Biotherapeutics are known for their potential to induce drug specific immune responses, which are commonly evaluated by the detection of anti-drug antibodies (ADAs). For some biotherapeutics, pre-existing ADAs against drug have been observed in drug-naïve matrix. The presence of pre-existing drug specific antibodies may significantly complicate assessment of the screening ADA assay cutpoint value, which is usually established based on the statistical analysis of signal distribution from the drug-naïve individuals. A Gaussian mixture model-based approach is presented herein to address high prevalence of pre-existing ADAs to a modified monoclonal antibody-based biotherapeutic (m-mAb). A high prevalence of pre-existing anti-m-mAb antibodies was observed in drug-naïve individual cynomolgus monkey serum samples with signal ranging from 100 to 7000 relative light units (RLU, as determined in an electrochemiluminescence readout-based assay). Application of the industry standard statistical algorithm resulted in a relatively high floating screening assay cutpoint factor (CPF) of 9.80, which potentially would have reported a high percent of false negative samples. An alternative, Gaussian mixture model-based approach was applied to identify the least reactive individual samples in the tested population, which resulted in a floating screening assay CPF of 2.35. The low CPF value significantly reduced the risk of reporting false negative results. The proposed Gaussian mixture model-based approach described herein provides an alternate method for the calculation of biologically relevant screening assay CPF when high prevalence of pre-existing drug specific antibodies is observed.
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http://dx.doi.org/10.1208/s12248-016-0011-2 | DOI Listing |
Ann Rheum Dis
January 2025
Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. Electronic address:
Objectives: The dynamics of monosodium urate (MSU) crystal changes across a range of serum urate concentrations in people with gout are unknown. This study aimed to systematically examine the relationship between serum urate and changes in dual-energy CT (DECT) urate volume in people with gout and stable serum urate concentrations.
Methods: Individual participant data were analysed from three studies of people with gout.
J Intensive Care Soc
January 2025
Department of Anaesthesia, Critical Care, and Pain Medicine, Royal Infirmary of Edinburgh, University of Edinburgh, Edinburgh, UK.
Background: Identifying women at highest or lowest risk of perinatal intensive care unit (ICU) admission may enable clinicians to risk stratify women antenatally so that enhanced care or elective admission to ICU may be considered or excluded in birthing plans. We aimed to develop a statistical model to predict the risk of maternal ICU admission.
Methods: We studied 762,918 pregnancies between 2005 and 2018.
Pediatr Res
January 2025
Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA.
Background: Unbound bilirubin (UB) was measured on day 5 ± 1 in 1101 ELBW newborns in the Aggressive vs Conservative Phototherapy randomized controlled trial. We accessed this dataset to quantify the UB-mediated risk of severe neurodevelopmental impairment (sNDI) in extremely low birthweight (ELBW) newborns.
Methods: UB levels were standardized within laboratories as z-score percentiles.
J Arthroplasty
January 2025
Hartford Healthcare Bone and Joint Institute, 32 Seymour Street, Hartford, CT 06106; Orthopaedic Associates of Hartford, 31 Seymour Street, Hartford, CT 06106.
Introduction: Facility discharges following an elective, primary, total joint arthroplasty are infrequent, but are associated with poor outcomes and significant cost. Therefore, investigating ways to identify patients most likely to be discharged to a facility could improve patient care, reduce costs, and potentially lead to strategies to mitigate these risks.
Methods: A total of 3,198 patients who underwent a total hip or knee arthroplasty between June 2021 and June 2023 were included in this study.
Brain Spine
December 2024
Division of Neurosurgery, Department of Clinical Neurosciences, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland.
Introduction: and research question: Prognostic factors to predict the behavior of pituitary neuroendocrine tumors (PitNET) are scarce. PD-L1 expression was associated with prognosis in other neuroendocrine neoplasms and we analyzed PD-L1 expression in PitNET, according to the 2022 WHO classification.
Material And Methods: A retrospective analysis was performed.
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