Evidence map›Paper›PMID 34935183›Full record

Trial reportBritish journal of clinical pharmacology2022

Emapalumab in primary haemophagocytic lymphohistiocytosis and the pathogenic role of interferon gamma: A pharmacometric model-based approach.

Philippe Jacqmin, Christian Laveille, Eric Snoeck, Michael B Jordan, Franco Locatelli, Maria Ballabio, Cristina de Min

Open access · greenAbstract readClinical Trial, Phase IIClinical Trial, Phase IIIMulticenter Study
In one paragraph

Trial report in British journal of clinical pharmacology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed
3.2field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 32 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 5 countries.

Philippe JacqminMnS Modelling and Simulation, Dinant, Belgium.
Christian LaveilleCalvagone Sarl, Liergues, France.
Eric SnoeckLuccio BV, Meerhout, Belgium.
Michael B JordanDivisions of Immunobiology and Bone Marrow Transplantation and Immune Deficiency, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Franco LocatelliDepartment of Pediatrics, Sapienza, University of Rome, Rome, Italy.
Maria BallabioSwedish Orphan Biovitrum AG (Sobi), Basel, Switzerland.
Cristina de MinSwedish Orphan Biovitrum AG (Sobi), Basel, Switzerland.
Swedish Orphan Biovitrum (Switzerland) · CHBambino Gesù Children's Hospital · ITCalvagone (France) · FRCincinnati Children's Hospital Medical Center · USLeefmilieu Brussel · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimPrimary haemophagocytic lymphohistiocytosis (HLH) is a rare, life-threatening, hyperinflammatory syndrome generally occurring in early childhood. The monoclonal antibody emapalumab binds and neutralises interferon γ (IFNγ). This study aimed to determine an emapalumab dosing regimen when traditional dose-finding approaches are not applicable, using pharmacokinetic-pharmacodynamic analyses to further clarify HLH pathogenesis and confirm IFNγ neutralisation as the relevant therapeutic target in pHLH.

methodsInitial emapalumab dosing (1 mg/kg) for pHLH patients participating in a pivotal multicentre, open-label, single-arm, phase 2/3 study was based on anticipated IFNγ levels and allometrically scaled pharmacokinetic parameters estimated in healthy volunteers. Emapalumab dosing was adjusted based on estimated IFNγ-mediated clearance and HLH clinical and laboratory criteria. Frequent dosing and emapalumab dose adaptation were used to account for highly variable IFNγ levels and potential target-mediated drug disposition.

resultsHigh inter- and intra-individual variability in IFNγ production (assessed by total IFNγ levels, range: 10

conclusionsThe variable and unanticipated extremely high IFNγ concentrations in patients with pHLH are reflected in parameters of disease activity. Improved outcomes can be achieved by neutralising IFNγ using frequent emapalumab dosing and dose adaptation guided by clinical and laboratory observations.

Indexed as

Interferon-gammaLymphohistiocytosis, HemophagocyticAntibodies, MonoclonalAntibodies, NeutralizingChild, PreschoolHumansAntibodies, MonoclonalAntibodies, NeutralizingEmapalumabInterferon-gammaimmunology - inflammationimmunology - monoclonal antibodiespaediatrics - childrenpharmacodynamics - modelling and simulationpharmacodynamics - pharmacokinetics-pharmacodynamics

Identifiers

PMID34935183
PMCPMC9305196
OpenAlexW3208854628

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.