Clinical Research, Drug Development Division, Sumitomo Pharma Co., Ltd., Osaka, Japan.
SOUSEIKAI Hakata Clinic, Fukuoka, Japan.
Clin Pharmacol Drug Dev. 2022 Oct;11(10):1136-1146. doi: 10.1002/cpdd.1146. Epub 2022 Aug 21.
EPI-589 attenuates oxidative stress due to the radical scavenging activity of the reduced form and affects mitochondrial energy metabolism as a substrate of quinone-oxidoreductases. Given the effects of EPI-589 on oxidative stress and mitochondrial dysfunction, EPI-589 shows promise as a potential therapy for patients with amyotrophic lateral sclerosis. This phase 1 study evaluated the safety, tolerability, and pharmacokinetic profiles of EPI-589. Sixty-eight healthy participants were randomly assigned to EPI-589 or placebo. All adverse events were mild or moderate in severity, and no severe adverse events were reported. After single-dose administration under fasting conditions, time to maximum plasma concentration (t ) occurred 0.25 to 1.00 hour after administration. Both peak plasma concentration (C ) and area under the plasma concentration-time curve (AUC) were approximately linear with increases in single doses over a dose range of 250-1000 mg. Under fed conditions, the C decreased to 62.6% of the C under fasting conditions, the AUC was slightly increased, and the t was delayed by 1 hour. When EPI-589 was administered daily on days 1 and 7 with twice-daily dosing on days 2 through 6, the plasma trough concentration appeared to reach steady state by day 3. At both doses studied (500 mg twice daily and 750 mg twice daily), C t , and AUC were generally comparable between day 1 and day 7 and between the Japanese and White participants. EPI-589 was well tolerated as a single daily dose up to 1000 mg and as twice-daily doses up to 750 mg, with a linear pharmacokinetic profile.
EPI-589 通过还原形式的自由基清除活性减轻氧化应激,并作为醌氧化还原酶的底物影响线粒体能量代谢。鉴于 EPI-589 对氧化应激和线粒体功能障碍的影响,EPI-589 有望成为肌萎缩侧索硬化症患者的潜在治疗方法。这项 1 期研究评估了 EPI-589 的安全性、耐受性和药代动力学特征。68 名健康参与者被随机分配到 EPI-589 或安慰剂组。所有不良事件均为轻度或中度严重程度,无严重不良事件报告。在禁食条件下单次给药后,达峰时间(t )在给药后 0.25 至 1.00 小时发生。在 250-1000mg 的剂量范围内,单次剂量增加时,峰值血浆浓度(C )和血浆浓度-时间曲线下面积(AUC)均近似呈线性。在进食条件下,C 降低至禁食条件下的 62.6%,AUC 略有增加,t 延迟 1 小时。当 EPI-589 在第 1 天和第 7 天每日给药两次,第 2 天至第 6 天每日给药两次时,血浆谷浓度似乎在第 3 天达到稳态。在研究的两个剂量(500mg 每日两次和 750mg 每日两次)下,C t 和 AUC 在第 1 天和第 7 天以及日本和白人参与者之间通常相似。EPI-589 作为每日单次剂量高达 1000mg 和每日两次剂量高达 750mg 时耐受性良好,具有线性药代动力学特征。