Victorian Heart Institute, Monash University, Melbourne, Victoria, Australia.
NewAmsterdam Pharma B.V, Naarden, The Netherlands.
Pharmacol Res Perspect. 2024 Dec;12(6):e70010. doi: 10.1002/prp2.70010.
Anacetrapib, a cholesteryl ester transfer protein (CETP) inhibitor previously under development, exhibited an usually extended terminal half-life and large food effect and accumulated in adipose tissue. Other CETP inhibitors have not shown such effects. Obicetrapib, a potent selective CETP inhibitor, is undergoing Phase III clinical development. Dedicated assessments were conducted in pre-clinical and Phase I and II clinical studies of obicetrapib to examine the pharmacokinetic issues observed with anacetrapib. After 9 months of dosing up to 50 mg/kg/day in cynomolgus monkeys, obicetrapib was completely eliminated from systemic circulation and not detected in adipose tissue after a 13-week recovery period. In healthy humans receiving 1-25 mg of obicetrapib, the mean terminal half-life of obicetrapib was 148, 131, and 121 h at 5, 10, and 25 mg, respectively, and food increased plasma levels by ~1.6-fold with a 10 mg dose. At the end of treatment in Phase II trials, mean plasma levels of obicetrapib ranged from 194.5 ng/mL with 2.5 mg to 506.3 ng/mL with 10 mg. Plasma levels of obicetrapib decreased by 92.2% and 98.5% at four and 15 weeks post-treatment, respectively. Obicetrapib shows no clinically relevant accumulation, is minimally affected by food, and has a mean terminal half-life of 131 h for the 10 mg dose. These data support once daily, chronic dosing of obicetrapib in Phase III trials for dyslipidemia management.
阿昔单抗是一种胆固醇酯转移蛋白(CETP)抑制剂,此前正在开发中,其表现出通常延长的终末半衰期和较大的食物效应,并在脂肪组织中蓄积。其他 CETP 抑制剂没有显示出这种作用。奥昔单抗是一种有效的选择性 CETP 抑制剂,正在进行 III 期临床开发。在奥昔单抗的临床前和 I 期和 II 期临床研究中专门进行了评估,以检查与阿昔单抗观察到的药代动力学问题。在食蟹猴中每天给药高达 50mg/kg 长达 9 个月后,奥昔单抗在 13 周恢复期后完全从全身循环中消除,在脂肪组织中未检测到。在接受 1-25mg 奥昔单抗的健康人中,奥昔单抗的平均终末半衰期分别为 148、131 和 121h,分别在 5、10 和 25mg 时,而食物使血浆水平增加了约 1.6 倍,剂量为 10mg。在 II 期试验的治疗结束时,奥昔单抗的平均血浆水平范围从 2.5mg 的 194.5ng/ml 到 10mg 的 506.3ng/ml。治疗结束后 4 周和 15 周,奥昔单抗的血浆水平分别下降了 92.2%和 98.5%。奥昔单抗没有显示出临床上相关的蓄积,受食物影响极小,10mg 剂量的平均终末半衰期为 131h。这些数据支持在 III 期试验中进行每日一次、慢性给药,以治疗血脂异常。