Methods and compositions for diagnosis and treatment of disorders in patients with elevated levels of CXCL9 and other biomarkers
Methods and compositions for treating hemophagocytic lymphohistiocytosis (HLH) are provided. The disclosure also relates generally to methods and compositions for diagnosing and treating disorders associated with elevated levels of CXCL9, elevated levels of total IFNγ, and other biomarkers. The disclosure also relates to methods of treating, delaying the progression of, or otherwise ameliorating a symptom of a disorder in patients with elevated levels of CXCL9 elevated levels of total IFNγ, and other biomarkers using agents that interfere with or otherwise antagonize interferon gamma (IFNγ) signaling, including neutralizing anti-IFNγ antibodies.
1. A method of treating hemophagocytic lymphohistiocytosis (HLH) comprising administering to a pediatric or adult human patient having HLH by IV infusion within a period of one hour, an antibody at an initial dose of 1 mg/kg wherein the antibody comprises a variable heavy chain complementarity determining region 1 (VH CDR1) comprising the amino acid sequence of SYAMS (SEQ ID NO: 1); a variable heavy chain complementarity determining region 2 (VH CDR2) comprising the amino acid sequence of AISGSGGSTYYADSVKG (SEQ ID NO: 2); and a variable heavy chain complementarity determining region 3 (VH CDR3) comprising the amino acid sequence of DGSSGWYVPHWFDP (SEQ ID NO: 3); a variable light chain complementarity determining region 1 (VL CDR1) comprising the amino acid sequence of TRSSGSIASNYVQ (SEQ ID NO: 4); a variable light chain complementarity determining region 2 (VL CDR2) region comprising the amino acid sequence of EDNQRPS (SEQ ID NO: 5); and a variable light chain complementarity determining region 3 (VL CDR3) region comprising the amino acid sequence of QSYDGSNRWM (SEQ ID NO: 6).
2. The method of claim 1 , wherein the antibody comprises the heavy chain variable amino acid sequence to the amino acid sequence of SEQ ID NO: 47, and the light chain variable amino acid sequence to the amino acid sequence of SEQ ID NO: 48.
3. The method of claim 1 or 2 , wherein the antibody is formulated in a pharmaceutical composition at a concentration of 5 mg/mL.
4. The method of claim 3 , wherein the pharmaceutical composition comprises L-histidine, L-histidine monohydrochloride, monohydrate, sodium chloride (NaCl), and Polysorbate 80, wherein the pH of the pharmaceutical composition is between 5.8 and 6.2.
5. The method of claim 4 , wherein the pH is 6.0.
6. The method of claim 1 , wherein the patient is administered with at least one additional IV infusion after the initial IV infusion, wherein the additional infusion is administered within a period of one hour.
7. The method of claim 6 , wherein the at least one additional IV infusion is at a dose that is higher than the initial dose of 1 mg/kg.
8. The method of claim 7 , wherein the at least one additional IV infusion is at a dose of 3 mg/kg.
9. The method of any one of claims 6 to 8 , wherein the at least one additional IV infusion is administered at least three days after the initial IV infusion.
10. The method of claim 1 , wherein the subject is administered a series of twice weekly IV infusions of the antibody after the initial IV infusion.
11. The method of claim 10 , wherein the series of twice weekly IV infusions is administered at a dose higher than the initial dose.
12. The method of claim 11 , wherein the series of twice weekly IV infusions is administered at a dose of at least 3 mg/kg.
13. The method of claim 1 , wherein the patient has been administered dexamethasone at least one day prior to the administration of the antibody.
14. The method of claim 13 , wherein the dexamethasone is administered at a dose of no more than 10 mg/m 2 .
15. The method of claim 13 , wherein the dexamethasone is administered at a dose of at least 5 mg/m 2 .
16. The method of claim 1 , wherein the method further comprises administering at least a second agent to the subject.
17. The method of claim 16 , wherein the second agent is a therapeutic agent, an anti-inflammatory agent, and/or an immunosuppressive agent.