Drugs for Neglected Diseases initiative (DNDi), Geneva, Switzerland.
Hammersmith Medicines Research Ltd, London, UK.
Br J Clin Pharmacol. 2021 Oct;87(10):3949-3960. doi: 10.1111/bcp.14816. Epub 2021 Mar 31.
Emodepside is an anthelmintic, originally developed for veterinary use. We investigated in healthy subjects the safety, and pharmacokinetics of a liquid service formulation (LSF) and immediate release (IR) tablet of emodepside in 2 randomised, parallel-group, placebo-controlled, Phase I studies.
Seventy-nine subjects in 10 cohorts in the single ascending dose study and 24 subjects in 3 ascending-dose cohorts in the multiple ascending dose study were enrolled. Emodepside as LSF was administered orally as single 1-40-mg doses and for 10 days as 5 or 10 mg once daily and 10-mg twice daily doses, respectively. Pharmacokinetics and safety were assessed up to 21 and 30 days, respectively. In addition, IR tablets containing 5 or 20 mg emodepside were tested in the single ascending dose study.
Emodepside as LSF was rapidly absorbed under fasting conditions, with dose-proportional increase in plasma concentrations at doses from 1 to 40 mg. Terminal half-life was > 500 hours. In the fed state, emodepside was absorbed more slowly but overall plasma exposure was not significantly affected. Compared to the LSF, the rate and extent of absorption was significantly lower with the tablets.
Overall, emodepside had acceptable safety and tolerability profiles, no major safety concerns, after single oral administration of 20 mg as LSF and after multiple oral administration over 10 days at 5 and 10 mg OD and at 10 mg twice daily. For further clinical trials, the development of a tablet formulation overcoming the limitations observed in the present study with the IR tablet formulation is considered.
依美加昔(Emodepside)是一种最初为兽医用途开发的驱虫药。我们在健康受试者中进行了两项随机、平行组、安慰剂对照、I 期研究,以研究液体配方制剂(LSF)和即时释放(IR)片剂的安全性和药代动力学。
在单次递增剂量研究中,共有 79 名受试者分 10 个队列,在多次递增剂量研究中,共有 24 名受试者分 3 个递增剂量队列入组。LSF 依美加昔经口给予,单次剂量为 1-40mg,连续 10 天分别给予 5 或 10mg 每日一次和 10mg 每日两次的剂量。药代动力学和安全性评估分别持续至 21 天和 30 天。此外,还在单次递增剂量研究中测试了含有 5 或 20mg 依美加昔的 IR 片剂。
在禁食条件下,LSF 依美加昔迅速吸收,1-40mg 剂量范围内,血浆浓度呈剂量比例增加。终末半衰期>500 小时。在进食状态下,依美加昔吸收较慢,但总体血浆暴露无明显影响。与 LSF 相比,片剂的吸收速率和程度明显较低。
总体而言,依美加昔口服单次给予 20mg 的 LSF 和连续口服 10 天 5 和 10mg 每日一次以及 10mg 每日两次时,具有可接受的安全性和耐受性特征,无重大安全性问题。对于进一步的临床试验,考虑开发一种片剂制剂,以克服本研究中 IR 片剂制剂观察到的局限性。