Centre for Human Drug Research (CHDR), Leiden, The Netherlands.
Leiden University Medical Center, Leiden, The Netherlands.
Br J Clin Pharmacol. 2022 Jun;88(6):2909-2925. doi: 10.1111/bcp.15229. Epub 2022 Jan 31.
ALKS 7119 is a novel compound with in vitro affinity highest for the SERT, and for μ receptor, α -adrenoceptor, α -adrenoceptor, NMDA receptor and sigma non-opioid intracellular receptor 1. This first-in-human study evaluated safety and PK/PD effects of single ascending doses (SAD) of ALKS 7119 in healthy males and compared effects with neurotransmitter modulators with partially overlapping targets.
In 10 cohorts (n = 10 subjects each), PK, safety and PD (NeuroCart tests, measuring neurophysiologic effects [pupillometry, pharmaco-EEG (pEEG)], visuomotor coordination, alertness, [sustained] attention [saccadic peak velocity, adaptive tracking], subjective drug effects [VAS Bowdle and VAS Bond and Lader] and postural stability [body sway]) were evaluated. Neuroendocrine effects (cortisol, prolactin, growth hormone) were measured. Data were analysed over the 12-hour post-dose period using mixed-effects model for repeated measure (MMRM) with baseline as covariate.
ALKS 7119 demonstrated linear PK and was generally well tolerated. QTcF interval increases of 30-60 ms compared to baseline were observed with ALKS 7119 doses of ≥50 mg without related adverse events. Significant increases in left and right pupil/iris ratio were observed at dose levels ≥50 mg (estimate of difference [95% CI], P-value) (0.04 [0.01; 0.07], P < .01) and (0.06 [0.03; 0.09], P = .01), respectively. From dose levels ≥50 mg significant increases (% change) of serum cortisol (51.7 [8.4; 112.3], P = .02) and prolactin (77.9 [34.2; 135.8], P < .01) were observed.
In line with ALKS 7119's in vitro pharmacological profile, the clinical profile observed in this study is most comparable to SERT inhibition.
ALKs7119 是一种新型化合物,对 SERT、μ 受体、α-肾上腺素能受体、α-肾上腺素能受体、NMDA 受体和 sigma 非阿片类细胞内受体 1 具有体外亲和力最高。这项首次人体研究评估了健康男性单次递增剂量(SAD)的 ALKS7119 的安全性和 PK/PD 效应,并将其与具有部分重叠靶点的神经递质调节剂进行了比较。
在 10 个队列(每组 10 名受试者)中,评估了 PK、安全性和 PD(NeuroCart 测试,测量神经生理效应[瞳孔测量、药物脑电图(pEEG)]、视动协调、警觉性、[持续]注意力[眼跳峰速度、自适应跟踪]、药物引起的主观效应[VASBowdle 和 VASBond 和 Lader]和姿势稳定性[身体晃动])。还测量了神经内分泌效应(皮质醇、催乳素、生长激素)。使用混合效应模型重复测量(MMRM),以基线为协变量,对 12 小时内的药物后数据进行分析。
ALKs7119 表现出线性 PK 特征,通常具有良好的耐受性。与基线相比,ALKs7119 剂量≥50mg 时,观察到 QTcF 间期增加 30-60ms,没有相关的不良事件。在剂量水平≥50mg 时,观察到左眼和右眼瞳孔/虹膜比率显著增加(剂量差异估计值[95%CI],P 值)(0.04 [0.01;0.07],P<.01)和(0.06 [0.03;0.09],P=.01)。在剂量水平≥50mg 时,观察到血清皮质醇(51.7 [8.4;112.3],P=.02)和催乳素(77.9 [34.2;135.8],P<.01)显著增加(%变化)。
与 ALKS7119 的体外药理学特征一致,该研究中观察到的临床特征与 SERT 抑制最为相似。