Compositions and methods for treating synucleinopathies
The present invention relates to stable and low viscosity liquid pharmaceutical compositions comprising antibodies binding to human alpha synuclein and to methods for use of antibodies binding to human alpha synuclein for treating synucleinopathies or prodromal synucleinopathy, incl. suitable doses and/or dosing regimens. These antibodies for use in treatment of synucleinopathies or prodromal synucleinopathy may be formulated in the stable and low viscosity liquid pharmaceutical compositions of the invention.
1. A method of treating multiple system atrophy (MSA) in a human patient, the method comprising intravenously administering an anti-alpha synuclein antibody at a dose of 2100 mg or 4200 mg once every 4 weeks to the patient, wherein the antibody is a full length monoclonal human IgG1 antibody which comprises heavy chain CDR1, CDR2, and CDR3 comprising the amino acid sequences of SEQ ID NOs: 1, 34, and 3, respectively, and light chain CDR1, CDR2, and CDR3 comprising the amino acid sequences of SEQ ID NOs: 4, 5, and 6, respectively.
2. The method of claim 1 , wherein the antibody comprises a heavy chain variable domain and a light chain variable domain comprising the amino acid sequences of SEQ ID NOs: 31 and 8, respectively.
3. The method of claim 1 , wherein the antibody comprises a constant heavy chain domain comprising the amino acid sequence of SEQ ID NO: 18 and a kappa light chain constant domain comprising the amino acid sequence of SEQ ID NO: 17.
4. The method of claim 1 , wherein the binding affinity of the antibody for the oligomeric form of alpha synuclein displays approximately a 65- to 75-fold enhancement relative to the binding affinity of the antibody for the monomeric form of alpha synuclein.
5. The method of claim 1 , wherein the antibody has a half-life in the human patient of about 28-30 days.
6. The method of claim 1 , wherein the MSA is possible MSA, probable MSA, MSA type C, MSA type P, clinically established MSA, or clinically probable MSA.
7. The method of claim 1 , wherein the treatment of MSA delays disease progression.
8. The method of claim 1 , wherein the treatment of MSA delays clinical progression.
9. The method of claim 1 , wherein the antibody is administered at a dose of 2100 mg at least 3 times at about 4 weeks intervals to achieve a CSF mean steady state concentration of the antibody in the patient of at least 6 nM.
10. The method of claim 1 , wherein the antibody is administered at a dose of 4200 mg at least 3 times at about 4 weeks intervals to achieve a CSF mean steady state concentration of the antibody in the patient of at least 12 nM.
11. The method of claim 1 , wherein the antibody is administered at a dose of 2100 mg at least 3 times at about 4 weeks intervals to achieve a target engagement of oligomeric forms of alpha synuclein in the CSF of the patient of at least 90%.
12. The method of claim 1 , wherein the antibody is administered at a dose of 4200 mg at least 3 times at about 4 weeks intervals to achieve a target engagement of oligomeric forms of alpha synuclein in the CSF of the patient of at least 95%.
13. A method of treating multiple system atrophy (MSA) in a human patient, the method comprising intravenously administering an anti-alpha synuclein antibody at a dose of 2100 mg or 4200 mg once monthly to the patient, wherein the antibody is a full length monoclonal human IgG1 antibody which comprises heavy chain CDR1, CDR2, and CDR3 comprising the amino acid sequences of SEQ ID NOs: 1, 34, and 3, respectively, and light chain CDR1, CDR2, and CDR3 comprising the amino acid sequences of SEQ ID NOs: 4, 5, and 6, respectively.
14. The method of claim 13 , wherein the antibody comprises a heavy chain variable domain and a light chain variable domain comprising the amino acid sequences of SEQ ID NOs: 31 and 8, respectively.
15. The method of claim 13 , wherein the antibody comprises a constant heavy chain domain comprising the amino acid sequence of SEQ ID NO: 18 and a kappa light chain constant domain comprising the amino acid sequence of SEQ ID NO: 17.
16. The method of claim 13 , wherein the binding affinity of the antibody for the oligomeric form of alpha synuclein displays approximately a 65- to 75-fold enhancement relative to the binding affinity of the antibody for the monomeric form of alpha synuclein.
17. The method of claim 13 , wherein the antibody has a half-life in the human patient of about 28-30 days.
18. The method of claim 13 , wherein the MSA is possible MSA, probable MSA, MSA type C, MSA type P, clinically established MSA, or clinically probable MSA.
19. The method of claim 13 , wherein the treatment of MSA delays disease progression.
20. The method of claim 13 , wherein the treatment of MSA delays clinical progression.
21. The method of claim 13 , wherein the antibody is administered at a dose of 2100 mg at least 3 times at about monthly intervals to achieve a CSF mean steady state concentration of the antibody in the patient of at least 6 nM.
22. The method of claim 13 , wherein the antibody is administered at a dose of 4200 mg at least 3 times at about monthly intervals to achieve a CSF mean steady state concentration of the antibody in the patient of at least 12 nM.
23. The method of claim 13 , wherein the antibody is administered at a dose of 2100 mg at least 3 times at about monthly intervals to achieve a target engagement of oligomeric forms of alpha synuclein in the CSF of the patient of at least 90%.
24. The method of claim 13 , wherein the antibody is administered at a dose of 4200 mg at least 3 times at about monthly intervals to achieve a target engagement of oligomeric forms of alpha synuclein in the CSF of the patient of at least 95%.
25. A method of treating multiple system atrophy (MSA) in a human patient, the method comprising intravenously administering an anti-alpha synuclein antibody at a dose of 2100 mg or 4200 mg once every 4 weeks to the patient, wherein the antibody is a human IgG1, kappa antibody which comprises a heavy chain variable domain and a light chain variable domain comprising the amino acid sequences of SEQ ID NOs: 31 and 8, respectively.
26. The method of claim 25 , wherein the antibody comprises a constant heavy chain domain comprising the amino acid sequence of SEQ ID NO: 18 and a kappa light chain constant domain comprising the amino acid sequence of SEQ ID NO: 17.
27. A method of treating multiple system atrophy (MSA) in a human patient, the method comprising intravenously administering an anti-alpha synuclein antibody at a dose of 2100 mg or 4200 mg once monthly to the patient, wherein the antibody is a human IgG1, kappa antibody which comprises a heavy chain variable domain and a light chain variable domain comprising the amino acid sequences of SEQ ID NOs: 31 and 8, respectively.
28. The method of claim 27 , wherein the antibody a constant heavy chain domain comprising the amino acid sequence of SEQ ID NO: 18 and a kappa light chain constant domain comprising the amino acid sequence of SEQ ID NO: 17.
29. The method of claim 1 , wherein the treatment of MSA slows clinical progression.
30. The method of claim 29 , wherein the slowing of clinical progression is quantified by Unified Multiple System Atrophy Rating Scale (UMSARS) score.
31. The method of claim 29 , wherein the slowing of clinical progression is quantified by modified UMSARS score.
32. The method of claim 29 , wherein the slowing of clinical progression is quantified by UMSARS total score.
33. The method of claim 13 , wherein the treatment of MSA slows clinical progression.
34. The method of claim 33 , wherein the slowing of clinical progression is quantified by UMSARS score.
35. The method of claim 33 , wherein the slowing of clinical progression is quantified by modified UMSARS score.
36. The method of claim 33 , wherein the slowing of clinical progression is quantified by UMSARS total score.