AIMSThis open label study was conducted to assess the effect of renal impairment (RI) on the pharmacokinetics (PK) of peginterferon lambda-1a (Lambda).
METHODSSubjects (age 18-75 years, BMI 18-35 kg m -2 ) were enrolled into one of five renal function groups: normal (n = 12), mild RI (n = 8), moderate RI (n = 8), severe RI (n = 7), end-stage renal disease (ESRD, n = 8) based on estimated glomerular filtration rate (eGFR) calculated using the Modification of Diet in Renal Disease (MDRD) equation. Subjects received a single dose of Lambda (180 μg) subcutaneously on day 1 followed by PK serum sample collections through day 29. Safety, tolerability and immunogenicity data were collected through day 43. PK parameters were estimated and summarized by group. Geometric mean ratios (GMR) and 90% confidence intervals (CIs) were calculated between normal and RI groups.
RESULTSWith decreasing eGFR, Lambda exposure (C max , AUC) increased while apparent clearance (CL/F) and apparent volume of distribution (V/F) decreased. Relative to subjects with normal renal function (geometric mean AUC = 99.5 ng ml
CONCLUSIONSThe results demonstrated that RI reduces the clearance of Lambda and suggests that dose modifications may not be required in patients with mild RI but may be required in patients with moderate to severe RI or ESRD.
WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT• Peginterferon lambda-1a is a novel type III interferon having potent antiviral effects in subjects with hepatitis C virus (HCV).• The kidneys are a major site of proteolysis and facilitate the elimination of therapeutic proteins.• Following administration of pegylated interferons to subjects with impaired renal function clearances of these proteins have been shown to be decreased
WHAT THIS STUDY ADDS• Renal insufficiency reduces the clearance of peginterferon lambda-1a, similarly to other pegylated interferon products used in the treatment of HCV.