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凯弗拉唑,一种新型钾离子竞争性酸阻滞剂:健康受试者多次口服的安全性、耐受性、药代动力学和药效学。

Keverprazan, a novel potassium-competitive acid blocker: Multiple oral doses safety, tolerability, pharmacokinetics, and pharmacodynamics in healthy subjects.

机构信息

Phase I Clinical Trial Unit, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.

Jiangsu Carephar Pharmaceutical Co., Ltd., Nanjing, China.

出版信息

Clin Transl Sci. 2023 Oct;16(10):1911-1922. doi: 10.1111/cts.13598. Epub 2023 Aug 2.

Abstract

Keverprazan, a novel potassium-competitive acid blocker, was approved for treating acid-related diseases. This study aimed to analyze the safety, pharmacokinetics (PKs) and pharmacodynamics (PDs) of multiple doses of keverprazan. This was a randomized, positive-/placebo-controlled, phase Ic trial. Twenty-six healthy adults were randomized to receive 20 mg/day keverprazan (n = 8), 40 mg/day keverprazan (n = 8), placebo (n = 6), or 20 mg/day vonoprazan (n = 4) for 7 days. Safety, PK and PD assessments were conducted. In the keverprazan, vonoprazan, and placebo groups, adverse events (AEs) were reported in nine (56.25%), two (50.00%), and three (50.00%) subjects, respectively. AEs were mild except a moderate abdominal pain leading to withdraw. No serious AEs occurred. The plasma concentration-time profiles of keverprazan showed rapid absorption (median time to maximum plasma concentration of 1.25-3.0 h). The terminal half-life was 6.23 and 7.01 h for keverprazan 20 and 40 mg groups on day 7. The maximum plasma concentration was 43.1 and 93.2 ng/mL, respectively. There was no apparent accumulation of keverprazan and the major metabolite after 7-day administration. The intragastric pH greater than 5 holding time ratios (HTRs) over 24 h postdose increased from 79.1%, 84.4%, and 84.5% on day 1 to 99.0%, 97.4%, and 100.0% on day 7 in the vonoprazan 20 mg and keverprazan 20 and 40 mg groups, respectively. The intragastric pH greater than 5 HTR of keverprazan reached a plateau at 20 mg. Keverprazan is well-tolerable. A steady-state in exposure was generally reached after 7 days of treatment. A dose of 20 mg/day keverprazan can elicit a significant, stable, and long-lasting gastric acid inhibition effect.

摘要

新型钾离子竞争性酸阻滞剂凯弗拉唑已被批准用于治疗酸相关疾病。本研究旨在分析多次给予凯弗拉唑的安全性、药代动力学(PK)和药效动力学(PD)。这是一项随机、阳性对照/安慰剂对照、Ic 期临床试验。26 名健康成年人被随机分为接受 20mg/天凯弗拉唑(n=8)、40mg/天凯弗拉唑(n=8)、安慰剂(n=6)或 20mg/天沃诺拉赞(n=4)治疗 7 天。进行安全性、PK 和 PD 评估。在凯弗拉唑、沃诺拉赞和安慰剂组中,分别有 9 名(56.25%)、2 名(50.00%)和 3 名(50.00%)受试者报告了不良事件(AE)。AE 均为轻度,除 1 例中度腹痛导致停药外,无严重 AE。凯弗拉唑的血浆浓度-时间曲线表现出快速吸收(中位达峰时间为 1.25-3.0h)。第 7 天,凯弗拉唑 20 和 40mg 组的终末半衰期分别为 6.23 和 7.01h。最大血浆浓度分别为 43.1 和 93.2ng/mL。7 天给药后,凯弗拉唑及其主要代谢物无明显蓄积。沃诺拉赞 20mg 和凯弗拉唑 20 和 40mg 组给药后 24h 内胃内 pH 值大于 5 的时间比例(HTR)从第 1 天的 79.1%、84.4%和 84.5%分别增加到第 7 天的 99.0%、97.4%和 100.0%。凯弗拉唑的胃内 pH 值大于 5 的 HTR在 20mg 时达到平台。凯弗拉唑具有良好的耐受性。治疗 7 天后,通常达到暴露量的稳态。20mg/天的剂量可产生显著、稳定和持久的胃酸抑制作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b53/10582672/ef8526b4d0ee/CTS-16-1911-g003.jpg

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