Pfizer Drug Safety R&D, Pfizer, Inc, Groton, CT, USA.
AbbVie Deutschland GmbH & Co. KG, Preclinical Safety, Knollstr, 67061 Ludwigshafen, Germany.
J Pharmacol Toxicol Methods. 2020 May-Jun;103:106683. doi: 10.1016/j.vascn.2020.106683. Epub 2020 Feb 24.
Clinical development of compounds that carry a convulsion liability is typically limited by safety margins based on the most sensitive nonclinical species. To better understand differences in sensitivity to drug-induced convulsion of commonly used nonclinical species, a survey was distributed amongst pharmaceutical companies through an IQ consortium (International Consortium for Innovation and Quality in Pharmaceutical Development) resulting in convulsion-related data on 80 unique compounds from 11 companies. The lowest free drug plasma concentration at which convulsions were observed and the no observed effect level for convulsions were compared between species to determine their relative sensitivity. Additionally, data were collected on other endpoints including use of electroencephalography, premonitory signs, convulsion type, the reason why development was stopped, and the highest development phase reached. The key outcomes were: (1) the dog was most often determined to be the most sensitive species by both non-exposure and exposure-based analyses, (2) there was not a clear sensitivity ranking of other species (NHP, rat and mouse), (3) CNS symptoms were frequently present at exposures that were not associated with convulsions, but no single reliable premonitory indicator of convulsion was identified, and (4) the lack of convulsions when compounds were tested in humans in this dataset may suggest that convulsion liability is well mitigated via current drug development strategies.
化合物的临床开发通常受到基于最敏感非临床物种的安全裕度的限制,这些化合物具有惊厥的潜在风险。为了更好地了解常用非临床物种对药物诱导惊厥敏感性的差异,通过一个 IQ 联盟(国际药品创新与质量联盟)向制药公司分发了一项调查,从 11 家公司的 80 种独特化合物中获得了与惊厥相关的数据。在比较物种之间的最低游离药物血浆浓度和观察到的无影响水平(即不会引起惊厥的药物浓度),以确定它们的相对敏感性。此外,还收集了其他终点的数据,包括使用脑电图、前驱症状、惊厥类型、开发停止的原因以及最高的开发阶段。主要结果如下:(1)非暴露和基于暴露的分析均表明犬是最敏感的物种;(2)其他物种(非人灵长类动物、大鼠和小鼠)的敏感性没有明确的排序;(3)在与惊厥无关的暴露下,中枢神经系统症状经常出现,但没有发现单一可靠的惊厥前驱指标;(4)在该数据集的人类临床试验中,当化合物被测试时没有出现惊厥,这可能表明通过当前的药物开发策略,惊厥的潜在风险得到了很好的缓解。