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Erschienen in: Clinical Pharmacokinetics 2/2011

01.02.2011 | Original Research Article

Quantitative Prediction of Human Pharmacokinetics for Monoclonal Antibodies

Retrospective Analysis of Monkey as a Single Species for First-in-Human Prediction

verfasst von: Jennifer Q. Dong, David H. Salinger, Christopher J. Endres, John P. Gibbs, Cheng-Pang Hsu, Brian J. Stouch, Eunju Hurh, Dr Megan Gibbs

Erschienen in: Clinical Pharmacokinetics | Ausgabe 2/2011

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Abstract

Background and Objectives

Prediction of human pharmacokinetics for monoclonal antibodies (mAbs) plays an important role for first-in-human (FIH) dose selection. This retrospective analysis compares observed FIH pharmacokinetic data for 16 mAbs to those predicted in humans based on allometric scaling of Cynomolgus monkey pharmacokinetic data.

Methods

Ten mAbs exhibited linear pharmacokinetics in monkeys based on non-compartmental analysis. For these, simple allometric scaling based on bodyweight was applied to predict human clearance (CL) and volume of distribution (Vd) from those obtained in monkeys. Six mAbs exhibited nonlinear pharmacokinetics in monkeys based on population modelling. For these, a population modelling approach using nonlinear mixed-effects modelling software, NONMEM®, was applied to describe monkey data by a two-compartment pharmacokinetic model with parallel linear and nonlinear elimination from the central compartment. The pharmacokinetic parameters in monkeys were then scaled to humans based on simple allometry. Human concentrationtime profiles of these mAbs were then simulated and compared with those observed in the FIH studies.

Results

Antibodies with linear elimination in monkeys also exhibited linear elimination in humans. For these, observed CL and Vd were predicted within 2.3-fold by allometry. The predictability of human peak serum concentration (Cmax) and area under the serum concentration-time curve (AUC) for mAbs with nonlinear pharmacokinetics in monkeys was, however, concentration dependent. Cmax was consistently overestimated (up to 5.3-fold higher) when below the predicted Michaelis-Menten constant (Km; range 0.3–4 μg/mL). The prediction of human Cmax was within 2.3-fold when concentrations greatly exceeded Km. Similarly, differences between predicted human AUCs and those observed in the FIH studies were much greater at low doses/concentrations. Consequently, predicted drug exposure in humans at low starting doses (range 0.01–0.3 mg/kg) in FIH studies was poorly estimated for three of six mAbs with nonlinear pharmacokinetics.

Conclusions

Allometric prediction of human pharmacokinetics may be sufficient for mAbs that exhibit linear pharmacokinetics. For mAbs that exhibited nonlinear pharmacokinetics, the best predictive performance was obtained after doses that achieved target-saturating concentrations.
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Literatur
1.
Zurück zum Zitat Meibohm The role of pharmacokinetics and pharmacodynamics in the development of biotech drugs. In: Meibohm B, editor. Pharmacokinetics and pharmacodynamics of biotech drugs: principles and case studies in drug development. Weinheim: Wiley-VCH, 2006: 3–12 Meibohm The role of pharmacokinetics and pharmacodynamics in the development of biotech drugs. In: Meibohm B, editor. Pharmacokinetics and pharmacodynamics of biotech drugs: principles and case studies in drug development. Weinheim: Wiley-VCH, 2006: 3–12
2.
Zurück zum Zitat Mascelli MA, Zhou H, Sweet R, et al. Molecular, biologic, and pharmacokinetic properties of monoclonal antibodies: impact of these parameters on early clinical development. J Clin Pharmacol 2007 May; 47(5): 553–65PubMedCrossRef Mascelli MA, Zhou H, Sweet R, et al. Molecular, biologic, and pharmacokinetic properties of monoclonal antibodies: impact of these parameters on early clinical development. J Clin Pharmacol 2007 May; 47(5): 553–65PubMedCrossRef
3.
Zurück zum Zitat Wang W, Wang EQ, Balthasar JP. Monoclonal antibody pharmacokinetics and pharmacodynamics. Clin Pharmacol Ther 2008 Nov; 84(5): 548–58PubMedCrossRef Wang W, Wang EQ, Balthasar JP. Monoclonal antibody pharmacokinetics and pharmacodynamics. Clin Pharmacol Ther 2008 Nov; 84(5): 548–58PubMedCrossRef
4.
Zurück zum Zitat Suntharalingam G, Perry MR, Ward S, et al. Cytokine storm in a phase 1 trial of the anti-CD28 monoclonal antibody TGN1412. N Engl J Med 2006 Sep 7; 355(10): 1018–28PubMedCrossRef Suntharalingam G, Perry MR, Ward S, et al. Cytokine storm in a phase 1 trial of the anti-CD28 monoclonal antibody TGN1412. N Engl J Med 2006 Sep 7; 355(10): 1018–28PubMedCrossRef
7.
Zurück zum Zitat Agoram BM, Martin SW, van der Graaf PH. The role of mechanism-based pharmacokinetic-pharmacodynamic (PK-PD) modelling in translational research of biologics. Drug Discov Today 2007 Dec; 12(23–24): 1018–24PubMedCrossRef Agoram BM, Martin SW, van der Graaf PH. The role of mechanism-based pharmacokinetic-pharmacodynamic (PK-PD) modelling in translational research of biologics. Drug Discov Today 2007 Dec; 12(23–24): 1018–24PubMedCrossRef
8.
Zurück zum Zitat Agoram BM. Use of pharmacokinetic/pharmacodynamic modelling for starting dose selection in first-in-human trials of high-risk biologics. Br J Clin Pharmacol 2009 Feb; 67(2): 153–60PubMedCrossRef Agoram BM. Use of pharmacokinetic/pharmacodynamic modelling for starting dose selection in first-in-human trials of high-risk biologics. Br J Clin Pharmacol 2009 Feb; 67(2): 153–60PubMedCrossRef
9.
Zurück zum Zitat Tabrizi MA, Roskos LK. Preclinical and clinical safety of monoclonal antibodies. Drug Discov Today 2007 Jul; 12(13–14): 540–7PubMedCrossRef Tabrizi MA, Roskos LK. Preclinical and clinical safety of monoclonal antibodies. Drug Discov Today 2007 Jul; 12(13–14): 540–7PubMedCrossRef
10.
Zurück zum Zitat Muller PY, Brennan FR. Safety assessment and dose selection for first-in-human clinical trials with immunomodulatory monoclonal antibodies. Clin Pharmacol Ther 2009 Mar; 85(3): 247–58PubMedCrossRef Muller PY, Brennan FR. Safety assessment and dose selection for first-in-human clinical trials with immunomodulatory monoclonal antibodies. Clin Pharmacol Ther 2009 Mar; 85(3): 247–58PubMedCrossRef
11.
Zurück zum Zitat Lobo ED, Hansen RJ, Balthasar JP. Antibody pharmacokinetics and pharmacodynamics. J Pharm Sci 2004 Nov; 93(11): 2645–68PubMedCrossRef Lobo ED, Hansen RJ, Balthasar JP. Antibody pharmacokinetics and pharmacodynamics. J Pharm Sci 2004 Nov; 93(11): 2645–68PubMedCrossRef
12.
Zurück zum Zitat Mould DR, Sweeney KR. The pharmacokinetics and pharmacodynamics of monoclonal antibodies: mechanistic modeling applied to drug development. Curr Opin Drug Discov Devel 2007 Jan; 10(1): 84–96PubMed Mould DR, Sweeney KR. The pharmacokinetics and pharmacodynamics of monoclonal antibodies: mechanistic modeling applied to drug development. Curr Opin Drug Discov Devel 2007 Jan; 10(1): 84–96PubMed
13.
Zurück zum Zitat Brambell F. The transimission of immunity from mother to young and the catabolism of immunoglobulins. Lancet 1966; 2(7473): 1087–93PubMedCrossRef Brambell F. The transimission of immunity from mother to young and the catabolism of immunoglobulins. Lancet 1966; 2(7473): 1087–93PubMedCrossRef
14.
Zurück zum Zitat Ling J, Zhou H, Jiao Q, et al. Interspecies scaling of therapeutic monoclonal antibobies: initial look. J Clin Pharmacol 2009 Dec; 49(12): 1382–402PubMedCrossRef Ling J, Zhou H, Jiao Q, et al. Interspecies scaling of therapeutic monoclonal antibobies: initial look. J Clin Pharmacol 2009 Dec; 49(12): 1382–402PubMedCrossRef
15.
Zurück zum Zitat Pendley C, Schantz A, Wagner C. Immunogenicity of therapeutic monoclonal antibodies. Curr Opin Mol Ther 2003 Apr; 5(2): 172–9PubMed Pendley C, Schantz A, Wagner C. Immunogenicity of therapeutic monoclonal antibodies. Curr Opin Mol Ther 2003 Apr; 5(2): 172–9PubMed
16.
Zurück zum Zitat Ponce R, Abad L, Amaravadi L, et al. Immunogenicity of biologically-derived therapeutics: assessment and interpretation of nonclinical safety studies. Regul Toxicol Pharmacol 2009 Jul; 54(2): 164–82PubMedCrossRef Ponce R, Abad L, Amaravadi L, et al. Immunogenicity of biologically-derived therapeutics: assessment and interpretation of nonclinical safety studies. Regul Toxicol Pharmacol 2009 Jul; 54(2): 164–82PubMedCrossRef
17.
Zurück zum Zitat Boxenbaum H. Interspecies scaling, allometry, physiological time, and the ground plan of pharmacokinetics. J Pharmacokinet Biopharm 1982 Apr; 10(2): 201–27PubMedCrossRef Boxenbaum H. Interspecies scaling, allometry, physiological time, and the ground plan of pharmacokinetics. J Pharmacokinet Biopharm 1982 Apr; 10(2): 201–27PubMedCrossRef
18.
Zurück zum Zitat Boxenbaum H. Interspecies pharmacokinetic scaling and the evolutionary-comparative paradigm. Drug Metab Rev 1984; 15(5–6): 1071–121PubMedCrossRef Boxenbaum H. Interspecies pharmacokinetic scaling and the evolutionary-comparative paradigm. Drug Metab Rev 1984; 15(5–6): 1071–121PubMedCrossRef
19.
Zurück zum Zitat Boxenbaum H, D’Souza RW. Interspecies pharmacokinetic scaling, biological design, and neoteny. In: Testa B, editor. Advances in drug research. London: Academic Press Limited, 1990: 139–96 Boxenbaum H, D’Souza RW. Interspecies pharmacokinetic scaling, biological design, and neoteny. In: Testa B, editor. Advances in drug research. London: Academic Press Limited, 1990: 139–96
20.
Zurück zum Zitat Chappell WR, Mordenti J. Extrapolation of toxicological and pharmacological data from animals to humans. In: Testa B, editor. Advances in drug research. San Diego (CA): Academic Press, 1991: 1–116 Chappell WR, Mordenti J. Extrapolation of toxicological and pharmacological data from animals to humans. In: Testa B, editor. Advances in drug research. San Diego (CA): Academic Press, 1991: 1–116
21.
Zurück zum Zitat Mordenti J, Chen SA, Moore JA, et al. Interspecies scaling of clearance and volume of distribution data for five therapeutic proteins. Pharm Res 1991 Nov; 8(11): 1351–9PubMedCrossRef Mordenti J, Chen SA, Moore JA, et al. Interspecies scaling of clearance and volume of distribution data for five therapeutic proteins. Pharm Res 1991 Nov; 8(11): 1351–9PubMedCrossRef
22.
Zurück zum Zitat Grene-Lerouge NA, Bazin-Redureau MI, Debray M, et al. Interspecies scaling of clearance and volume of distribution for digoxin-specific Fab. Toxicol Appl Pharmacol 1996 May; 138(1): 84–9PubMedCrossRef Grene-Lerouge NA, Bazin-Redureau MI, Debray M, et al. Interspecies scaling of clearance and volume of distribution for digoxin-specific Fab. Toxicol Appl Pharmacol 1996 May; 138(1): 84–9PubMedCrossRef
23.
Zurück zum Zitat Bazin-Redureau M, Pepin S, Hong G, et al. Interspecies scaling of clearance and volume of distribution for horse antivenom F(ab’)2. Toxicol Appl Pharmacol 1998 Jun; 150(2): 295–300PubMedCrossRef Bazin-Redureau M, Pepin S, Hong G, et al. Interspecies scaling of clearance and volume of distribution for horse antivenom F(ab’)2. Toxicol Appl Pharmacol 1998 Jun; 150(2): 295–300PubMedCrossRef
24.
Zurück zum Zitat Mahmood I. Interspecies scaling of protein drugs: prediction of clearance from animals to humans. J Pharm Sci 2004 Jan; 93(1): 177–85PubMedCrossRef Mahmood I. Interspecies scaling of protein drugs: prediction of clearance from animals to humans. J Pharm Sci 2004 Jan; 93(1): 177–85PubMedCrossRef
25.
Zurück zum Zitat Kelley SK, Gelzleichter T, Xie D, et al. Preclinical pharmacokinetics, pharmacodynamics, and activity of a humanized anti-CD40 antibody (SGN-40) in rodents and non-human primates. Br J Pharmacol 2006 Aug; 148(8): 1116–23PubMedCrossRef Kelley SK, Gelzleichter T, Xie D, et al. Preclinical pharmacokinetics, pharmacodynamics, and activity of a humanized anti-CD40 antibody (SGN-40) in rodents and non-human primates. Br J Pharmacol 2006 Aug; 148(8): 1116–23PubMedCrossRef
26.
Zurück zum Zitat Lin YS, Nguyen C, Mendoza JL, et al. Preclinical pharmacokinetics, interspecies scaling, and tissue distribution of a humanized monoclonal antibody against vascular endothelial growth factor. J Pharmacol Exp Ther 1999 Jan; 288(1): 371–8PubMed Lin YS, Nguyen C, Mendoza JL, et al. Preclinical pharmacokinetics, interspecies scaling, and tissue distribution of a humanized monoclonal antibody against vascular endothelial growth factor. J Pharmacol Exp Ther 1999 Jan; 288(1): 371–8PubMed
27.
Zurück zum Zitat Duconge J, Fernandez-Sanchez E, Alvarez D. Interspecies scaling of the monoclonal anti-EGF receptor ior EGFantibody disposition using allometric paradigm: is it really suitable? Biopharm Drug Dispos 2004 May; 25(4): 177–86PubMedCrossRef Duconge J, Fernandez-Sanchez E, Alvarez D. Interspecies scaling of the monoclonal anti-EGF receptor ior EGFantibody disposition using allometric paradigm: is it really suitable? Biopharm Drug Dispos 2004 May; 25(4): 177–86PubMedCrossRef
28.
Zurück zum Zitat Kuester K, Kloft C. Pharmacokinetics of monoclonal antibodies. In: Meibohm B, editor. Pharmacokinetics and pharmacodynamics of biotech drugs: principles and case studies in drug development. Weinheim: Wiley-VCH, 2006: 45–91CrossRef Kuester K, Kloft C. Pharmacokinetics of monoclonal antibodies. In: Meibohm B, editor. Pharmacokinetics and pharmacodynamics of biotech drugs: principles and case studies in drug development. Weinheim: Wiley-VCH, 2006: 45–91CrossRef
30.
Zurück zum Zitat Mordenti J. Man versus beast: pharmacokinetic scaling in mammals. J Pharm Sci 1986 Nov; 75(11): 1028–40PubMedCrossRef Mordenti J. Man versus beast: pharmacokinetic scaling in mammals. J Pharm Sci 1986 Nov; 75(11): 1028–40PubMedCrossRef
32.
Zurück zum Zitat Hakimi J, Chizzonite R, Luke DR, et al. Reduced immunogenicity and improved pharmacokinetics of humanized anti-Tac in cynomolgus monkeys. J Immunol 1991 Aug 15; 147(4): 1352–9PubMed Hakimi J, Chizzonite R, Luke DR, et al. Reduced immunogenicity and improved pharmacokinetics of humanized anti-Tac in cynomolgus monkeys. J Immunol 1991 Aug 15; 147(4): 1352–9PubMed
33.
Zurück zum Zitat Rojas JR, Taylor RP, Cunningham MR, et al. Formation, distribution, and elimination of infliximab and anti-infliximab immune complexes in cynomolgus monkeys. J Pharmacol Exp Ther 2005 May; 313(2): 578–85PubMedCrossRef Rojas JR, Taylor RP, Cunningham MR, et al. Formation, distribution, and elimination of infliximab and anti-infliximab immune complexes in cynomolgus monkeys. J Pharmacol Exp Ther 2005 May; 313(2): 578–85PubMedCrossRef
36.
Zurück zum Zitat Ng CM, Bruno R, Combs D, et al. Population pharmacokinetics of rituximab (anti-CD20 monoclonal antibody) in rheumatoid arthritis patients during a phase II clinical trial. J Clin Pharmacol 2005 Jul; 45(7): 792–801PubMedCrossRef Ng CM, Bruno R, Combs D, et al. Population pharmacokinetics of rituximab (anti-CD20 monoclonal antibody) in rheumatoid arthritis patients during a phase II clinical trial. J Clin Pharmacol 2005 Jul; 45(7): 792–801PubMedCrossRef
38.
Zurück zum Zitat Thurmann PA, Sonnenburg-Chatzopoulos C, Lissner R. Pharmacokinetic characteristics and tolerability of a novel intravenous immunoglobulin preparation. Eur J Clin Pharmacol 1995; 49(3): 237–42PubMedCrossRef Thurmann PA, Sonnenburg-Chatzopoulos C, Lissner R. Pharmacokinetic characteristics and tolerability of a novel intravenous immunoglobulin preparation. Eur J Clin Pharmacol 1995; 49(3): 237–42PubMedCrossRef
39.
Zurück zum Zitat Ito K, Houston JB. Prediction of human drug clearance from in vitro and preclinical data using physiologically based and empirical approaches. Pharm Res 2005 Jan; 22(1): 103–12PubMedCrossRef Ito K, Houston JB. Prediction of human drug clearance from in vitro and preclinical data using physiologically based and empirical approaches. Pharm Res 2005 Jan; 22(1): 103–12PubMedCrossRef
40.
Zurück zum Zitat Adolph EF. Quantitative relations in the physiological constitutions of mammals. Science 1949 Jun 10; 109(2841): 579–85PubMedCrossRef Adolph EF. Quantitative relations in the physiological constitutions of mammals. Science 1949 Jun 10; 109(2841): 579–85PubMedCrossRef
44.
Zurück zum Zitat Kagan L, Abraham AK, Harrold JM, et al. Interspecies scaling of receptor-mediated pharmacokinetics and pharmacodynamics of type I interferons. Pharm Res 2010 May; 27(5): 920–32PubMedCrossRef Kagan L, Abraham AK, Harrold JM, et al. Interspecies scaling of receptor-mediated pharmacokinetics and pharmacodynamics of type I interferons. Pharm Res 2010 May; 27(5): 920–32PubMedCrossRef
45.
Zurück zum Zitat Gibiansky L, Gibiansky E, Kakkar T, et al. Approximations of the targetmediated drug disposition model and identifiability of model parameters. J Pharmacokinet Pharmacodyn 2008 Oct; 35(5): 573–91PubMedCrossRef Gibiansky L, Gibiansky E, Kakkar T, et al. Approximations of the targetmediated drug disposition model and identifiability of model parameters. J Pharmacokinet Pharmacodyn 2008 Oct; 35(5): 573–91PubMedCrossRef
46.
Zurück zum Zitat Gibiansky L, Gibiansky E. Target-mediated drug disposition model: approximations, identifiability of model parameters and applications to the population pharmacokinetic-pharmacodynamic modeling of biologics. Expert Opin Drug Metab Toxicol 2009 Jul; 5(7): 803–12PubMedCrossRef Gibiansky L, Gibiansky E. Target-mediated drug disposition model: approximations, identifiability of model parameters and applications to the population pharmacokinetic-pharmacodynamic modeling of biologics. Expert Opin Drug Metab Toxicol 2009 Jul; 5(7): 803–12PubMedCrossRef
47.
Zurück zum Zitat Xu Z, Vu T, Lee H, et al. Population pharmacokinetics of golimumab, an antitumor necrosis factor-alpha human monoclonal antibody, in patients with psoriatic arthritis. J Clin Pharmacol 2009 Sep; 49(9): 1056–70PubMedCrossRef Xu Z, Vu T, Lee H, et al. Population pharmacokinetics of golimumab, an antitumor necrosis factor-alpha human monoclonal antibody, in patients with psoriatic arthritis. J Clin Pharmacol 2009 Sep; 49(9): 1056–70PubMedCrossRef
48.
Zurück zum Zitat Sun YN, Lu JF, Joshi A, et al. Population pharmacokinetics of efalizumab (humanized monoclonal anti-CD 11a antibody) following long-term subcutaneous weekly dosing in psoriasis subjects. J Clin Pharmacol 2005 Apr; 45(4): 468–76PubMedCrossRef Sun YN, Lu JF, Joshi A, et al. Population pharmacokinetics of efalizumab (humanized monoclonal anti-CD 11a antibody) following long-term subcutaneous weekly dosing in psoriasis subjects. J Clin Pharmacol 2005 Apr; 45(4): 468–76PubMedCrossRef
49.
Zurück zum Zitat Zhou H, Hu C, Zhu Y, et al. Population-based exposure-efficacy modeling of ustekinumab in patients with moderate to severe plaque psoriasis. J Clin Pharmacol 2010 Mar; 50(3): 257–67PubMedCrossRef Zhou H, Hu C, Zhu Y, et al. Population-based exposure-efficacy modeling of ustekinumab in patients with moderate to severe plaque psoriasis. J Clin Pharmacol 2010 Mar; 50(3): 257–67PubMedCrossRef
50.
Zurück zum Zitat Mager DE, Jusko WJ. Receptor-mediated pharmacokinetic/pharmacodynamic model of interferon-beta 1a in humans. Pharm Res 2002 Oct; 19(10): 1537–43PubMedCrossRef Mager DE, Jusko WJ. Receptor-mediated pharmacokinetic/pharmacodynamic model of interferon-beta 1a in humans. Pharm Res 2002 Oct; 19(10): 1537–43PubMedCrossRef
51.
Zurück zum Zitat Savic RM, Jonker DM, Kerbusch T, et al. Implementation of a transit compartment model for describing drug absorption in pharmacokinetic studies. J Pharmacokinet Pharmacodyn 2007 Oct; 34(5): 711–26PubMedCrossRef Savic RM, Jonker DM, Kerbusch T, et al. Implementation of a transit compartment model for describing drug absorption in pharmacokinetic studies. J Pharmacokinet Pharmacodyn 2007 Oct; 34(5): 711–26PubMedCrossRef
52.
Zurück zum Zitat Vugmeyster Y, Tian X, Szklut P, et al. Pharmacokinetic and pharmacodynamic modeling of a humanized anti-IL-13 antibody in naive and Ascaris-challenged cynomolgus monkeys. Pharm Res 2009 Feb; 26(2): 306–15PubMedCrossRef Vugmeyster Y, Tian X, Szklut P, et al. Pharmacokinetic and pharmacodynamic modeling of a humanized anti-IL-13 antibody in naive and Ascaris-challenged cynomolgus monkeys. Pharm Res 2009 Feb; 26(2): 306–15PubMedCrossRef
53.
Zurück zum Zitat Lowe PJ. Applying physiological and biochemical concepts to optimize biological drug development. Clin Pharmacol Ther 2010 Apr; 87(4): 492–6PubMedCrossRef Lowe PJ. Applying physiological and biochemical concepts to optimize biological drug development. Clin Pharmacol Ther 2010 Apr; 87(4): 492–6PubMedCrossRef
54.
Zurück zum Zitat Mager DE, Woo S, Jusko WJ. Scaling pharmacodynamics from in vitro and preclinical animal studies to humans. Drug Metab Pharmacokinet 2009; 24(1): 16–24PubMedCrossRef Mager DE, Woo S, Jusko WJ. Scaling pharmacodynamics from in vitro and preclinical animal studies to humans. Drug Metab Pharmacokinet 2009; 24(1): 16–24PubMedCrossRef
Metadaten
Titel
Quantitative Prediction of Human Pharmacokinetics for Monoclonal Antibodies
Retrospective Analysis of Monkey as a Single Species for First-in-Human Prediction
verfasst von
Jennifer Q. Dong
David H. Salinger
Christopher J. Endres
John P. Gibbs
Cheng-Pang Hsu
Brian J. Stouch
Eunju Hurh
Dr Megan Gibbs
Publikationsdatum
01.02.2011
Verlag
Springer International Publishing
Erschienen in
Clinical Pharmacokinetics / Ausgabe 2/2011
Print ISSN: 0312-5963
Elektronische ISSN: 1179-1926
DOI
https://doi.org/10.2165/11537430-000000000-00000

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