Pharmacodynamics of mAbs

Compared to polyclonal antibodies, mAbs display molecular homogeneity and significantly higher specificity leading to increased in-vivo activity. For example, 100-170 mg serum containing polyclonal antibodies against the tetanus toxin are necessary to achieve the same effect as 0.7 mg of a respective mAb. This section will provide an overview on therapeutic antibodies which have either been approved or are in clinical development, and will classify them according to different pharmacodynamically relevant properties. 

With respect to the different modes of actions and effector function (as discussed in Section 3.5), there are  

Three different pharmacodynamic principles of action can be distinguished for mAbs, comprising lysis or apoptotic activity, coating activity, and inactivating activity (see Section 3.5.2), depending on the type of antigen and the antigen-antibody interaction. 

Efficacious mAbs are used in a variety of therapeutic indications such as cancer, rheumatoid arthritis, Crohn s disease, psoriasis, organ transplantation, asthma, infectious diseases, and cardiovascular diseases, while for other diseases research and development is currently ongoing. The current three major therapeutic areas include oncology (eight mAbs against solid tumors and lymphoma/leukemia), inflammatory diseases (five mAbs), and the immunosuppression/prophylaxis or treatment of organ rejection in transplantation (three mAbs). The reader is referred to Chapter 12 for a detailed discussion on the exposure-response relationships and pharmacodynamics of therapeutically administered mAbs. 

Monoclonal antibody Brand name Indication for use Year of approvala) 

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