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The data from this clinical trial support the study hypothesis that rHuPH20 increases the relative bioavailability of the SC injected HUMIRA:
-- For the primary endpoint of area under the curve (AUC) for adalimumab
plasma concentration, the AUC over the 14 days following administration
was higher when the HUMIRA was co-injected with rHuPH20 compared to the
HUMIRA injection without rHuPH20 for 100% (15/15) of the patients in
the study.
-- The modeled population PK analysis estimated a 59% maximal increase in
the relative SC bioavailability of adalimumab at steady state if
co-injected with rHuPH20; thus, the reported reference 64% SC absolute
bioavailability HUMIRA injected alone was estimated to increase to 100%
when co-injected with rHuPH20, achieving essentially complete
absorption.
-- The modeled PK analysis estimated that a high dose of rHuPH20 (at least
6,400 U) was required to assure the maximal rHuPH20 effect.
-- Injection of rHuPH20 with HUMIRA was well tolerated at all rHuPH20 dose
levels, without dose-limiting toxicity, premature withdrawals, or
serious adverse events. Of the total of five adverse events reported
in this study, two were assessed as having no association with either
study drug (basal cell carcinoma and urinary tract infection). The
remaining three events consisted of mild injection site erythema
(redness) that occurred on the day of the co-injection and resolved
within one or two days.
As a spreading agent, hyaluronidase has traditionally been used
to accelerate the delivery of drugs and fluids, including local
anesthetics, other co-injected drugs, and contrast agents, and for
subcutaneous fluid replacement. Although a large body of clinical
experience supports the benefits and safety of using
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