New drug tour: KHK-4083 challenges the first drug of OX40 target

Nowadays, the field of new drug research and development can be described as fierce battles.

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OX40 (also known as CD134) was initially identified on activated CD4-positive T cells with a size of 50kDa, and was later identified as containing a single transmembrane protein domain and a cysteine-rich extracellular domain Targeting receptors

Current studies have found that after antigen presentation, under the influence of various other pro-inflammatory factors such as CD28, CD40L, and interferon-γ, the expression of OX40 on CD4+ T cells increases, and its high expression is often at the 24-hour level after antigen presentation.

In addition, the interaction of OX40/OX40L can effectively promote the secretion of IL-2, IL-4, IL-5, IL-17, IFN-γ and other cytokines through NF-κB, ERK, PI3K, AKT and other signaling pathways; Inhibit CTLA-4 and other immunosuppressive receptors to promote immune response; by stimulating chemokine receptors, enhance the mobility of T cells

Due to its important role in immune regulation, the OX40 target is currently used in the development of autoimmune diseases and anti-tumor diseases

Global distribution of OX40 pipelines

At present, the specific conditions of the OX40 pipeline that has entered clinical phase II globally are as follows:

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KHK-4083 is a fully humanized monoclonal antibody jointly developed by Japanese pharmaceutical companies Kyowa Hakko Kirin and Amgen.

At present, mainstream antibody drugs are basically IgG antibodies, which have N-sugar chains in the Fc segment of IgG, and the composition and structure of sugar chains affect the structure, effector function, and pharmacokinetic properties of the antibody

AD indications

Atopic dermatitis (AD) is a common inflammatory skin disease that is affected by genetic and environmental factors

In October 2018, a double-blind, randomized, parallel-assigned, multi-center, placebo-controlled phase II trial (NCT03703102) was launched.

In February 2021, the positive test results were released.

The results of the phase Ib clinical trial published earlier showed that the EASI score of subjects dropped by 74% at 22 weeks

UC indications

Ulcerative colitis (UC) is a chronic and often recurring inflammatory disease of the colonic mucosa.

In January 2016, a randomized, double-blind, parallel assignment, multicenter, placebo-controlled, multi-dose escalation phase II trial (NCT02647866) was launched to evaluate the safety and resistance of KHK-4083 in patients with moderate UC Susceptible
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The test results show that the long-term treatment of KHK-4083 is well tolerated, and the treatment-related adverse events are mainly related to mild to moderate infusion-related reactions
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Analysis of biopsy samples showed that after 12 weeks of KHK-4083 treatment, OX40+ cells in the colonic mucosa were almost completely eliminated
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Cooperation situation

In January 2021, Kyowa Hakko Kirin and Amgen reached an agreement that Amgen will be responsible for the development, manufacturing and commercialization of KHK-4083 drugs in the global market except Japan.
Kyowa Hakko Kirin will jointly promote the product in the US market with Amgen
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Amgen will pay Kyowa Hakko Kirin an upfront payment of US$400 million, as well as milestone payments of up to US$850 million in the future
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Currently, the research and development of the OX40 target is advancing rapidly.
In addition to the aforementioned Amgen, BMS, and ModeRNA, well-known companies such as Abbive and BeiGene have all entered the game
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It is expected that the OX40 target will bring innovative therapies and products to the treatment of cancer and autoimmune diseases in the future
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Reference

1.
The structure and function of the sugar chain of therapeutic antibody[J].
Chinese Journal of Biochemical Pharmaceutics, 2017

2.
New era of biologic therapeutics in atopic dermatitis.
Expert Opin BiolTher.
2013 Apr

3.
Randomized, Ascending Dose, Phase 2 Study of KHK4083, an Anti-OX40Monoclonal Antibody, in Moderately Active Ulcerative Colitis

4.
Kyowa Kirin Announces Positive Phase 2 Results for KHK4083in Patientswith Moderate to Severe Atopic Dermatitis

5.
OX40, OX40L and Autoimmunity: a Comprehensive Review.
Clin Rev AllergyImmunol.
2016 Jun

6.
The company's official website