors determines cell survival. J Neurosci. 1998;18:3273–81.PubMed
5.
6.
go back to reference McArthur JC, Yiannoutsos C, Simpson DM, Adornato BT, Singer EJ, Hollander H, Marra C, Rubin M, Cohen BA, Tucker T, Navia BA, Schifitto G, Katzenstein D, Rask C, Zaborski L, Smith ME, Shriver S, Millar L, Clifford DB, Karalnik IJ. A phase II trial of nerve growth factor for sensory neuropathy associated with HIV infection. AIDS Clinical Trials Group Team 291. Neurology. 2000;54:1080–8.PubMedCrossRef McArthur JC, Yiannoutsos C, Simpson DM, Adornato BT, Singer EJ, Hollander H, Marra C, Rubin M, Cohen BA, Tucker T, Navia BA, Schifitto G, Katzenstein D, Rask C, Zaborski L, Smith ME, Shriver S, Millar L, Clifford DB, Karalnik IJ. A phase II trial of nerve growth factor for sensory neuropathy associated with HIV infection. AIDS Clinical Trials Group Team 291. Neurology. 2000;54:1080–8.PubMedCrossRef
7.
go back to reference Apfel SC, Kessler JA, Adornato BT, Litchy WJ, Sanders C, Rask CA. Recombinant human nerve growth factor in the treatment of diabetic polyneuropathy. NGF Study Group. Neurology. 1998;51:695–702.PubMedCrossRef Apfel SC, Kessler JA, Adornato BT, Litchy WJ, Sanders C, Rask CA. Recombinant human nerve growth factor in the treatment of diabetic polyneuropathy. NGF Study Group. Neurology. 1998;51:695–702.PubMedCrossRef
8.
go back to reference Schifitto G, Yiannoutsos C, Simpson DM, Adornato BT, Singer EJ, Hollander H, et al. AIDS Clinical Trials Group Team 291. Long-term treatment with recombinant nerve growth factor for HIV-associated sensory neuropathy. Neurology 2001;57:1313–6. Schifitto G, Yiannoutsos C, Simpson DM, Adornato BT, Singer EJ, Hollander H, et al. AIDS Clinical Trials Group Team 291. Long-term treatment with recombinant nerve growth factor for HIV-associated sensory neuropathy. Neurology 2001;57:1313–6.
9.
go back to reference Apfel SC, Schwartz S, Adornato BT, Freeman R, Biton V, Rendell M, Vinik A, Giuliani M, Stevens JC, Barbano R, Dyck PJ. Efficacy and safety of recombinant human nerve growth factor in patients with diabetic polyneuropathy: a randomized controlled trial. rhNGF Clinical Investigator Group. JAMA. 2000;284:2215–21.PubMedCrossRef Apfel SC, Schwartz S, Adornato BT, Freeman R, Biton V, Rendell M, Vinik A, Giuliani M, Stevens JC, Barbano R, Dyck PJ. Efficacy and safety of recombinant human nerve growth factor in patients with diabetic polyneuropathy: a randomized controlled trial. rhNGF Clinical Investigator Group. JAMA. 2000;284:2215–21.PubMedCrossRef
10.
go back to reference Lambiase A, Mantelli F, Sacchetti M, Rossi S, Aloe L, Bonini S. Clinical applications of NGF in ocular diseases. Arch Ital Biol. 2011;149:283–92.PubMed Lambiase A, Mantelli F, Sacchetti M, Rossi S, Aloe L, Bonini S. Clinical applications of NGF in ocular diseases. Arch Ital Biol. 2011;149:283–92.PubMed
11.
go back to reference Bonini S, Aloe L, Bonini S, Rama P, Lamagna A, Lambiase A. Nerve growth factor (NGF): an important molecule for trophism and healing of the ocular surface. Adv Exp Med Biol. 2002;506:531–7.PubMed Bonini S, Aloe L, Bonini S, Rama P, Lamagna A, Lambiase A. Nerve growth factor (NGF): an important molecule for trophism and healing of the ocular surface. Adv Exp Med Biol. 2002;506:531–7.PubMed
12.
go back to reference Lambiase A, Aloe L, Mantelli F, Sacchetti M, Perrella E, Bianchi P, Rocco ML, Bonini S. Capsaicin-induced corneal sensory denervation and healing impairment are reversed by NGF treatment. Investig Ophthalmol Vis Sci. 2012;53:8280–7.CrossRef Lambiase A, Aloe L, Mantelli F, Sacchetti M, Perrella E, Bianchi P, Rocco ML, Bonini S. Capsaicin-induced corneal sensory denervation and healing impairment are reversed by NGF treatment. Investig Ophthalmol Vis Sci. 2012;53:8280–7.CrossRef
13.
go back to reference Lambiase A, Rama P, Bonini S, Caprioglio G, Aloe L. Topical treatment with nerve growth factor for neurotrophic corneal ulcers. N Engl J Med. 1998;338:1174–80.PubMedCrossRef Lambiase A, Rama P, Bonini S, Caprioglio G, Aloe L. Topical treatment with nerve growth factor for neurotrophic corneal ulcers. N Engl J Med. 1998;338:1174–80.PubMedCrossRef
14.
go back to reference Lambiase A, Bonini S, Aloe L, Rama P, Bonini S. Anti-inflammatory and healing activities of nerve growth factor in immune corneal ulcers with stromal melting. Arch Ophthalmol. 2000;118:1446–9.PubMedCrossRef Lambiase A, Bonini S, Aloe L, Rama P, Bonini S. Anti-inflammatory and healing activities of nerve growth factor in immune corneal ulcers with stromal melting. Arch Ophthalmol. 2000;118:1446–9.PubMedCrossRef
15.
go back to reference Bonini S, Lambiase A, Rama P, Caprioglio G, Aloe L. Topical treatment with nerve growth factor for neurotrophic keratitis. Ophthalmology. 2000;107:1347–52.PubMedCrossRef Bonini S, Lambiase A, Rama P, Caprioglio G, Aloe L. Topical treatment with nerve growth factor for neurotrophic keratitis. Ophthalmology. 2000;107:1347–52.PubMedCrossRef
16.
go back to reference Lambiase A, Tirassa P, Micera A, Aloe L, Bonini S. Pharmacokinetics of conjunctivally applied nerve growth factor in the retina and optic nerve of adult rats. Investig Ophthalmol Vis Sci. 2005;46(10):3800–6.CrossRef Lambiase A, Tirassa P, Micera A, Aloe L, Bonini S. Pharmacokinetics of conjunctivally applied nerve growth factor in the retina and optic nerve of adult rats. Investig Ophthalmol Vis Sci. 2005;46(10):3800–6.CrossRef
17.
go back to reference Lambiase A, Aloe L, Centofanti M, Parisi V, Mantelli F, Colafrancesco V, Manni GL, Bucci MG, Bonini S, Levi-Montalcini R. Experimental and clinical evidence of neuroprotection by nerve growth factor eye drops: implications for glaucoma. Proc Natl Acad Sci USA. 2009;106:13469–74.PubMedCentralCrossRef Lambiase A, Aloe L, Centofanti M, Parisi V, Mantelli F, Colafrancesco V, Manni GL, Bucci MG, Bonini S, Levi-Montalcini R. Experimental and clinical evidence of neuroprotection by nerve growth factor eye drops: implications for glaucoma. Proc Natl Acad Sci USA. 2009;106:13469–74.PubMedCentralCrossRef
18.
go back to reference Ullrich A, Gray A, Berman C, Dull TJ. Human beta-nerve growth factor gene sequence highly homologous to that of mouse. Nature. 1983;30(303):821–5.CrossRef Ullrich A, Gray A, Berman C, Dull TJ. Human beta-nerve growth factor gene sequence highly homologous to that of mouse. Nature. 1983;30(303):821–5.CrossRef
19.
go back to reference Serrano T, Lorigados LC, Armenteros S. Nerve growth factor levels in normal human sera. Neuroreport. 1996;8(1):179–81.PubMedCrossRef Serrano T, Lorigados LC, Armenteros S. Nerve growth factor levels in normal human sera. Neuroreport. 1996;8(1):179–81.PubMedCrossRef
20.
go back to reference Mantelli F, Massaro-Giordano M, Macchi I, Lambiase A, Bonini S. The cellular mechanisms of dry eye: from pathogenesis to treatment. J Cell Physiol 2013;228(12):2253-6 Mantelli F, Massaro-Giordano M, Macchi I, Lambiase A, Bonini S. The cellular mechanisms of dry eye: from pathogenesis to treatment. J Cell Physiol 2013;228(12):2253-6
21.
go back to reference Coassin M, Lambiase A, Costa N, De Gregorio A, Sgrulletta R, Sacchetti M, Aloe L, Bonini S. Efficacy of topical nerve growth factor treatment in dogs affected by dry eye. Graefes Arch Clin Exp Ophthalmol. 2005;243:151–5.PubMedCrossRef Coassin M, Lambiase A, Costa N, De Gregorio A, Sgrulletta R, Sacchetti M, Aloe L, Bonini S. Efficacy of topical nerve growth factor treatment in dogs affected by dry eye. Graefes Arch Clin Exp Ophthalmol. 2005;243:151–5.PubMedCrossRef
22.
go back to reference Lambiase A, Coassin M, Tirassa P, Mantelli F, Aloe L. Nerve growth factor eye drops improve visual acuity and electrofunctional activity in age-related macular degeneration: a case report. Ann Ist Super Sanita. 2009;45:439–42.PubMed Lambiase A, Coassin M, Tirassa P, Mantelli F, Aloe L. Nerve growth factor eye drops improve visual acuity and electrofunctional activity in age-related macular degeneration: a case report. Ann Ist Super Sanita. 2009;45:439–42.PubMed
23.
go back to reference Lambiase A, Aloe L. Nerve growth factor delays retinal degeneration in C3H mice. Graefes Arch Clin Exp Ophthalmol. 1996;234(Suppl 1):S96–100.PubMedCrossRef Lambiase A, Aloe L. Nerve growth factor delays retinal degeneration in C3H mice. Graefes Arch Clin Exp Ophthalmol. 1996;234(Suppl 1):S96–100.PubMedCrossRef
24.
go back to reference Falsini B, Chiaretti A, Barone G, Piccardi M, Pierri F, Colosimo C, Lazzareschi I, Ruggiero A, Parisi V, Fadda A, Balestrazzi E, Riccardi R. Topical nerve growth factor as a visual rescue strategy in pediatric optic gliomas: a pilot study including electrophysiology. Neurorehabil Neural Repair. 2011;25:512–20.PubMedCrossRef Falsini B, Chiaretti A, Barone G, Piccardi M, Pierri F, Colosimo C, Lazzareschi I, Ruggiero A, Parisi V, Fadda A, Balestrazzi E, Riccardi R. Topical nerve growth factor as a visual rescue strategy in pediatric optic gliomas: a pilot study including electrophysiology. Neurorehabil Neural Repair. 2011;25:512–20.PubMedCrossRef
Metadata
Title
Safety and Pharmacokinetics of Escalating Doses of Human Recombinant Nerve Growth Factor Eye Drops in a Double-Masked, Randomized Clinical Trial
Authors
Mauro P. Ferrari
Flavio Mantelli
Marta Sacchetti
Maria Irene Antonangeli
Franca Cattani
Gaetano D’Anniballe
Francesco Sinigaglia
Pier Adelchi Ruffini
Alessandro Lambiase
Publication date
01-06-2014
Publisher
Springer International Publishing
Published in
BioDrugs / Issue 3/2014
Print ISSN: 1173-8804
Electronic ISSN: 1179-190X
DOI
https://doi.org/10.1007/s40259-013-0079-5

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