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单次给药转甲状腺素蛋白靶向 N-乙酰半乳糖胺小干扰 RNA 偶联物,Vutrisiran,在健康受试者中的药代动力学和药效学。

Single-Dose Pharmacokinetics and Pharmacodynamics of Transthyretin Targeting N-acetylgalactosamine-Small Interfering Ribonucleic Acid Conjugate, Vutrisiran, in Healthy Subjects.

机构信息

Alnylam Pharmaceuticals, Cambridge, Massachusetts, USA.

Moderna Therapeutics, Cambridge, Massachusetts, USA.

出版信息

Clin Pharmacol Ther. 2021 Feb;109(2):372-382. doi: 10.1002/cpt.1974. Epub 2020 Aug 13.

DOI:10.1002/cpt.1974
PMID:32599652
Abstract

Vutrisiran (ALN-TTRsc02) is a liver-directed, investigational, small interfering ribonucleic acid drug for the treatment of transthyretin (TTR)-mediated amyloidosis. This phase I, randomized, single-blind, placebo-controlled, single ascending dose study evaluated the pharmacodynamics, pharmacokinetics, and safety profile of subcutaneously administered vutrisiran (5-300 mg) in healthy subjects (n = 80). Vutrisiran treatment achieved potent and sustained TTR reduction in a dose-dependent manner, with mean maximum TTR reduction of 57-97%, maintained for ≥ 90 days post dose. Vutrisiran was rapidly absorbed (peak plasma concentration 3-5 hours post dose), had a short plasma half-life (4.2-7.5 hours), and plasma concentrations increased in a dose-proportional manner. Pharmacodynamic and pharmacokinetic results were similar in Japanese and non-Japanese subjects. Vutrisiran had an acceptable safety profile; the most common treatment-related adverse event was mild, transient injection site reactions in four (6.7%) vutrisiran-treated subjects. The favorable pharmacokinetic, pharmacodynamic, and safety results observed here support vutrisiran's continued clinical development.

摘要

维特利西单抗(ALN-TTRsc02)是一种针对肝脏的、正在研究中的、小干扰核糖核酸药物,用于治疗转甲状腺素(TTR)介导的淀粉样变性。这项 I 期、随机、单盲、安慰剂对照、单次递增剂量研究评估了皮下给予维特利西单抗(5-300mg)在健康受试者(n=80)中的药效学、药代动力学和安全性特征。维特利西单抗治疗以剂量依赖性方式实现了强效和持续的 TTR 降低,平均最大 TTR 降低 57-97%,维持至少 90 天。维特利西单抗吸收迅速(给药后 3-5 小时达到血浆峰值浓度),血浆半衰期短(4.2-7.5 小时),且血浆浓度呈剂量比例增加。日本和非日本受试者的药效学和药代动力学结果相似。维特利西单抗具有可接受的安全性特征;最常见的与治疗相关的不良事件是四名(6.7%)接受维特利西单抗治疗的受试者出现轻度、短暂的注射部位反应。在此观察到的良好的药代动力学、药效学和安全性结果支持维特利西单抗的持续临床开发。

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