Comprehensive Safety Exposure-Response Analysis to Support Ritlecitinib Dose Selection.

IF 3.1 3区 医学 Q2 PHARMACOLOGY & PHARMACY
Yeamin Huh, Ruolun Qiu, John Prybylski, Jessica Wojciechowski, Yuchen Wang, Vivek S Purohit
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Abstract

Ritlecitinib is a kinase inhibitor drug recently approved for the treatment of alopecia areata (AA) in both adults and adolescents based on a single, combined Phase 2b/3 study. Various QD doses with and without a loading dose have been evaluated in the pivotal Phase 2b/3 study. Therefore, characterization of the ritlecitinib safety profile becomes important to help inform the dose selection within the single Phase 2b/3 trial in conjunction with efficacy analysis. The purpose of this study is to characterize the safety profile of ritlecitinib with comprehensive exposure-response (ER) analyses. The concentration-QTc model was developed using a scientific white paper model, indicating no evidence of ritlecitinib-induced QTc prolongation. The semi-mechanistic PK/PD model well described the longitudinal profile of lymphocytes, indicating ritlecitinib-induced decrease in lymphocytes was marginal and the incidence of Grade 3/4 lymphopenia was predicted to be small across the investigated dose range except for a slight increase in the loading dose regimen. The ritlecitinib-dependent increase in the incidence of infections and rash was successfully described by a Poisson regression model using time-weighted average concentration as an exposure metric, indicating that the dose-dependent increase in the incidence of AEs is not dose-proportionally large in the investigated dose range. Covariate analysis within each model indicated that the safety ER relationship of ritlecitinib is similar across all the patient subgroups and no unique safety risks associated with ritlecitinib are anticipated in adolescent patients. Therefore, this comprehensive safety ER analysis supported the selection of the ritlecitinib 50 mg non-loading dose regimen for AA patients including both adults and adolescents.

支持利来替尼剂量选择的综合安全暴露反应分析。
Ritlecitinib是一种激酶抑制剂药物,最近在一项2b/3期联合研究中被批准用于治疗成人和青少年斑秃(AA)。在关键性的2b/3期研究中,已经评估了有和没有负荷剂量的各种QD剂量。因此,ritlecitinib安全性特征的表征对于帮助告知单期2b/3期试验中的剂量选择以及疗效分析变得非常重要。本研究的目的是通过综合暴露-反应(ER)分析来描述利来替尼的安全性。采用科学白皮书模型建立了浓度-QTc模型,未发现利来替尼诱导QTc延长的证据。半机械性PK/PD模型很好地描述了淋巴细胞的纵向分布,表明利来替尼诱导的淋巴细胞减少是边缘性的,3/4级淋巴细胞减少的发生率预计在整个研究剂量范围内都很小,除了在负荷剂量方案中略有增加。使用时间加权平均浓度作为暴露度量标准的泊松回归模型成功地描述了利来替尼依赖性感染和皮疹发生率的增加,表明在所研究的剂量范围内,ae发生率的剂量依赖性增加并不按剂量比例大。每个模型中的协变量分析表明,利来替尼的安全性ER关系在所有患者亚组中都是相似的,并且在青少年患者中没有预期与利来替尼相关的独特安全风险。因此,这项综合安全性ER分析支持成人和青少年AA患者选择利来替尼50 mg非负荷给药方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.00
自引率
11.40%
发文量
146
审稿时长
8 weeks
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