Phase 1 Renal Impairment Trial Results Supports Targeted Individualized Dosing of ELX‐02 in Patients With Nephropathic Cystinosis
| Autor: | Kate Banks, Ming‐yi Hu, Andi Leubitz, Kaela M. Porter, Paul Goodyer, David J. Wyatt, Thomas Haverty |
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| Rok vydání: | 2021 |
| Předmět: |
Male
renal impairment medicine.medical_specialty Metabolic Clearance Rate Injections Subcutaneous Urinary system Cystinosis Population Urology Renal function Urine 030226 pharmacology & pharmacy ELX‐02 03 medical and health sciences 0302 clinical medicine Pharmacokinetics Nephropathic Cystinosis eGFR medicine Humans nonsense mutations Pharmacology (medical) Dosing Furans education Aged Pharmacology education.field_of_study Dose-Response Relationship Drug business.industry Patient Acuity Middle Aged Special Populations Amino Acid Transport Systems Neutral Renal Elimination Area Under Curve 030220 oncology & carcinogenesis Female business pharmacokinetics Glomerular Filtration Rate Half-Life |
| Zdroj: | Journal of Clinical Pharmacology |
| ISSN: | 1552-4604 0091-2700 |
| DOI: | 10.1002/jcph.1807 |
| Popis: | The aim of this study was to assess the pharmacokinetics (PK) and safety of ELX‐02 in a renally impaired population and apply these findings to the individualized dosing of patients with nephropathic cystinosis. This phase 1 renal impairment (RI; mild, moderate, or severe), single‐dose, PK, and safety evaluation included 6 participants assigned to each RI group. Six healthy controls with normal renal function were matched to participants with renal impairment. All received a single subcutaneous dose of 1‐mg/kg ELX‐02 on day 1 and were monitored for 72 hours after dosing with serial blood and urine samples. An estimated glomerular filtration rate (eGFR)‐PK model of ELX‐02 was developed from the RI study data and used to implement individualized dosing in a phase 2a study in patients with nephropathic cystinosis to achieve a weekly targeted exposure (area under the plasma concentration–time curve [AUC]). In participants with RI, ELX‐02 clearance decreased, and exposure increased with severity of RI. ELX‐02 plasma exposure was similar to healthy controls in participants with mild RI, but increasing severity of RI resulted in significantly decreased clearance, increased maximum plasma concentration, AUC from time zero to infinity, and half‐life compared to controls. ELX‐02 urinary clearance showed a similar pattern. Relationships between eGFR and exposure were defined supporting individualized dose determination for prediction of dose and AUC in patients with nephropathic cystinosis, achieving overall mean 110.7% of AUC targets. ELX‐02 was well tolerated by RI and nephropathic cystinosis populations. ELX‐02 exhibits a consistent PK profile across increasing degrees of RI with reduced clearance, increased exposure, and prolonged renal elimination proportional to reductions in eGFR. The defined relationship between eGFR and plasma exposure enabled individualized dose adjustment in patients with nephropathic cystinosis. |
| Databáze: | OpenAIRE |
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