Methods for treating conditions associated with MASP-2 dependent complement activation
In one aspect, the invention provides methods of inhibiting the effects of MASP-2-dependent complement activation in a human subject suffering from TMA associated with hematopoietic stem cell transplant. The methods comprise the step of administering, to a subject in need thereof, an amount of a MASP-2 inhibitory agent effective to inhibit MASP-2-dependent complement activation.
1. A method of treating a human subject suffering from persistent TMA associated with hematopoietic stem cell transplant (HSCT-TMA) comprising
(i) identifying a human subject suffering from persistent HSCT-TMA wherein said subject has TMA that persists despite a reduction or discontinuation of an immunosuppressive agent, or wherein said subject has TMA that persists at least 30 days after transplant; and
(ii) administering to the subject a composition comprising a MASP-2 inhibitory antibody, or antigen-binding fragment thereof, wherein the MASP-2 inhibitory monoclonal antibody or antigen-binding fragment thereof comprises a heavy chain variable region set forth as SEQ ID NO:67 and a light chain variable region set forth as SEQ ID NO:70, wherein the composition is administered at a dosage of at least 4 mg/kg at least once a week for a time period of at least three weeks, wherein said administration is effective to improve at least one or more of the following clinical parameters associated with persistent TMA associated with hematopoietic stem cell transplant: (i) an increase in platelet count (e.g., at least double, at least triple, at least quadruple the platelet count prior to treatment)); (ii) an increase in haptoglobin; (iii) a decrease in lactate dehydrogenase (LDH); and/or (iv) a decrease in creatinine.
2. The method of claim 1 , wherein the antibody or fragment thereof is selected from the group consisting of a recombinant antibody, an antibody having reduced effector function, a chimeric antibody, a humanized antibody, and a human antibody.
3. The method of claim 1 , wherein the MASP-2 inhibitory antibody inhibits C3b deposition in 90% human serum with an IC 50 of 30 nM or less.
4. The method of claim 1 , wherein the MASP-2 inhibitory antibody is delivered to the subject systemically.
5. The method of claim 1 , wherein the subject has previously undergone, or is currently undergoing, treatment with a humanized anti-05 antibody or antigen-binding fragment thereof.
6. The method of claim 1 , wherein the subject suffering from persistent HSCT-TMA has TMA that persists for at least two weeks after the reduction or discontinuation of an immunosuppression agent.
7. The method of claim 1 , wherein the subject suffering from persistent HSCT-TMA has TMA that persists for at least 30 days after transplant.
8. The method of claim 1 , wherein the immunosuppression agent is a calcineurin inhibitor.