Clinical Pharmacokinetics Laboratory, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, 211100, Jiangsu, China.
Clinical Pharmacology Research Center, Peking Union Medical College Hospital and Chinese Academy of Medical Sciences, Beijing, 100032, China.
Clin Pharmacokinet. 2018 Oct;57(10):1307-1323. doi: 10.1007/s40262-018-0631-z.
The objective of this study was to develop a physiologically based pharmacokinetic (PBPK) model for sinogliatin (HMS-5552, dorzagliatin) by integrating allometric scaling (AS), in vitro to in vivo exploration (IVIVE), and steady-state concentration-mean residence time (C-MRT) methods and to provide mechanistic insight into its pharmacokinetic properties in humans.
Human major pharmacokinetic parameters were analyzed using AS, IVIVE, and C-MRT methods with available preclinical in vitro and in vivo data to understand sinogliatin drug metabolism and pharmacokinetic (DMPK) characteristics and underlying mechanisms. On this basis, an initial mechanistic PBPK model of sinogliatin was developed. The initial PBPK model was verified using observed data from a single ascending dose (SAD) study and further optimized with various strategies. The final model was validated by simulating sinogliatin pharmacokinetics under a fed condition. The validated model was applied to support a clinical drug-drug interaction (DDI) study design and to evaluate the effects of intrinsic (hepatic cirrhosis, genetic) factors on drug exposure.
The two-species scaling method using rat and dog data (TS-) was the best AS method in predicting human systemic clearance in the central compartment (CL). The IVIVE method confirmed that sinogliatin was predominantly metabolized by cytochrome P450 (CYP) 3A4. The C-MRT method suggested dog pharmacokinetic profiles were more similar to human pharmacokinetic profiles. The estimated CL using the AS and IVIVE approaches was within 1.5-fold of that observed. The C-MRT method in dogs also provided acceptable prediction of human pharmacokinetic characteristics. For the PBPK approach, the 90% confidence intervals (CIs) of the simulated maximum concentration (C), CL, and area under the plasma concentration-time curve (AUC) of sinogliatin were within those observed and the 90% CI of simulated time to C (t) was closed to that observed for a dose range of 5-50 mg in the SAD study. The final PBPK model was validated by simulating sinogliatin pharmacokinetics with food. The 90% CIs of the simulated C, CL, and AUC values for sinogliatin were within those observed and the 90% CI of the simulated t was partially within that observed for the dose range of 25-200 mg in the multiple ascending dose (MAD) study. This PBPK model selected a final clinical DDI study design with itraconazole from four potential designs and also evaluated the effects of intrinsic (hepatic cirrhosis, genetic) factors on drug exposure.
Sinogliatin pharmacokinetic properties were mechanistically understood by integrating all four methods and a mechanistic PBPK model was successfully developed and validated using clinical data. This PBPK model was applied to support the development of sinogliatin.
本研究旨在通过整合体表面积(AS)、体外到体内探索(IVIVE)和稳态浓度-平均驻留时间(C-MRT)方法,建立一种基于生理学的药代动力学(PBPK)模型来研究 sinogliatin(HMS-5552,dorzagliatin),以深入了解其在人体内的药代动力学特性和潜在机制。
利用 AS、IVIVE 和 C-MRT 方法,对现有的临床前体外和体内数据进行分析,以了解 sinogliatin 的药物代谢和药代动力学(DMPK)特征及潜在机制,从而分析人体主要药代动力学参数。在此基础上,建立了 sinogliatin 的初步机制 PBPK 模型。使用单剂量递增(SAD)研究中的观察数据对初步 PBPK 模型进行验证,并采用各种策略对其进行进一步优化。采用 fed 条件下的 sinogliatin 药代动力学模拟对最终模型进行验证。该验证后的模型用于支持临床药物相互作用(DDI)研究设计,并评估内在(肝硬变、遗传)因素对药物暴露的影响。
使用大鼠和狗数据的双物种缩放方法(TS-)是预测人体中央室系统清除率(CL)的最佳 AS 方法。IVIVE 方法证实,sinogliatin 主要通过细胞色素 P450(CYP)3A4 代谢。C-MRT 方法表明狗的药代动力学特征与人体药代动力学特征更相似。使用 AS 和 IVIVE 方法估计的 CL 与观察到的 CL 之比在 1.5 倍以内。狗的 C-MRT 方法也可以对人体药代动力学特征进行可接受的预测。对于 PBPK 方法,在 SAD 研究中,5-50mg 剂量范围内,模拟的 sinogliatin 最大浓度(C)、CL 和血浆浓度-时间曲线下面积(AUC)的 90%置信区间(CI)在观察值范围内,模拟的 t 90%CI 接近观察值。在 SAD 研究中,使用食物模拟 sinogliatin 药代动力学的最终 PBPK 模型得到了验证。在 MAD 研究中,25-200mg 剂量范围内,模拟的 sinogliatin 的 C、CL 和 AUC 值的 90%CI 在观察值范围内,模拟的 t 90%CI 部分在观察值范围内,对 4 种潜在设计中的一种最终临床 DDI 研究设计进行了选择,并评估了内在(肝硬变、遗传)因素对药物暴露的影响。
通过整合这四种方法,对 sinogliatin 的药代动力学特性进行了机制上的理解,并使用临床数据成功地建立和验证了一种机制性的 PBPK 模型。该 PBPK 模型用于支持 sinogliatin 的开发。