Bioequivalence Study of Denosumab CP4 Drug Product and Commercially Available Denosumab CP2 Drug Product
Bioequivalence Study of Denosumab CP4 Drug Product and Commercially Available Denosumab CP2 Drug Product
To evaluate the bioequivalence based on pharmacokinetics (PK) of a single 120 mg subcutaneous
 dose of denosumab administered to healthy volunteers using denosumab CP4 or denosumab CP2
 drug products.
Key Inclusion:

 -  Healthy male and female, ages ≥ 18 to ≤ 65 years (inclusive)

 -  Body weight > 60 to < 100 kg at time of screening

 -  Clinically acceptable physical exams and laboratory tests (blood hematology, blood
 chemistry, urinalysis) and no history or evidence of any clinically significant
 medical disorder that would pose a risk to subject safety or interfere with study
 evaluations or procedures

 -  Normal or clinically acceptable electrocardiogram (ECG) (12-lead reporting heart rate
 and PR, QRS, QT, and QTc intervals) at screening

 -  Willing to be confined to the research facility for 2 consecutive nights

 -  Subject will be available for follow-up assessments

 Exclusion Criteria:

 Prior diagnosis of bone disease, or any condition that will affect bone metabolism such as,
 but not limited to: osteoporosis, osteogenesis imperfecta, hyperparathyroidism,
 hyperthyroidism, hypothyroidism, osteomalacia, rheumatoid arthritis, psoriatic arthritis,
 ankylosing spondylitis, current flare-up of osteoarthritis and/or gout, active malignancy,
 renal disease (defined as glomerular filtration rate [GFR] < 45 mL/min), Paget's disease of
 the bone, recent bone fracture (within 6 months), malabsorption syndrome

 -  Presents with any psychiatric disorder, which may prevent the subject from completing
 the study or interfere with the interpretation of the study results

 -  Significant changes in physical activity during the 6 months before study drug
 administration or constant levels of intense physical exercise

 -  Prior use of any non-Amgen approved medications within 4 weeks or 5-half lives
 (whichever time period is longer) of study drug administration and for the duration of
 the study. This includes medications such as, but not limited to: bisphosphonates,
 fluoride, hormone replacement therapy (ie, estrogen) or selective estrogen receptor
 modulator, such as ralaxofene, calcitonin, strontium, parathyroid hormone or
 derivatives, supplemental vitamin D [>1000 IU/day], glucocorticosteroids, anabolic
 steroids, calcitriol, diuretics, over the counter medications, herbal supplements

 -  Positive for human immunodeficiency virus (HIV) at screening or known diagnosis of
 acquired immune deficiency syndrome (AIDS)

 -  Positive hepatitis B surface antigen (HepBsAg) (indicative of chronic hepatitis B) or
 detectable hepatitis C virus ribonucleic acid (RNA) by polymerase chain reaction (PCR)
 at screening (indicative of active hepatitis C - screening is generally done by
 hepatitis C antibody [HepCAb], followed by hepatitis C virus RNA by PCR if HepCAb is
 positive)

 -  Known sensitivity to any of the products to be administered during the study

 -  Prior denosumab administration

 -  Receiving or has received any investigational drug (or is currently using an
 investigational device) within 30 days before receiving study drug, or at least 10
 times the respective elimination half-life (whichever period is longer) and for the
 duration of the study

 -  Women with a positive pregnancy test at screening or day-1

 -  Men and women of reproductive potential who are unwilling to practice a highly
 effective method of birth control while on study through 5 months after receiving the
 last dose of study drug. Highly effective methods of birth control include sexual
 abstinence (men, women); vasectomy; or a condom with spermicide (men) in combination
 with either barrier methods, hormonal birth control or intrauterine device (women)

 -  Women who are lactating/breastfeeding or who plan to breastfeed while on study through
 5 half-lives after receiving the dose of study drug

 -  Women planning to become pregnant while on study through 5 months after receiving the
 dose of study drug

 -  Men with partners who are pregnant or planning to become pregnant while the subject is
 on study through 5 months after receiving the last dose of study drug

 -  Unwilling or unable to limit alcohol consumption throughout the course of the study.
 Alcohol is prohibited 24 hours prior to screening, 24 hours prior to check-in on day
 -1, and throughout confinement. Alcohol is also limited to no more than 2 drinks per
 day during the outpatient period of the study through completion of day 127 (EOS). A
 standard drink is equivalent to 12 ounces of regular beer, 8 to 9 ounces of malt
 liquor, 5 ounces of wine, or 1.5 ounces of 80 proof distilled spirits

 -  Positive urine screen for alcohol and/or drugs with a high potential for abuse at
 screening or day -1. Rescreening of the subject within 48 hours of a positive result
 is permitted

 -  Any other condition that might reduce the chance of obtaining data required by
 protocol or that might compromise the ability to give truly informed consent and/or
 comply with study procedures

 -  Osteonecrosis of the jaw (ONJ) or risk factors for ONJ such as invasive dental
 procedures (eg, tooth extraction, dental implants, oral surgery in the past 6 months),
 poor oral hygiene, periodontal, and/or pre-existing dental disease

 -  Recent tooth extraction (within 6 months of screening visit)

 -  Evidence of hypocalcemia at screening

 -  Known vitamin D deficiency

 -  Known intolerance to calcium or vitamin D supplements