Scientific article
OA Policy
English

A Randomized Phase 1 Study Comparing the PK, PD, Safety, and Immunogenicity of Proposed Biosimilar RGB-14-X and Denosumab in Healthy Adult Males

Published inClinical and translational science, vol. 19, no. 2, e70468
Publication date2026-02
Abstract

Denosumab is a monoclonal antibody targeting the receptor activator of nuclear factor kappa-b ligand widely used for the prevention of skeletal-related events in patients with bone metastases. This Phase 1 randomized, double-blind, two-arm, parallel-group study assessed the equivalence in pharmacokinetics (PK) and compared the pharmacodynamics (PD), safety, and immunogenicity of the proposed biosimilar RGB-14-X and reference denosumab in healthy males. Participants were randomized 1:1 to a single subcutaneous 60 mg dose of RGB-14-X or reference denosumab, with 252 days of follow-up. Primary PK endpoints were maximum observed serum concentration (Cmax ) and area under the concentration-time curve from time 0 to last quantifiable concentration (AUC0-last ) and extrapolated to infinity (AUC0-inf ). Secondary objectives were to compare additional PK parameters, safety and tolerability, PD and immunogenicity between groups. Of 165 participants randomized, 162 (98.2%) completed the study. The geometric mean ratios and corresponding 90% confidence intervals of RGB-14-X versus reference denosumab for Cmax , AUC0-last , and AUC0-inf were within the pre-specified range of 0.80-1.25, demonstrating equivalence. No notable differences were observed in secondary PK or PD parameters between groups; maximum reduction in concentration of the bone resorption marker serum C-terminal telopeptide of type I collagen (CTX) and the extent and duration of reduction in CTX levels over time were similar. RGB-14-X was well tolerated with a similar safety profile to reference denosumab. No anti-drug or neutralizing antibodies were detected in either group. RGB-14-X demonstrated biosimilarity to reference denosumab, with equivalent PK and similar PD, safety, and immunogenicity outcomes in healthy males.

Keywords
  • Adverse events
  • Bioequivalence
  • Healthy subjects
  • Monoclonal antibodies
  • Pharmacodynamics
  • Pharmacokinetics‐pharmacodynamics
  • Humans
  • Male
  • Denosumab / pharmacokinetics
  • Denosumab / administration & dosage
  • Denosumab / adverse effects
  • Denosumab / immunology
  • Denosumab / pharmacology
  • Biosimilar Pharmaceuticals / pharmacokinetics
  • Biosimilar Pharmaceuticals / administration & dosage
  • Biosimilar Pharmaceuticals / adverse effects
  • Biosimilar Pharmaceuticals / pharmacology
  • Adult
  • Double-Blind Method
  • Middle Aged
  • Healthy Volunteers
  • Young Adult
  • Area Under Curve
  • Injections, Subcutaneous
  • Therapeutic Equivalency
  • Bone Density Conservation Agents / pharmacokinetics
  • Bone Density Conservation Agents / administration & dosage
  • Bone Density Conservation Agents / adverse effects
Citation (ISO format)
BIVER, Emmanuel et al. A Randomized Phase 1 Study Comparing the PK, PD, Safety, and Immunogenicity of Proposed Biosimilar RGB-14-X and Denosumab in Healthy Adult Males. In: Clinical and translational science, 2026, vol. 19, n° 2, p. e70468. doi: 10.1111/cts.70468
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Identifiers
Journal ISSN1752-8054
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