TGN1412: Time to Change the Paradigm for the Testing of New Pharmaceuticals

Clinical studies in human volunteers are an essential part of drug development. These studies are designed to account for possible differences between the effects of pharmaceutical products in pre-clinical studies and in humans. However, the tragic outcome of the recent Phase 1 clinical trial on TGN1412 casts considerable doubt over the relevance of this traditional drug development paradigm to the testing of therapeutic agents for human use. The role of alternatives to animal testing is considered, and a series of recommendations are made, which could ensure that clinical trials are well informed and based on the most relevant scientific information.

[1]  C. Silliman,et al.  The merits of in vitro versus in vivo modeling in investigation of the immune system. , 2006, Environmental toxicology and pharmacology.

[2]  T. Hanke,et al.  Topological Requirements and Signaling Properties of T Cell–activating, Anti-CD28 Antibody Superagonists , 2003, The Journal of experimental medicine.

[3]  D. Stuart,et al.  Crystal structure of a soluble CD28-Fab complex , 2005, Nature Immunology.

[4]  T. Hanke,et al.  CD28‐mediated induction of proliferation in resting T cells in vitro and in vivo without engagement of the T cell receptor: Evidence for functionally distinct forms of CD28 , 1997, European journal of immunology.

[5]  R. Gold,et al.  Treatment and prevention of experimental autoimmune neuritis with superagonistic CD28-specific monoclonal antibodies , 2003, Journal of Neuroimmunology.

[6]  P. Foster,et al.  Interleukin‐5 and eosinophils induce airway damage and bronchial hyperreactivity during allergic airway inflammation in BALB/c mice , 1997, Immunology and cell biology.

[7]  Barnett S Kramer,et al.  Getting It Right: Being Smarter about Clinical Trials , 2006, PLoS medicine.

[8]  P. Vereerstraeten,et al.  RELEASE OF TUMOR NECROSIS FACTOR, INTERLEUKIN‐2, AND GAMMA‐INTERFERON IN SERUM AFTER INJECTION OF OKT3 MONOCLONAL ANTIBODY IN KIDNEY TRANSPLANT RECIPIENTS , 1989, Transplantation.

[9]  R D Combes,et al.  Early microdose drug studies in human volunteers can minimise animal testing: Proceedings of a workshop organised by Volunteers in Research and Testing. , 2003, European journal of pharmaceutical sciences : official journal of the European Federation for Pharmaceutical Sciences.

[10]  T. Hanke,et al.  Superagonistic anti-CD28 antibodies: potent activators of regulatory T cells for the therapy of autoimmune diseases , 2005, Annals of the rheumatic diseases.

[11]  T. Hanke,et al.  CD28 superagonists put a break on autoimmunity by preferentially activating CD4+CD25+ regulatory T cells. , 2006, Autoimmunity reviews.

[12]  I. Kola,et al.  Can the pharmaceutical industry reduce attrition rates? , 2004, Nature Reviews Drug Discovery.

[13]  D. Margulies CD28, Costimulator or Agonist Receptor? , 2003, The Journal of experimental medicine.

[14]  F. Villinger,et al.  Comparative sequence analysis of cytokine genes from human and nonhuman primates. , 1995, Journal of immunology.

[15]  R. Gold,et al.  Selective targeting of regulatory T cells with CD28 superagonists allows effective therapy of experimental autoimmune encephalomyelitis , 2005, The Journal of experimental medicine.

[16]  Kay Dickersin,et al.  Registering clinical trials. , 2003, JAMA.

[17]  E. D. Harris The changing dimensions of rheumatoid arthritis and its treatment. , 2003, Bulletin of the World Health Organization.

[18]  R. Horn,et al.  Investigating the Putative Glycine Hinge in Shaker Potassium Channel , 2005, The Journal of general physiology.