Hansen S, Leslie RG. Archived from the original on 31 December From these studies, TGN, a genetically engineered humanized anti-CD28 antibody was produced by transferring complement-determining regions from variable regions of heavy and light chains of monoclonal anti-mouse CD28 antibody 5. Archived from the original on 21 May Two antibodies specific for human CD28 were identified.

Retrieved 18 March Despite this, the Medicines and Healthcare products Regulatory Agency MHRA has confirmed that they had approved the trial, including the protocol of giving the dose to all men within a short time. They mentioned that the severe reactions were as a result of unexpected biological effect of the drug. In addition, no signs of toxicity were observed in any of the physiological systems including cardiovascular system, respiratory system, or central nervous system. When incubated with different subsets of T cells obtained from healthy donars, only TGN but not conventional CD28 antibody was able to cause rapid proliferation of T cells in the absence of stimuli from T-cell receptor.

The US patent application states “it could be shown in a pilot study that an in vitro administration of anti-human CDSuperMAB induces in a rhesus monkey in vivo a tgj1412 activation of T cells, without clinically visible side effects” and goes on to say casee antibody—in spite of its strong T cell-stimulatory properties—is very well tolerated in vivo, in contrast to all other known T cell activating substances. On the basis of this hypothesis, it was decided that results obtained from pharmacokinetic and pharmacodynamic studies in these closely related species would most closely predict fate of drug response when tested in humans.

TGN From Discovery to Disaster

According to Weis, CD28 is also expressed by the cells responsible hgn1412 allergy. Ethical flaws in the TeGenero trial. Preparing for first-in-man studies: While the drug had appeared to be safe in animal models, researchers noted stud there were reasons why these may not be indicative of the response in humans, particularly with respect to this type of drug. These results showed that TGN had superagonistic activity for T cells obtained from healthy donars and that they could specifically react with CD28 receptor having sequence homology with human CD28 receptor.


After these studies, toxicological studies using rhesus and cynomolgus tgnn1412 were conducted. The recombinant genes were transfected into Chinese hamster ovary cells and the recombinant antibody harvested from culture supernatant. In addition, healthy subjects would not only exclude effects of other medications administered to diseased patients, but also exclude the effects of functional activation or dysfunctionalization of T cells as a result of prior diseased condition.


Shamoo A, Woeckner E. Plasma half-life of TGN was found to be 8 h which was as expected for a large protein molecule like an antibody. Archived from the original on 21 August After a drug is confirmed as safe and efficacious in preclinical studies, it is tested in healthy human volunteers for first in man trials.

Originally intended for the treatment of B cell chronic lymphocytic leukemia B-CLL and rheumatoid arthritis[4] TGN is a humanised monoclonal antibody that not only binds to, but is a strong agonist for, the CD28 receptor of the immune system ‘s T cells. Based on a work at https: The main aim of cxse study was to develop a suitable animal model, which can predict clinical toxicity in humans by preclinical studies prior to use of nucleoside analogs in clinical trials. Archived from the original on 5 December The drug, which was designated as an orphan medical product by the European Medicines Agency in March tn1412, was developed by TeGenero Immuno Therapeutics, tested by Parexel and manufactured by Boehringer Ingelheim.

The trial resulted in hospitalization of all six volunteers administered the drug, at least four of whom suffered multiple organ dysfunction.

tgn1412 case study

Paradoxically, the men’s white blood cells had vanished almost completely several hours after administration of TGN The above-mentioned incidents especially the TeGenero incident was an alarming call for the researchers and also for the trial approving regulatory authorities on toxicity-related unpredictability of new drugs in human subjects especially for biological with a novel mechanism of action like TGN The more active of the two, 5.


By using this site, you agree to the Terms of Use and Privacy Policy. A first-in-human trial, which had successful preclinical testing, obtained regulatory approval ended abruptly after the first dose. Since activation of regulatory T cells can be useful for the treatment of a variety of autoimmune diseases and cancer, they were investigated for their therapeutic potential in different animal models for their superagonist activity.

Preparation for possible adverse events cytokine storm was inadequate — investigators did not expect it, recognize it or treat early. For this purpose, it was decided to conduct the trials on healthy human volunteers because disease free subjects have comparable CD28 receptors as in case of rhematioid arthritis or B-cell lymphoma.

Articles from Journal of Young Pharmacists: The patients were treated with corticosteroids to reduce inflammation, and plasma-exchange to attempt to remove TGN from their circulation.

Theralizumab – Wikipedia

All of the men were reported to have experienced severe cytokine release syndrome resulting in angioedemaswelling of skin and mucous membranesakin to the effects of the complement cascade in severe allergic reaction. German regulatory authorities inspected the production of the material by Boehringer Ingelheim, looking at the manufacture, testing, storage and distribution of the TGN, but found stuudy deficiencies were identified which could have contributed to the serious adverse effects.

These studies demonstrated that doses hundred times higher than that administered to humans did not induce any toxic reactions. Insufficient in-vitro human studies were performed.

tgn1412 case study

Phase I antibody risks, trial safety examined.