IP Library Granted Patent US 12,358,976
Granted Patent B2
US 12,358,976 · App. 18/366,447 · Granted Jul 15, 2025

Methods for increasing serum concentration of phosphorous and/or 1,25-hydroxy vitamin d

Inventors: Emil D. Kakkis (Novato, CA); Javier San Martin (Novato, CA); Tomohiro Sudo (Tokyo, JP)
Assignees: Ultragenyx Pharmaceutical Inc.; Kyowa Kirin Co., Ltd.
C07K16/22A61K39/001132A61K2039/505A61K2039/54A61K2039/545C07K2317/21C07K2317/565C07K2317/76C07K2317/90
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Quick Facts
Patent No.
US 12,358,976
App. No.
18/366,447
Granted
Jul 15, 2025
Kind
B2
Abstract

The present invention provides compositions and methods for treating a hypophosphatemic disorder, such as X-linked hypophosphatemia (XLH). The method entails administering to a subject a pharmaceutical composition containing an anti-FGF23 ligand, wherein the dosing regimen of the pharmaceutical is designed to reach effective and efficient control of FGF23 activity.

Claims (20)

1. A method of increasing serum phosphorus levels in a subject having a hypophosphatemic disorder, said method comprising administering to the subject an effective amount of an anti-FGF23 antibody, wherein the anti-FGF23 antibody is administered about every two weeks, and wherein the anti-FGF23 antibody comprises the CDR sequences of SEQ ID NO: 1, SEQ ID NO: 2, SEQ ID NO: 3, SEQ ID NO: 4, SEQ ID NO: 5, and SEQ ID NO: 6.

2. The method of claim 1 , wherein the heavy chain of the anti-FGF23 antibody comprises a sequence of SEQ ID NO: 7.

3. The method of claim 1 , wherein the light chain of the anti-FGF23 antibody comprises a sequence of SEQ ID NO: 8.

4. The method of claim 1 , wherein the heavy chain of the anti-FGF23 antibody comprises a sequence of SEQ ID NO: 7 and the light chain of the anti-FGF23 antibody comprises a sequence of SEQ ID NO: 8.

5. The method of claim 1 , wherein the anti-FGF23 antibody is administered with a pharmaceutically-acceptable carrier.

6. The method of claim 1 , wherein the subject is a pediatric subject.

7. The method of claim 1 , wherein the anti-FGF23 antibody is administered subcutaneously.

8. The method of claim 1 , wherein the anti-FGF23 antibody is administered at a dose from about 0.05 mg/kg to about 1.0 mg/kg.

9. The method of claim 1 , wherein the anti-FGF23 antibody is administered at a dose of about 0.8 mg/kg.

10. The method of claim 1 , wherein the anti-FGF23 antibody is administered at a dose of about 1.0 mg/kg.

11. The method of claim 1 , wherein the hypophosphatemic disorder is selected from the group consisting of autosomal dominant hypophosphatemic rickets (ADHR), X-linked hypophosphatemia (XLH), autosomal recessive hypophosphatemic rickets (ARHR), fibrous dysplasia (FD), McCune-Albright syndrome complicated by fibrous dysplasia (MAS/FD), Jansen's metaphyseal chondrodysplasia (Jansen's Syndrome), autosomal dominant polycystic kidney disease (ADPKD), tumor-induced osteomalacia (TIO), and chronic metabolic acidosis.

12. The method of claim 11 , wherein the hypophosphatemic disorder is XLH.

13. The method of claim 11 , wherein the hypophosphatemic disorder is TIO.

14. A method of increasing serum 1,25-dihydroxy vitamin D levels in a subject having a hypophosphatemic disorder, said method comprising administering to the subject an effective amount of an anti-FGF23 antibody, wherein the anti-FGF23 antibody is administered about every two weeks, and wherein the anti-FGF23 antibody comprises the CDR sequences of SEQ ID NO: 1, SEQ ID NO: 2, SEQ ID NO: 3, SEQ ID NO: 4, SEQ ID NO: 5, and SEQ ID NO: 6.

15. The method of claim 14 , wherein the heavy chain of the anti-FGF23 antibody comprises a sequence of SEQ ID NO: 7 and the light chain of the anti-FGF23 antibody comprises a sequence of SEQ ID NO: 8.

16. The method of claim 14 , wherein the subject is a pediatric subject.

17. The method of claim 14 , wherein the anti-FGF23 antibody is administered subcutaneously.

18. The method of claim 14 , wherein the hypophosphatemic disorder is selected from the group consisting of autosomal dominant hypophosphatemic rickets (ADHR), X-linked hypophosphatemia (XLH), autosomal recessive hypophosphatemic rickets (ARHR), fibrous dysplasia (FD), McCune-Albright syndrome complicated by fibrous dysplasia (MAS/FD), Jansen's metaphyseal chondrodysplasia (Jansen's Syndrome), autosomal dominant polycystic kidney disease (ADPKD), tumor-induced osteomalacia (TIO), and chronic metabolic acidosis.

19. The method of claim 18 , wherein the hypophosphatemic disorder is selected from XLH and TIO.

20. A method of increasing serum concentrations of phosphorus and/or 1,25-dihydroxy vitamin D in a subject having a hypophosphatemic disorder, said method comprising administering to the subject an effective amount of an anti-FGF23 antibody, wherein the anti-FGF23 antibody is administered about every two weeks, and wherein the anti-FGF23 antibody comprises the CDR sequences of SEQ ID NO: 1, SEQ ID NO: 2, SEQ ID NO: 3, SEQ ID NO: 4, SEQ ID NO: 5, and SEQ ID NO: 6.

Assignments (3)
ASSIGNMENT OF ASSIGNOR'S INTEREST Recorded Oct 9, 2023
From: SUDO, TOMOHIRO
To: KYOWA HAKKO KIRIN CO., LTD.
Reel/Frame 065161/0233 →
ASSIGNMENT OF ASSIGNOR'S INTEREST Recorded Oct 9, 2023
From: KAKKIS, EMIL D.; MARTIN, JAVIER SAN
To: ULTRAGENYX PHARMACEUTICAL INC.
Reel/Frame 065161/0459 →
CHANGE OF NAME Recorded Oct 9, 2023
From: KYOWA HAKKO KIRIN CO., LTD.
To: KYOWA KIRIN CO., LTD.
Reel/Frame 065190/0403 →
Continuity (5)
Continuation 17525738 · Nov 12, 2021
Continuation 16831179 · Mar 26, 2020
Continuation 14725320 · May 29, 2015
Provisional Application 62009474 · Jun 9, 2014
Related Publication 20240115683A1 · Apr 11, 2024
References Cited (91)
US 7223563B2 · Econs et al. · 2007 [cited by applicant]
US 7314618B2 · Econs et al. · 2008 [cited by applicant]
US 7745406B2 · Econs et al. · 2010 [cited by applicant]
US 7883705B2 · Yamazaki et al. · 2011 [cited by applicant]
US 7923012B2 · Yamazaki et al. · 2011 [cited by applicant]
US 7947810B2 · Econs et al. · 2011 [cited by applicant]
US 7981419B2 · Yamashita et al. · 2011 [cited by applicant]
US 8586317B2 · Econs et al. · 2013 [cited by applicant]
US 8889426B2 · Mohammadi et al. · 2014 [cited by applicant]
US 8889621B2 · Mohammadi et al. · 2014 [cited by applicant]
US 9272017B2 · Mohammadi et al. · 2016 [cited by applicant]
US 9290599B2 · Hogan et al. · 2016 [cited by applicant]
US 10639360B2 · Kakkis et al. · 2020 [cited by applicant]
US 11202822B2 · Kakkis et al. · 2021 [cited by applicant]
US 11771748B2 · Kakkis et al. · 2023 [cited by applicant]
US 20090148461A1 · Yamazaki et al. · 2009 [cited by applicant]
US 20110182913A1 · Yamazaki et al. · 2011 [cited by applicant]
US 20120064544A1 · Econs et al. · 2012 [cited by applicant]
US 20150353633A1 · Kakkis et al. · 2015 [cited by applicant]
US 20160159895A1 · Yamazaki et al. · 2016 [cited by applicant]
US 20200330575A1 · Kakkis et al. · 2020 [cited by applicant]
US 20220133871A1 · Kakkis et al. · 2022 [cited by applicant]
AU 2005202100A1 · 2005 [cited by applicant]
CN 1446227A · 2003 [cited by applicant]
CN 102702355A · 2012 [cited by applicant]
JP 2004504063A · 2004 [cited by applicant]
KR 20090114452A · 2009 [cited by applicant]
WO WO0208271A1 · 2002 [cited by applicant]
WO WO2008099969A1 · 2008 [cited by applicant]
WO WO2012050673A1 · 2012 [cited by applicant]
WO WO2015191312A1 · 2015 [cited by applicant]
Wu et al. Antibody-Mediated Activation of FGFR1 Induces FGF23 Production and Hypophosphatemia. PLoS ONE 8(2): e57322, 2013. //doi.org/10.1371/journal.pone.0057322. [cited by examiner]
Saito et al. Fibroblast Growth Factor 23 (FGF23) and Disorders of Phosphate Metabolism. Int. J. Pediatr. Endocrinol. 496514, 2009. //doi.org/10.1155/2009/496514. [cited by examiner]
Alon, et al., Calcimimetics as an adjuvant treatment for familial hypophosphatemic rickets, Clinical journal of the American Society of Nephrology, CJASN, May 2008, 11 pages. [cited by applicant]
Aono, et al., anti-FGF-23 Neutralizing Antibodies Ameliorate Muscle Weakness and Decreased Spontaneous Movement of Hyp Mice, Journal of Bone and Mineral Research, Apr. 2011, pp. 803-810. [cited by applicant]
Aono, et al., Therapeutic effects of anti-FGF23 antibodies in hypophosphatemic rickets/osteomalacia, Journal of Bone and Mineral Research, Nov. 2009, pp. 879-888. [cited by applicant]
Capenter, et al., A Clinician's Guide to X-Linked Hypophosphatemia, Journal of Bone and Mineral Research, Jul. 2011, pp. 1381-1388. [cited by applicant]
Capenter, et al., A randomized, double-blind, placebo-controlled, ascending, single-dose study of a human monoclonal anti-FGF23 antibody (KRN23) in X-linked hypophosphatemia, Bone Abstracts, May 2014, 2 pages. [cited by applicant]
Carpenter, et al., A Randomized, Open-label Phase 2 Study of KRN23, a Fully Human Anti-FGF23 Monoclonal Antibody, in 52 Children with X-linked Hypophosphatemia (XLH): 40-Week Results, ASBMR: Plenary Oral Session No. 115… [cited by applicant]
Carpenter, et al., Efficacy and Safety of a Human Monoclonal Anti-FGF23 Antibody (KRN23) in a Cumulative 4-Month Dose Escalation (KRN23-INT-001) and 12-Month Long-Term Extension Study (KRN23-INT-002) in Adult Subjects w… [cited by applicant]
Carpenter, et al., Randomized trial of the anti-FGF23 antibody KRN23 in X-linked hypophosphatemia, The Journal of Clinical Investigation, Apr. 2014, pp. 1587-1597. [cited by applicant]
ClinicalTrials.gov, Trial Record NCT02163577, Study of KRN23, a Recombinant Fully Human Monoclonal Antibody Against FGF23, in Pediatric Subjects With X-linked Hypophosphatemia (XLH), Sponsored by Ultragenyx Pharmaceutic… [cited by applicant]
Database GenBank [Online], XP002776304, Database Accession No. AED38397.1, Apr. 2011, 1 page. [cited by applicant]
Database GenBank [Online], XP002776305, Database Accession No. AED38398.1, Apr. 2011, 1 page. [cited by applicant]
Day, et al., Burosumab in tumor-induced osteomalacia: a case report, Joint Bone Spine, Jan. 2020, pp. 81-83. [cited by applicant]
Domrongkitchaiporn, et al.,Oral phosphate supplementation corrects hypophosphatemia and normalizes plasma FGF23 and 25-hydroxyvitamin D3 levels in women with chronic metabolic acidosis, Experimental and clinical endocri… [cited by applicant]
Endo, et al., Clinical usefulness of measurement of fibroblast growth factor 23 (FGF23) in hypophosphatemic patients: proposal of diagnostic criteria using FGF23 measurement, Bone, Jun. 2008, pp. 1235-1239. [cited by applicant]
Erbitux Product Label, ImClone Systems Incorporated and Bristol-Myers Squibb Company, 2004, 18 pages. [cited by applicant]
Fukumoto, Anti-fibroblast growth factor 23 antibody therapy, Current opinion in nephrology and hypertension, Jul. 2014, pp. 346-351. [cited by applicant]
Fukumoto, FGF23-FGF receptor/Klotho pathway as a new drug target for disorders of bone and mineral metabolism, Calcified tissue international, Apr. 2016, pp. 334-340. [cited by applicant]
Fukumoto, Bone and Calcium Research Update 2015. Novel treatment for FGF23-related hypophosphatemic diseases, Clinical Calcium, Jan. 2015, pp. 37-44. [cited by applicant]
Geller, et al., Cinacalcet in the management of tumor-induced osteomalacia, Journal of Bone and Mineral Research, Jun. 2007, pp. 931-937. [cited by applicant]
Imanishi, et al. Interim analysis of a phase 2 open-label trial assessing burosumab efficacy and safety in patients with tumor-induced osteomalacia, Journal of Bone and Mineral Research, Feb. 2021, pp. 262-270. [cited by applicant]
Imel, OR431 the First Multi-Dose Trial of a Human Anti-FGF23 (Fibroblast Growth Factor 23) Antibody (KRN23) in Adults with X-Linked Hypophosphatemia (XLH). Abstracts-Orals, Poster Preview Presentations, and Posters Sess… [cited by applicant]
Imel, et al., The First Multi-Dose Trial of a Human Anti-FGF23 (Fibroblast Growth Factor 23) Antibody (KRN23) in Adults with X-Linked Hypophosphatemia (XLH), Oral presentation (OR43-1), 2014 IC, InENDO Annual Meeting Ju… [cited by applicant]
Imel, et al., Treatment of X-linked hypophosphatemia with calcitriol and phosphate increases circulating fibroblast growth factor 23 concentrations, The Journal of Clinical Endocrinology & Metabolism Apr. 2010, pp. 1846… [cited by applicant]
Imura et al., Secreted Klotho protein in sera and CSF: implication for post-translational cleavage in release of Klotho protein from cell membrane, FEBS letters, May 2004, pp. 143-147. [cited by applicant]
Ito, Effects of burosumab, an anti-FGF23 antibody, in patients with tumor-induced osteomalacia: Results from an ongoing phase 2 study, Embase, Elsevier Science Publishers, Amsterdam, NL, Database accession No. EMB-63180… [cited by applicant]
Jan De Beur, et al., Burosumab improved serum phosphorus, osteomalacia, mobility, and fatigue in the 48-week, phase 2 study in adults with tumor-induced osteomalacia syndrome, atabase accession No. EMB-631808042, Journa… [cited by applicant]
Jan De Beur, et al. Burosumab improves the biochemical, skeletal, and clinical symptoms of tumor-induced osteomalacia (TIO) syndrome, Embase, Elsevier Science Publishers, Amsterdam, NL, Database accession No. EMB-633781… [cited by applicant]
Keizer, et al., Clinical pharmacokinetics of therapeutic monoclonal antibodies, Clinical pharmacokinetics, Aug. 2010, pp. 493-507. [cited by applicant]
Kinoshita, et al., X-linked hypophosphatemia and FGF23-related hypophosphatemic diseases: prospect for new treatment, Endocrine reviews, Jun. 2018, pp. 274-291. [cited by applicant]
Kolek et al., 1α, 25-Dihydroxyvitamin D3 upregulates FGF23 gene expression in bone: the final link in a renal-gastrointestinal-skeletal axis that controls phosphate transport, American Journal of Physiology—Gastrointest… [cited by applicant]
Kurosu et al., Suppression of aging in mice by the hormone Klotho, Science, Sep. 2005, pp. 1829-1833. [cited by applicant]
Larsson et al., Transgenic mice expressing fibroblast growth factor 23 under the control of the α1 (I) collagen promoter exhibit growth retardation, osteomalacia, and disturbed phosphate homeostasis, Endocrinology, Jul.… [cited by applicant]
Liu et al., Novel regulators of Fgf23 expression and mineralization in Hyp bone, Molecular endocrinology, Sep. 2009, pp. 1505-1518. [cited by applicant]
Liu, et al., Fibroblast growth factor 23 is a counter-regulatory phosphaturic hormone for vitamin D, Journal of the American Society of Nephrology, May 2006, pp. 1305-1315. [cited by applicant]
Lucentis Product Label, Genentech, Inc., 2014, 14 pages. [cited by applicant]
Matsumara et al., Identification of the humanklothogene and its two transcripts encoding membrane and secretedklothoprotein, Abstract, Biochemical and biophysical research communications, Jan. 1998, pp. 626-630. [cited by applicant]
Onuchic, et al., Potential effects of alendronate on fibroblast growth factor 23 levels and effective control of hypercalciuria in an adult with Jansen's metaphyseal chondrodysplasia, The Journal of Clinical Endocrinolo… [cited by applicant]
Pavik, et al., Patients with autosomal dominant polycystic kidney disease have elevated fibroblast growth factor 23 levels and a renal leak of phosphate, Kidney international, Jan. 2011, pp. 234-240. [cited by applicant]
Perwad, et al., Dietary and serum phosphorus regulate fibroblast growth factor 23 expression and 1, 25-dihydroxyvitamin D metabolism in mice, Endocrinology, Dec. 2005, pp. 5358-5364. [cited by applicant]
Remicade Product Label, Janssen Biotech, Inc., 2013, 58 pages. [cited by applicant]
Riminucci et al., FGF-23 in fibrous dysplasia of bone and its relationship to renal phosphate wasting, The Journal of clinical investigation, Sep. 2003, pp. 683-692. [cited by applicant]
Rituxan Product Label, Genentech, Inc., 2012, 40 pages. [cited by applicant]
Ruppe, et al., Effect of four monthly doses of a human monoclonal anti-FGF23 antibody (KRN23) on quality of life in X-linked hypophosphatemia. Bone reports. Dec. 1, 2016;5:158-62., ICE/ENDO 2014, Abstracts—Orals, Poster… [cited by applicant]
Shimada et al., FGF-23 is a potent regulator of vitamin D metabolism and phosphate homeostasis, Abstract, Journal of bone and mineral research, Mar. 2004, pp. 429-435. [cited by applicant]
Shimada et al., FGF-23 transgenic mice demonstrate hypophosphatemic rickets with reduced expression of sodium phosphate cotransporter type lia, Abstract, Biochemical and biophysical research communications, Feb. 2004, p… [cited by applicant]
Shimada, Anti-FGF23 antibody, a new therapeutic approach for hypophosphatemic rickets/osteomalacia, Clinical Calcium, 2013, pp. 77-83. [cited by applicant]
Shimada, et al., FGF23 As A Novel Therapeutic Target, Chap. 10 In: Endocrine FGFs and Klothos, Makoto Kuro-o (eds)., 2012, pp. 158-170. [cited by applicant]
Shiraki-Iida et al., Structure of the mouse klotho gene and its two transcripts encoding membrane and secreted protein 1, FEBS letters, Mar. 1998, pp. 6-10. [cited by applicant]
Ultragenyx Pharmaceutical Inc., Ultragenyx Announces Initiation of a Phase 2 Study of KRN [cited by applicant]
Ultragenyx Reports Positive Interim Data from Pediatric and Adult Phase 2 Studies of KRN23 in X-Linked Hypophosphatemia, Press Release, Sep. 19, 2016, 5 pages. [cited by applicant]
Vajdos, et al., Comprehensive functional maps of the antigen-binding site of an anti-ErbB2 antibody obtained with shotgun scanning mutagenesis, Journal of Molecular Biology, Jul. 2002, pp. 415-428. [cited by applicant]
Vectibix Product Label, Amgen Inc., 2009, 14 pages. [cited by applicant]
Yamashita et al., Identification of a novel fibroblast growth factor, FGF-23, preferentially expressed in the ventrolateral thalamic nucleus of the brain, Biochemical and biophysical research communications, Oct. 2000, … [cited by applicant]
Yamazaki, et al., Anti-FGF23 neutralizing antibodies show the physiological role and structural features of FGF23, Journal of Bone and Mineral Research, Sep. 2008, pp. 1509-1518. [cited by applicant]
Yasuhara, Fundamentals of Clinical Pharmacokinetics, Proceedings of the 16th Training Course in Clinical Pharmacology, Pharmacokinetics for Primers. Jul. 2010. pp. 155-158. (Machine Translation included). [cited by applicant]
Zhang, et al., Pharmacokinetics (PK) and Pharmacodynamics (PD) Following Four Monthly Doses of a Human Monoclonal Anti-FGF23 (Fibroblast Growth Factor 23) Antibody (KRN23) in Adults with X-Linked Hypophosphatemia (XLH),… [cited by applicant]
Barnas, Christoph, European Patent Office, Extended European Search Report for European Application No. 15806501.1, Dec. 19, 2017, 7 pages. [cited by applicant]
Thomas, Shane, International Searching Authority, International Search Report and Written Opinion for International Application No. PCT/US2015/033226, Nov. 13, 2015, 12 pages. [cited by applicant]