Comparison of Pharmacokinetics, Pharmacodynamics, Safety, and Tolerability of the Amyloid β Monoclonal Antibody Solanezumab in Japanese and White Patients With Mild to Moderate Alzheimer Disease

Objectives: Solanezumab is a humanized anti-amyloid beta monoclonal antibody being developed as a passive immunization treatment to slow the progression of Alzheimer disease (AD). Pharmacokinetics (PK), pharmacodynamics, safety, and tolerability after a single dose of solanezumab were compared between Japanese and white patients with AD. Methods: Japanese and white patients with mild to moderate AD were enrolled in 2 separate studies. In each study, single doses of solanezumab at 0.5, 1.5, 4.0, and 10.0 mg/kg were administered by intravenous infusion. Plasma concentrations of solanezumab and amyloid beta (A beta) were measured. A safety assessment was conducted up to 112 days after a single-dose administration of solanezumab. Results: The PK profile was similar between the Japanese and the white patients with AD. In both the Japanese and the white patients, clearance and volume of distribution appeared similar across doses, suggesting that solanezumab exhibited dose-proportional PK within the studied dose range. Amarked increase in plasma total A beta was observed; both the magnitude and time to reach maximum concentration tended to increase with increasing doses of solanezumab. Administration of solanezumab was generally well-tolerated in both Japanese and white patients with AD. Conclusions: When administered as a per-kilogram single dose of solanezumab, PK and pharmacodynamics (plasma total A beta(1-40) concentration) in the Japanese patients with AD were comparable with those in the white patients with AD. In addition, solanezumab was generally well tolerated in both Japanese and white patients at all dose levels.