Background: Activation of the classical and lectin pathway of complement may contribute to
tissue damage and organ dysfunction of antibody-mediated diseases and ischemia-reperfusion
conditions. Complement factors are being considered as targets for therapeutic intervention.
Objective: We sought to characterize ARGX-117, a humanized inhibitory monoclonal antibody
against complement C2.
Methods: The mode-of-action and binding characteristics of ARGX-117 were investigated in detail.
Furthermore, its efficacy was analyzed in in vitro complement cytotoxicity assays.
Finally, a pharmacokinetic/pharmacodynamic study was conducted in cynomolgus monkeys.
Results: Through binding to the Sushi-2 domain of C2, ARGX-117 prevents the formation of the C3
proconvertase and inhibits classical and lectin pathway activation upstream of C3 activation. As
ARGX-117 does not inhibit the alternative pathway, it is expected not to affect the
antimicrobial activity of this complement pathway. ARGX-117 prevents complement-mediated
cytotoxicity in in vitro models for autoimmune hemolytic anemia and antibody-mediated
rejection of organ transplants. ARGX-117 exhibits pH- and calcium-dependent target binding and
is Fc-engineered to increase affinity at acidic pH to the neonatal Fc receptor, and to reduce
effector functions. In cynomolgus monkeys, ARGX-117 dose-dependently reduces free C2 levels and
classical pathway activity. A 2-dose regimen of 80 and 20 mg/kg separated by a week, resulted in
profound reduction of classical pathway activity lasting for at least 7 weeks.
Conclusions: ARGX-117 is a promising new complement inhibitor that is uniquely positioned to
target both the classical and lectin pathways while leaving the alternative pathway intact.
Keywords: C2; Complement system; complement inhibitor; monoclonal antibody.
Reference
Van de Walle, I., Silence, K., Budding, K., Van de Ven, L., Dijkxhoorn, K., de Zeeuw, E., ... & Boross, P. (2021). ARGX-117, a therapeutic complement inhibiting antibody targeting C2. Journal of Allergy and Clinical Immunology, 147(4), 1420-1429.