A bispecific antibody approach for the potential prophylactic treatment of inherited bleeding disorders

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  • Prafull S. Gandhi
  • Minka Zivkovic
  • Henrik Østergaard
  • Amalie C. Bonde
  • Torben Elm
  • Monika N. Løvgreen
  • Gerd Schluckebier
  • Eva Johansson
  • Ole H. Olsen
  • Eva H.N. Olsen
  • Ian Arris de Bus
  • Karien Bloem
  • Oskar Alskär
  • Catherine J. Rea
  • Søren E. Bjørn
  • Roger E. Schutgens
  • Benny Sørensen
  • Rolf T. Urbanus
  • Johan H. Faber

Inherited bleeding disorders such as Glanzmann thrombasthenia (GT) lack prophylactic treatment options. As a result, serious bleeding episodes are treated acutely with blood product transfusions or frequent, repeated intravenous administration of recombinant activated coagulation factor VII (rFVIIa). Here we describe HMB-001, a bispecific antibody designed to bind and accumulate endogenous FVIIa and deliver it to sites of vascular injury by targeting it to the TREM (triggering receptor expressed on myeloid cells)-like transcript-1 (TLT-1) receptor that is selectively expressed on activated platelets. In healthy nonhuman primates, HMB-001 prolonged the half-life of endogenous FVIIa, resulting in its accumulation. Mouse bleeding studies confirmed antibody-mediated potentiation of FVIIa hemostatic activity by TLT-1 targeting. In ex vivo models of GT, HMB-001 localized FVIIa on activated platelets and potentiated fibrin-dependent platelet aggregation. Taken together, these results indicate that HMB-001 has the potential to offer subcutaneous prophylactic treatment to prevent bleeds in people with GT and other inherited bleeding disorders, with a low-frequency dosing regimen.

OriginalsprogEngelsk
TidsskriftNature Cardiovascular Research
Vol/bind3
Udgave nummer2
Sider (fra-til)166-185
Antal sider20
DOI
StatusUdgivet - 2024
Eksternt udgivetJa

Bibliografisk note

Funding Information:
We acknowledge several current and previous employees of Novo Nordisk for an earlier investigation of HMB-001. We acknowledge expert assistance from H. Gluver and L. Kempf-Amkær (both employees of Hemab Therapeutics). Medical writing assistance was provided by D. Lester and C. Hoare from Bioscript Group, Macclesfield, UK, and funded by Hemab Therapeutics ApS, Copenhagen, Denmark. Financial support for this study was provided by Hemab Therapeutics ApS, Copenhagen, Denmark.

Publisher Copyright:
© The Author(s) 2024.

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