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新型毒蕈碱型乙酰胆碱 M1 受体正变构调节剂 TAK-071 在健康受试者中的安全性、药代动力学和定量脑电图调制。

Safety, pharmacokinetics and quantitative EEG modulation of TAK-071, a novel muscarinic M1 receptor positive allosteric modulator, in healthy subjects.

机构信息

Takeda Pharmaceutical Company Ltd, Cambridge, MA, USA.

Signal Insights, LLC, Cambridge, MA, USA.

出版信息

Br J Clin Pharmacol. 2022 Feb;88(2):600-612. doi: 10.1111/bcp.14975. Epub 2021 Jul 31.

Abstract

AIMS

TAK-071 is a muscarinic M receptor positive allosteric modulator designed to have low cooperativity with acetylcholine. This was a first-in-human study to evaluate the safety, pharmacokinetics, and pharmacodynamics of TAK-071.

METHODS

TAK-071 was administered as single and multiple doses in a randomized, double-blind, placebo-controlled, parallel-group design in healthy volunteers alone and in combination with donepezil. Laboratory, electrocardiogram (ECG) and electroencephalogram (EEG) evaluations were performed. Cerebrospinal fluid and blood samples were taken to evaluate the pharmacokinetics (PK), relative bioavailability and food effect.

RESULTS

TAK-071 was safe and well tolerated, and no deaths or serious adverse events occurred. TAK-071 demonstrated a long mean (% coefficient of variation) half-life of 46.3 (25.2%) to 60.5 (51.5%) hours and excellent brain penetration following oral dosing. Coadministration with donepezil had no impact on the PK of either drug. There was no food effect on systemic exposure. Quantitative EEG analysis revealed that TAK-071 40-80 mg increased power in the 7-9 Hz range in the posterior electrode group with eyes open and 120-160 mg doses increased power in the 16-18 Hz range and reduced power in the 2-4 Hz range in central-posterior areas with eyes open and eyes closed. Functional connectivity was significantly reduced after TAK-071 at high doses and was enhanced with coadministration of donepezil under the eyes-closed condition.

CONCLUSIONS

PK and safety profiles of TAK-071 were favorable, including those exceeding expected pharmacologically active doses based on preclinical data. When administered without donepezil TAK-071 was largely free of cholinergic adverse effects. Further clinical evaluation of TAK-071 is warranted.

摘要

目的

TAK-071 是一种毒蕈碱 M 受体正变构调节剂,设计为与乙酰胆碱的协同性低。这是一项在健康志愿者中评估 TAK-071 的安全性、药代动力学和药效学的首次人体研究。

方法

TAK-071 以单剂量和多剂量的方式在一项随机、双盲、安慰剂对照、平行组设计中给药,单独给予和与多奈哌齐联合给予。进行了实验室、心电图(ECG)和脑电图(EEG)评估。采集脑脊液和血液样本以评估药代动力学(PK)、相对生物利用度和食物效应。

结果

TAK-071 安全且耐受良好,无死亡或严重不良事件发生。TAK-071 表现出较长的平均(%变异系数)半衰期,口服给药后为 46.3(25.2%)至 60.5(51.5%)小时,且具有良好的脑穿透性。与多奈哌齐联合给药对两种药物的 PK 均无影响。系统暴露无食物效应。定量脑电图分析显示,TAK-071 40-80mg 增加了睁眼时后电极组 7-9Hz 范围内的功率,120-160mg 剂量增加了睁眼和闭眼时中央-后区 16-18Hz 范围内的功率,并降低了 2-4Hz 范围内的功率。高剂量 TAK-071 后功能连接显著降低,与多奈哌齐联合给药在闭眼状态下增强。

结论

TAK-071 的 PK 和安全性特征良好,包括基于临床前数据预期的药理学有效剂量。在没有多奈哌齐的情况下,TAK-071 基本没有胆碱能不良反应。需要进一步评估 TAK-071 的临床疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7c2/9291057/28cea482a38a/BCP-88-600-g004.jpg

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