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Safety, tolerability, pharmacokinetics, and pharmacodynamics of PF-06650833, a selective interleukin-1 receptor-associated kinase 4 (IRAK4) inhibitor, in single and multiple ascending dose randomized phase 1 studies in healthy subjects.
Arthritis Research & Therapy ( IF 4.9 ) Pub Date : 2019-12-05 , DOI: 10.1186/s13075-019-2008-6
Spencer I Danto 1 , Negin Shojaee 1 , Ravi Shankar P Singh 1 , Cheryl Li 1 , Steven A Gilbert 1 , Zorayr Manukyan 1 , Iain Kilty 1
Affiliation  

PF-06650833 is a potent, selective inhibitor of interleukin-1 receptor-associated kinase 4 (IRAK4). Two randomized, double-blind, sponsor-open phase 1 studies evaluated the safety, pharmacokinetics, and pharmacodynamics of single (SAD) and multiple ascending doses (MAD) of PF-06650833 immediate-release (IR) and modified-release (MR) oral formulations in healthy adult subjects. Study 1 (NCT02224651) was a 96-day, placebo-substitution, SAD study of once-daily (QD) oral PF-06650833 IR 1 to 6000 mg and MR 30 to 300 mg in fasted and fed states. Study 2 (NCT02485769) was a 14-day, placebo-controlled, MAD study of PF-06650833 IR 25 to 750 mg twice daily, IR 1000 mg four times per day, IR 330 mg three times per day, and MR 300 mg QD. PF-06650833 was generally well tolerated, with no dose-limiting treatment-emergent adverse events (TEAEs) identified in either study. TEAEs were generally mild in severity, with headache, gastrointestinal disorders, and acne most commonly reported. No serious AEs or deaths were reported. A maximum tolerated dose was not established in either study. In the SAD study, food intake delayed absorption of IR 30 mg and increased total exposure by 33%. Delayed absorption was achieved with the MR formulation (Tmax of 1 h versus 8 h for IR 100 mg and MR 100 mg formulations, respectively). Food had no effect on total exposure for MR 30 mg, but reduced half-life 1.8-fold and increased Cmax by 62%. In the MAD study, accumulation ranged from 0.9-fold to 1.4-fold for AUCtau and 0.9-fold to 1.3-fold for Cmax. Less than 1% of the dose was recovered unchanged in urine for all dose groups, with renal clearance ranging from 14 to 23 mL/min for IR < 750 mg and MR 300 mg. There was a sustained decrease in serum high-sensitivity C-reactive protein for IR ≥ 250 mg and MR 300 mg. Based on the cholesterol/hydroxycholesterol ratio, no apparent CYP3A induction or inhibition was observed. PF-06650833, the first IRAK4 inhibitor to enter clinical development, has a favorable safety and pharmacokinetic profile and has shown evidence of pharmacological effect. The data support continued evaluation in human clinical trials for the treatment of rheumatic and autoimmune diseases. Clinicaltrials.gov, NCT02224651, registered 25 August 2014; NCT02485769, registered 30 June 2015

中文翻译:

在健康受试者的单次或多次递增剂量随机1期研究中,PF-06650833(一种选择性的白介素1受体相关激酶4(IRAK4)抑制剂)的安全性,耐受性,药代动力学和药效学。

PF-06650833是有效的,白介素1受体相关激酶4(IRAK4)的选择性抑制剂。两项随机,双盲,申办者开放式1期研究评估了PF-06650833立即释放(IR)和改良释放(MR)的单次(SAD)和多次递增剂量(MAD)的安全性,药代动力学和药效学健康成人受试者的口服制剂。研究1(NCT02224651)是一项96天的安慰剂替代SAD研究,在禁食和进食状态下,每日一次(QD)口服PF-06650833 IR 1至6000 mg和MR 30至300 mg。研究2(NCT02485769)是一项为期14天的安慰剂对照MAD研究,涉及PF-06650833红外辐射25至750毫克,每天两次,红外辐射1000毫克,每天四次,红外辐射330毫克,每天三遍,MR 300毫克QD 。PF-06650833的耐受性一般良好,两项研究中均未发现限制剂量的治疗紧急不良事件(TEAE)。TEAE的严重程度通常较轻,最常报告有头痛,胃肠道疾病和痤疮。没有严重的不良事件或死亡的报道。两项研究均未确定最大耐受剂量。在SAD研究中,食物摄入延迟了IR的吸收30 mg,并使总暴露量增加了33%。使用MR制剂可实现延迟吸收(IR 100 mg和MR 100 mg制剂的Tmax为1小时,而Tmax为8小时)。食物对MR 30 mg的总暴露没有影响,但半衰期降低了1.8倍,Cmax升高了62%。在MAD研究中,AUCtau的累积范围为0.9倍至1.4倍,Cmax的累积范围为0.9倍至1.3倍。在所有剂量组中,尿液中未恢复的剂量不足1%,IR <750 mg和MR 300 mg的肾脏清除率范围为14至23 mL / min。对于IR≥250 mg和MR 300 mg,血清高敏C反应蛋白持续降低。基于胆固醇/羟胆固醇比率,未观察到明显的CYP3A诱导或抑制作用。PF-06650833是第一个进入临床开发的IRAK4抑制剂,具有良好的安全性和药代动力学特性,并已显示出药理作用的证据。数据支持继续在风湿性和自身免疫性疾病的人类临床试验中进行评估。Clinicaltrials.gov,NCT02224651,2014年8月25日注册;NCT02485769,注册于2015年6月30日 基于胆固醇/羟胆固醇比率,未观察到明显的CYP3A诱导或抑制作用。PF-06650833是第一个进入临床开发的IRAK4抑制剂,具有良好的安全性和药代动力学特性,并已显示出药理作用的证据。数据支持继续在风湿性和自身免疫性疾病的人类临床试验中进行评估。Clinicaltrials.gov,NCT02224651,2014年8月25日注册;NCT02485769,注册于2015年6月30日 基于胆固醇/羟胆固醇比率,未观察到明显的CYP3A诱导或抑制作用。PF-06650833是第一个进入临床开发的IRAK4抑制剂,具有良好的安全性和药代动力学特性,并已显示出药理作用的证据。数据支持继续在风湿性和自身免疫性疾病的人类临床试验中进行评估。Clinicaltrials.gov,NCT02224651,2014年8月25日注册;NCT02485769,注册于2015年6月30日 数据支持在人类风湿性和自身免疫性疾病的临床试验中继续进行评估。Clinicaltrials.gov,NCT02224651,2014年8月25日注册;NCT02485769,注册于2015年6月30日 数据支持继续在风湿性和自身免疫性疾病的人类临床试验中进行评估。Clinicaltrials.gov,NCT02224651,2014年8月25日注册;NCT02485769,注册于2015年6月30日
更新日期:2019-12-05
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