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在健康的日本和非日本参与者中,奥拉西壬的药代动力学、药效学和耐受性:一项 I 期、单次、开放标签研究的结果。

Pharmacokinetics, Pharmacodynamics, and Tolerability of Olpasiran in Healthy Japanese and Non-Japanese Participants: Results from a Phase I, Single-dose, Open-label Study.

机构信息

Amgen Inc, Thousand Oaks, California.

CenExel Clinical Research Center, Anaheim, California.

出版信息

Clin Ther. 2022 Sep;44(9):1237-1247. doi: 10.1016/j.clinthera.2022.07.008. Epub 2022 Aug 11.

Abstract

PURPOSE

Olpasiran, an N-acetyl galactosamine-conjugated, hepatocyte-targeted, small interfering RNA, is being developed to reduce plasma lipoprotein (Lp)-(a) concentration by directly targeting the LPA gene. This study evaluated the pharmacokinetics, pharmacodynamics, and tolerability of a single SC injection of olpasiran in healthy, Japanese and non-Japanese participants.

METHODS

In this Phase I, open-label, parallel-design study, Japanese participants were randomized in a 1:1:1:1 ratio to receive a single 3, 9, 75, or 225 mg dose of olpasiran. Non-Japanese participants received a single 75 mg dose of olpasiran. The primary end points were pharmacokinetic parameters, including C, AUC, t, and t. Tolerability and change in Lp(a) concentration were also assessed.

FINDINGS

A total of 27 enrolled participants had a mean (SD) age of 48.0 (12.5) years. Olpasiran C and AUC were increased in an approximately dose-proportional manner in the Japanese groups. Mean (SD) C values were 242 (121.0) and 144 (71.3) ng/mL, and mean (SD) AUC values were 3550 (592.0) and 2620 (917.0) h·ng/mL, in the Japanese and non-Japanese groups, respectively, given 75 mg of olpasiran. Median t ranged from 3.0 to 9.0 hours and mean (SD) t ranged from 4.0 (0.3) to 6.9 (1.6) hours across all groups. The maximal Lp(a) reduction occurred at day 57, with mean (SD) Lp(a) percentage reductions from baseline ranging from 56.0% (21.0%) to 99.0% (0.2%). A reductions in Lp(a) was observed as early as day 4. All adverse events were mild in severity, with no serious or fatal adverse events. No clinically important changes in tolerability-related laboratory analytes or vital signs were observed.

IMPLICATIONS

In this population of healthy Japanese participants, dose-proportional increases in exposure and reduced Lp(a) in a dose-dependent manner were found with single 3, 9, 75, and 225 mg doses of olpasiran. The magnitude and durability of Lp(a) reductions were similar between the Japanese and non-Japanese groups. Olpasiran was well tolerated, with no clinically important adverse events or laboratory or vital sign abnormalities.

摘要

目的

Olpasiran 是一种 N-乙酰半乳糖胺缀合的、靶向肝细胞的小干扰 RNA,通过直接靶向 LPA 基因,用于降低血浆脂蛋白(Lp)-(a)浓度。本研究评估了健康的日本和非日本参与者单次皮下注射 olpasiran 的药代动力学、药效学和耐受性。

方法

在这项 I 期、开放标签、平行设计研究中,日本参与者按照 1:1:1:1 的比例随机接受单次 3、9、75 或 225mg 剂量的 olpasiran。非日本参与者接受单次 75mg 剂量的 olpasiran。主要终点是药代动力学参数,包括 C、AUC、t 和 t。还评估了耐受性和 Lp(a)浓度的变化。

结果

总共 27 名入组参与者的平均(SD)年龄为 48.0(12.5)岁。在日本组中,olpasiran 的 C 和 AUC 呈近似剂量比例增加。日本和非日本组分别给予 75mg olpasiran 后,C 值的平均值(SD)分别为 242(121.0)和 144(71.3)ng/ml,AUC 值的平均值(SD)分别为 3550(592.0)和 2620(917.0)h·ng/ml。中位 t 值范围为 3.0 至 9.0 小时,平均(SD)t 值范围为 4.0(0.3)至 6.9(1.6)小时,所有组均如此。最大 Lp(a)降低发生在第 57 天,Lp(a)百分比从基线的平均(SD)降低范围为 56.0%(21.0%)至 99.0%(0.2%)。从第 4 天开始就观察到 Lp(a)的降低。所有不良事件均为轻度,无严重或致命不良事件。未观察到与耐受性相关的实验室分析物或生命体征的临床相关变化。

结论

在这组健康的日本参与者中,单次给予 3、9、75 和 225mg 剂量的 olpasiran 可使暴露量呈剂量依赖性的比例增加,并使 Lp(a)降低,呈剂量依赖性。日本组和非日本组的 Lp(a)降低幅度和持续时间相似。Olpasiran 耐受性良好,无临床相关的不良事件或实验室或生命体征异常。

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