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帕罗维诺特在日本和非日本健康参与者中的药代动力学、安全性和耐受性试验。

A Pharmacokinetic, Safety, and Tolerability Trial of Palovarotene in Healthy Japanese and Non-Japanese Participants.

机构信息

Pleiades Consultation Inc, Phoenix, Arizona, USA.

Department of Rehabilitation Medicine, The University of Tokyo, Tokyo, Japan.

出版信息

Eur J Drug Metab Pharmacokinet. 2023 Mar;48(2):141-150. doi: 10.1007/s13318-023-00815-x. Epub 2023 Feb 18.

Abstract

UNLABELLED

BACKGROUND AND OBJECTIVE: Palovarotene is an oral, selective retinoic acid receptor gamma agonist under investigation for fibrodysplasia ossificans progressiva (FOP). Palovarotene is primarily metabolized by cytochrome P450 (CYP) 3A4. Differences in CYP-mediated metabolism of CYP substrates have been observed between Japanese and non-Japanese individuals. This phase I trial (NCT04829786) compared the pharmacokinetic profile of palovarotene in healthy Japanese and non-Japanese participants and evaluated the safety of single doses.

METHODS

Healthy Japanese and non-Japanese participants were matched individually (1:1) and randomized to receive a single oral dose of palovarotene 5 or 10 mg, followed by the alternate dose after a 5-day washout period. Maximum plasma drug concentration (C) and area under the plasma concentration-time curve (AUC) were assessed. Estimates of the geometric mean difference between dose and Japanese and non-Japanese groups were calculated for natural log-transformed C and AUC parameters. Adverse events (AEs), serious AEs, and treatment-emergent AEs were recorded.

RESULTS

Eight pairs of matched non-Japanese and Japanese individuals and two unmatched Japanese individuals participated. Mean plasma concentration-time profiles were similar between the two cohorts at both dose levels, demonstrating that palovarotene absorption and elimination are similar irrespective of dose level. The pharmacokinetic parameters of palovarotene were similar between groups at both dose levels. C and AUC values were dose-proportional between doses in each group. Palovarotene was well tolerated; there were no deaths or AEs leading to treatment discontinuation.

CONCLUSIONS

Japanese and non-Japanese groups had similar pharmacokinetic profiles, indicating that palovarotene dose adjustments are not necessary for Japanese patients with FOP.

摘要

背景和目的

Palovarotene 是一种正在研究用于进行性骨化性纤维发育不良(FOP)的口服、选择性维甲酸受体γ激动剂。Palovarotene 主要通过细胞色素 P450(CYP)3A4 代谢。已经观察到日本人和非日本人之间 CYP 底物的 CYP 介导代谢存在差异。这项 I 期试验(NCT04829786)比较了健康的日本人和非日本参与者中 palovarotene 的药代动力学特征,并评估了单剂量的安全性。

方法

健康的日本人和非日本人参与者按个体(1:1)匹配并随机分配,接受单次口服 palovarotene 5 或 10mg 剂量,在 5 天洗脱期后接受交替剂量。评估最大血浆药物浓度(C)和血浆浓度-时间曲线下面积(AUC)。计算自然对数转换的 C 和 AUC 参数的剂量与日本和非日本组之间的几何均数差值估计。记录不良事件(AE)、严重 AE 和治疗后出现的 AE。

结果

8 对匹配的非日本人和日本人和 2 名非匹配的日本参与者参加了试验。在两个剂量水平下,两组的平均血浆浓度-时间曲线相似,表明 palovarotene 的吸收和消除相似,与剂量水平无关。两组在两个剂量水平的 palovarotene 药代动力学参数相似。每个组的 C 和 AUC 值在剂量之间呈剂量比例关系。palovarotene 耐受性良好;没有死亡或导致治疗中断的 AE。

结论

日本人和非日本人组具有相似的药代动力学特征,表明 FOP 日本患者不需要调整 palovarotene 剂量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5298/10011291/466d6e3a00fa/13318_2023_815_Fig1_HTML.jpg

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