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Bridging Gaps in Oncology: Comparative Analysis of Development and Approval Pathways for Anticancer Drugs and Companion Diagnostic in the United States and Japan
IF 3.1 3区 医学
Cts-Clinical and Translational Science Pub Date : 2025-02-18 DOI: 10.1111/cts.70162
Kaku Saito, Mamoru Narukawa
{"title":"Bridging Gaps in Oncology: Comparative Analysis of Development and Approval Pathways for Anticancer Drugs and Companion Diagnostic in the United States and Japan","authors":"Kaku Saito,&nbsp;Mamoru Narukawa","doi":"10.1111/cts.70162","DOIUrl":"https://doi.org/10.1111/cts.70162","url":null,"abstract":"<p>Companion diagnostics (CDxs) are essential in personalized medicine for oncology, where specific genetic mutations drive treatment decisions. Some differences remain in the regulatory frameworks and approval processes for CDx between the United States (U.S.) and Japan. Data were collected from public databases for CDxs and anticancer drugs approved between January 1, 2014, and August 15, 2024, in both countries. The analysis included both initial drug approvals and supplemental approvals to examine the characteristics of approved CDxs and anticancer drugs, identify regional differences, compare development and approval timelines of CDxs and associated anticancer drugs in both countries, and assess the factors influencing approval timelines. CDx approval has increased significantly in both countries since 2014, driven by next-generation sequencing technologies, with 96 anticancer drug indications approved with CDx in the U.S. and 61 in Japan. In the U.S., drug approvals often preceded CDx approvals, influenced by post-marketing commitments (PMCs), whereas Japan tended to approve CDxs and drugs almost simultaneously. The median gap between CDx and drug approvals in the U.S. was 0 days (interquartile range (IQR): 0–391), indicating a broader range and often longer delay compared to 18 days (IQR: −52 to 0) in Japan, with a statistically significant difference between the two countries (<i>p</i> &lt; 0.0001). Logistic regression analysis revealed orphan drug designation was significantly associated with CDx-related PMC in the U.S. (<i>p</i> = 0.042). These results highlight the need for greater regulatory harmonization between the U.S. and Japan to streamline approval processes and improve patient access to personalized treatments.</p>","PeriodicalId":50610,"journal":{"name":"Cts-Clinical and Translational Science","volume":"18 2","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cts.70162","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143438875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Real-World Utilization of Medications With Pharmacogenetic Recommendations in Older Adults: A Scoping Review
IF 3.1 3区 医学
Cts-Clinical and Translational Science Pub Date : 2025-02-18 DOI: 10.1111/cts.70126
Bella D. Ianni, Chin Hang Yiu, Edwin C. K. Tan, Christine Y. Lu
{"title":"Real-World Utilization of Medications With Pharmacogenetic Recommendations in Older Adults: A Scoping Review","authors":"Bella D. Ianni,&nbsp;Chin Hang Yiu,&nbsp;Edwin C. K. Tan,&nbsp;Christine Y. Lu","doi":"10.1111/cts.70126","DOIUrl":"https://doi.org/10.1111/cts.70126","url":null,"abstract":"<p>Pharmacogenetic testing provides patient genotype information which could influence medication selection and dosing for optimal patient care. Insurance coverage for pharmacogenetic testing varies widely. A better understanding of the commonly used medications with clinically important pharmacogenetic recommendations can inform which medications and/or genes should be prioritized for coverage and reimbursement in the context of finite healthcare resources. The aim of this scoping review was to collate previous studies that investigated the utilization rate of medications that could be guided by pharmacogenetic testing. Included studies utilized electronic medical records or claims data to assess pharmacogenetic medication prescription rates for older adults (≥ 65 years old). Identified pharmacogenetic medications were classified according to therapeutic class and assessed for actionability based on the Clinical Pharmacogenetics Implementation Consortium guidelines. Across the 31 included studies, analgesic (<i>n</i> = 29), psychotropic (<i>n</i> = 29), and cardiovascular (<i>n</i> = 27) therapeutic classes were most commonly investigated. Study populations were primarily generalized (48%); however, some studies focused on specific populations, such as, cancer (<i>n</i> = 6), mental health (<i>n</i> = 1), and nursing home (<i>n</i> = 2) cohorts. A total of 215 unique pharmacogenetic medications were reported, of which, 82 were associated with actionable pharmacogenetic recommendations. The most frequent genes implicated in potential drug–gene interactions with these actionable pharmacogenetic drugs were <i>CYP2D6</i> (25.6%), <i>CYP2C19</i> (18.3%), and <i>CYP2C9</i> (11%). Medications most frequently prescribed included pantoprazole (range 0%–49.6%), simvastatin (range 0%–54.9%), and ondansetron (range 0.1%–62.6%). Overall, the frequently prescribed medications and associated genes identified in this review could guide pharmacogenetic testing implementation into clinical practice, including insurer subsidization.</p>","PeriodicalId":50610,"journal":{"name":"Cts-Clinical and Translational Science","volume":"18 2","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cts.70126","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143438938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Safety, Pharmacokinetics and Target Engagement of a Novel Brain Penetrant RIPK1 Inhibitor (SIR9900) in Healthy Adults and Elderly Participants
IF 3.1 3区 医学
Cts-Clinical and Translational Science Pub Date : 2025-02-17 DOI: 10.1111/cts.70151
Ofer Michael Gonen, Tim Porter, Buwei Wang, Fenchao Xue, Yongfen Ma, Linan Song, Pei Sun, Weiliang Fan, Yang Shen
{"title":"Safety, Pharmacokinetics and Target Engagement of a Novel Brain Penetrant RIPK1 Inhibitor (SIR9900) in Healthy Adults and Elderly Participants","authors":"Ofer Michael Gonen,&nbsp;Tim Porter,&nbsp;Buwei Wang,&nbsp;Fenchao Xue,&nbsp;Yongfen Ma,&nbsp;Linan Song,&nbsp;Pei Sun,&nbsp;Weiliang Fan,&nbsp;Yang Shen","doi":"10.1111/cts.70151","DOIUrl":"https://doi.org/10.1111/cts.70151","url":null,"abstract":"<p>Receptor-interacting serine/threonine kinase 1 (RIPK1) regulates inflammatory signaling and induces apoptosis and necroptosis. Pharmacological inhibition of RIPK1 kinase activity has demonstrated efficacy in animal models of neurodegenerative, autoimmune and inflammatory diseases. SIR9900 is a potent and selective novel small molecule RIPK1 inhibitor. This first-in-human, phase I, randomized, double-blind, placebo-controlled study evaluated the safety, pharmacokinetics, and pharmacodynamics of single (3–200 mg) and multiple (3–60 mg daily for 10 days) ascending oral doses of SIR9900 in healthy adult (18–64 years, <i>n</i> = 80) and elderly participants (≥ 65 years, multiple doses 30 mg, <i>n</i> = 8). The study included a food effect component. Overall, SIR9900 was safe and well tolerated with no concerning dose-dependent trends in safety observed. SIR9900 was rapidly absorbed with a plasma maximum concentration time (<i>T</i><sub>max</sub>) of 3.0–4.0 h and plasma half-life (<i>t</i><sub>1/2</sub>) of 31.92–37.75 h following single doses. Similar <i>T</i><sub>max</sub> and <i>t</i><sub>1/2</sub> results were observed following multiple doses. Systemic exposure to SIR9900 increased in a dose-proportional manner and was similar between adult and elderly participants. No appreciable food effect was observed. The cerebrospinal fluid to unbound plasma ratio was 1.15. A robust pharmacodynamic effect was demonstrated with approximately 90% peripheral target engagement at 3 h post-dose, and sustained RIPK1 inhibition over the 10-day treatment period. The promising safety, pharmacokinetic, and pharmacodynamic profile of SIR9900 with central nervous system penetrating potential in healthy adult and elderly participants supports its further clinical development in patients with inflammatory and degenerative diseases, particularly in the central nervous system.</p>","PeriodicalId":50610,"journal":{"name":"Cts-Clinical and Translational Science","volume":"18 2","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cts.70151","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hemodynamic and Pharmacokinetic Interactions of TPN171 with Alcohol in Healthy Male Subjects
IF 3.1 3区 医学
Cts-Clinical and Translational Science Pub Date : 2025-02-17 DOI: 10.1111/cts.70165
Jie Cheng, Hongjie Qian, Yu Wang, Liyu Liang, Wenjing Xu, Ye Liu, Qian Chen, Chen Yu, Huaqing Duan, Zhen Wang, Hang Wang, Jingying Jia
{"title":"Hemodynamic and Pharmacokinetic Interactions of TPN171 with Alcohol in Healthy Male Subjects","authors":"Jie Cheng,&nbsp;Hongjie Qian,&nbsp;Yu Wang,&nbsp;Liyu Liang,&nbsp;Wenjing Xu,&nbsp;Ye Liu,&nbsp;Qian Chen,&nbsp;Chen Yu,&nbsp;Huaqing Duan,&nbsp;Zhen Wang,&nbsp;Hang Wang,&nbsp;Jingying Jia","doi":"10.1111/cts.70165","DOIUrl":"https://doi.org/10.1111/cts.70165","url":null,"abstract":"<p>This study aimed to evaluate the effects of the concomitant administration of TPN171 and alcohol on hemodynamic and pharmacokinetic characteristics in healthy Chinese male subjects. Fifteen eligible subjects were randomly assigned to one of three sequences, each comprising three treatments: Treatment A (placebo +0.5 g/kg alcohol), Treatment B (TPN171 + 0.5 g/kg alcohol), and Treatment C (TPN171 + placebo). Enrolled subjects were administered with 10 mg TPN171 and/or 0.5 g/kg alcohol in fasting state in a randomized crossover design. Blood pressure, pulse rate (PR), blood samples, and breath alcohol test were measured at designated time points for hemodynamic and pharmacokinetic analyses. Compared with 10 mg TPN171 alone, administration of 10 mg TPN171 + 0.5 g/kg alcohol significantly lowered the area under the effect–time curve from 0 to 4 h (AUEC<sub>0-4h</sub>) of systolic blood pressure (95% confidence interval [CI]: −29.75 to −0.83, <i>p</i> = 0.039) and significantly increased AUEC<sub>0–4h</sub> of PR (95% CI: 7.47–28.92, <i>p</i> = 0.003). Compared with 0.5 g/kg alcohol alone, administration of 10 mg TPN171 + 0.5 g/kg alcohol contributed to significantly higher maximal increase of PR (95% CI: 2.78–9.44, <i>p</i> = 0.002) and AUEC<sub>0-4h</sub> of PR (95% CI: 1.08–24.52, <i>p</i> = 0.035). Alcohol had no influence on the pharmacokinetics of TPN171, and vice versa. Though the concomitant administration of TPN171 and alcohol induced a more pronounced increase in PR, this did not result in clinical symptoms or heart rate increase-related adverse events, indicating that the combined use was generally safe and well-tolerated.</p>","PeriodicalId":50610,"journal":{"name":"Cts-Clinical and Translational Science","volume":"18 2","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cts.70165","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Participant-Centered Engagement for Sustained Adherence to Smartwatches: A 12-Month Prospective Decentralized Digital Health Study
IF 3.1 3区 医学
Cts-Clinical and Translational Science Pub Date : 2025-02-15 DOI: 10.1111/cts.70155
Angelina R. Wilton, Christina T. Saliba, Jean Marrero-Polanco, Katharine Sheffield, Quantia Wilkes, Miriam Anacker, Paul E. Croarkin, Mohit Chauhan, Liselotte N. Dyrbye, Sherry Chesak, William V. Bobo, Arjun P. Athreya
{"title":"Participant-Centered Engagement for Sustained Adherence to Smartwatches: A 12-Month Prospective Decentralized Digital Health Study","authors":"Angelina R. Wilton,&nbsp;Christina T. Saliba,&nbsp;Jean Marrero-Polanco,&nbsp;Katharine Sheffield,&nbsp;Quantia Wilkes,&nbsp;Miriam Anacker,&nbsp;Paul E. Croarkin,&nbsp;Mohit Chauhan,&nbsp;Liselotte N. Dyrbye,&nbsp;Sherry Chesak,&nbsp;William V. Bobo,&nbsp;Arjun P. Athreya","doi":"10.1111/cts.70155","DOIUrl":"https://doi.org/10.1111/cts.70155","url":null,"abstract":"<p>Adherence in digital health studies with extended observation periods (≥ 12 months) is limited, and participant retention considerably reduces with time. The US Food and Drug Administration has issued guidelines for improving participant engagement, adherence, and diversity in digital health studies combined with decentralized procedures. A decentralized digital health study on well-being was designed with protocolized procedures to study the feasibility of participant engagement and technology support to facilitate adherence (wearing the smartwatch ≥ 70% of time) sustained over a 12-month period. At the end of the study, participants were asked about their ease of participation and free-response questions about how wearing the smartwatches impacted their physical wellness. An inductive thematic analysis (ITA) was performed to assess themes of those responses and association with adherence. A total of 298 participants were recruited between 2022 and 2023 (<i>n</i> = 129 in Cohort A in October 22, <i>n</i> = 169 in Cohort B in April 23), with 23% non-white participants accrued. Among the 298 participants accrued, 273 (92% of accrued participants) completed the 12-month study with an average overall adherence of 77.4% (SD = 32.64) wear-time across 12 months. Median adherence of participants whose responses exemplified an ITA theme encompassing perceived behavior changes in sleep and physical activity was higher than those who did not have a response exemplifying that theme. Conversely, those expressing perceived discomfort or intrusiveness of the smartwatch had a statistically lower adherence. These results highlight the crucial roles of technology support and robust engagement efforts to enable sustained adherence over extended follow-up periods in decentralized digital health studies.</p>","PeriodicalId":50610,"journal":{"name":"Cts-Clinical and Translational Science","volume":"18 2","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cts.70155","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143423699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Risk of major adverse cardiovascular events in CYP2C19 LoF genotype guided clopidogrel against alternative antiplatelets for CAD patients undergoing PCI: Meta-analysis
IF 3.1 3区 医学
Cts-Clinical and Translational Science Pub Date : 2025-02-14 DOI: 10.1111/cts.70080
Mohitosh Biswas, Murshadul Alam Murad, Maliheh Ershadian, Most Sumaiya Khatun Kali, Chonlaphat Sukasem
{"title":"Risk of major adverse cardiovascular events in CYP2C19 LoF genotype guided clopidogrel against alternative antiplatelets for CAD patients undergoing PCI: Meta-analysis","authors":"Mohitosh Biswas,&nbsp;Murshadul Alam Murad,&nbsp;Maliheh Ershadian,&nbsp;Most Sumaiya Khatun Kali,&nbsp;Chonlaphat Sukasem","doi":"10.1111/cts.70080","DOIUrl":"https://doi.org/10.1111/cts.70080","url":null,"abstract":"<p>Selection of rational antagonists of P2Y<sub>12</sub> receptor for CAD patients who inherit <i>CYP2C19</i> LoF alleles remains still conflicting. This study compared the clinical outcomes in CAD patients inheriting <i>CYP2C19</i> LoF alleles undergoing PCI and treated with clopidogrel against alternative antagonists of P2Y<sub>12</sub> receptor. A thorough literature search was performed across multiple scientific databases following the PRISMA guidelines and PICO model. Setting the statistical significance at <i>p</i> &lt; 0.05 and RevMan software was used to calculate the risk ratios (RRs). Estimation of the pooled analysis revealed a significant 62% increased risk of major adverse cardiovascular events (MACE) in CAD patients inheriting <i>CYP2C19</i> LoF alleles and treated with clopidogrel against those treated with alternative P2Y<sub>12</sub> receptor antagonists such as prasugrel or ticagrelor (RR 1.62; 95% CI 1.42–1.86; <i>p</i> &lt; 0.00001). In addition, Asian CAD patients were found at a significantly higher risk of MACE (RR 1.93; 95% CI: 1.49–2.49; <i>p</i> &lt; 0.00001) juxtaposed to CAD patients of other ethnicities (RR 1.51; 95% CI: 1.29–1.78; <i>p</i> &lt; 0.00001). Conversely, between these two treatment groups, taking clopidogrel against prasugrel/ticagrelor, who possess <i>CYP2C19</i> LoF alleles, no significant differences in bleeding events were observed (RR 0.94; 95% CI 0.79–1.11; <i>p</i> = 0.47). CAD patients undergoing PCI who inherited <i>CYP2C19</i> LoF alleles and treated with clopidogrel were associated with significantly higher risk of MACE against those treated with alternative antagonists of P2Y<sub>12</sub> receptor, that is, prasugrel or ticagrelor.</p>","PeriodicalId":50610,"journal":{"name":"Cts-Clinical and Translational Science","volume":"18 2","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cts.70080","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143423741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Global Trends in the Value of Author Order Across Medical Publications: A Cross-Sectional Bibliometric Study 医学出版物作者订单价值的全球趋势:跨部门文献计量学研究
IF 3.1 3区 医学
Cts-Clinical and Translational Science Pub Date : 2025-02-13 DOI: 10.1111/cts.70157
Hidenori Hashimoto, Miwa Sekine, Yuji Nishizaki, David Aune, Atsushi Mizuno, Yasuhiro Homma, Yasuhiko Kiyama, Shoji Sanada, Shigeki Aoki
{"title":"Global Trends in the Value of Author Order Across Medical Publications: A Cross-Sectional Bibliometric Study","authors":"Hidenori Hashimoto,&nbsp;Miwa Sekine,&nbsp;Yuji Nishizaki,&nbsp;David Aune,&nbsp;Atsushi Mizuno,&nbsp;Yasuhiro Homma,&nbsp;Yasuhiko Kiyama,&nbsp;Shoji Sanada,&nbsp;Shigeki Aoki","doi":"10.1111/cts.70157","DOIUrl":"https://doi.org/10.1111/cts.70157","url":null,"abstract":"<p>This study aimed to analyse the value of author order across countries, within the ‘Medicine General Internal’ and ‘Surgery’ fields, to enhance transparency and fairness in academic evaluations, particularly in international collaborative research. A cross-sectional bibliometric study was conducted using data from 2,845,748 papers published in 2022 across over 18,000 journals listed on Web of Science. The study focused on 124,736 papers from the ‘Medicine General Internal’ and ‘Surgery’ fields published in the top 19 countries. The analysis examined the position of the corresponding author relative to other co-authors by country and specialty. Hierarchical clustering was applied to identify patterns and group countries based on author order. Three distinct clusters were identified with regard to the corresponding author's position. In Cluster A (South Korea, China and Taiwan), the corresponding author was often the last author. In Cluster B (India, Japan, Italy, Türkiye and Spain), the corresponding author was frequently the second author. Cluster C (the United States, England and Germany) included countries where the corresponding author was typically the first author. The findings underscore the need for clear, internationally accepted author order standards. Establishing such standards is crucial for promoting fairness, transparency and efficiency in international collaborative research and for ensuring equitable scientific communication.</p>","PeriodicalId":50610,"journal":{"name":"Cts-Clinical and Translational Science","volume":"18 2","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cts.70157","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143396833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pharmacokinetics of SARS-CoV-2 RNA Polymerase Inhibitor Remdesivir in Participants With Moderate and Severe Hepatic Impairment SARS-CoV-2 RNA 聚合酶抑制剂 Remdesivir 在中度和重度肝功能不全患者中的药代动力学研究
IF 3.1 3区 医学
Cts-Clinical and Translational Science Pub Date : 2025-02-13 DOI: 10.1111/cts.70159
Sean Regan, Rita Humeniuk, Luzelena Caro, Mazin Abdelghany, Santosh Davies, Amarylliz Baysa, Gong Shen, Robert H. Hyland, Aryun Kim
{"title":"Pharmacokinetics of SARS-CoV-2 RNA Polymerase Inhibitor Remdesivir in Participants With Moderate and Severe Hepatic Impairment","authors":"Sean Regan,&nbsp;Rita Humeniuk,&nbsp;Luzelena Caro,&nbsp;Mazin Abdelghany,&nbsp;Santosh Davies,&nbsp;Amarylliz Baysa,&nbsp;Gong Shen,&nbsp;Robert H. Hyland,&nbsp;Aryun Kim","doi":"10.1111/cts.70159","DOIUrl":"https://doi.org/10.1111/cts.70159","url":null,"abstract":"<p>Remdesivir is an RNA polymerase inhibitor of severe acute respiratory syndrome coronavirus 2 administered intravenously (IV) that is approved for the treatment of coronavirus disease 2019 in hospitalized and nonhospitalized patients. The clinical dosing regimen is a single loading dose of 200 mg on Day 1 followed by once-daily maintenance doses of 100 mg from Day 2, for a total duration of up to 10 days. The prodrug, remdesivir, undergoes metabolic activation inside the cell to form the intracellular active metabolite (GS-443902) along with two plasma metabolites (GS-704277 and GS-441524). The pharmacokinetics and safety of a single IV 100-mg dose of remdesivir were evaluated in a Phase 1, open-label, multicenter study in participants with moderate (<i>n</i> = 10) or severe (<i>n</i> = 6) hepatic impairment (Child–Pugh–Turcotte Class B or C, respectively) and participants with normal liver function (<i>n</i> = 16). Compared with the normal hepatic function group, plasma exposures (geometric least squares mean ratios of area under the concentration–time curve extrapolated to infinity and maximum concentration) of remdesivir, GS-704277, and GS-441524 were similar in the moderate hepatic impairment group and up to 1.56-fold, 2.41-fold, and 1.48-fold higher, respectively, in the severe hepatic impairment group. Remdesivir was generally safe and well tolerated in hepatically impaired individuals, and the modest exposure increases of remdesivir and its metabolites were not associated with adverse events. Based on these findings, no dose adjustment of remdesivir is recommended for patients with mild, moderate, or severe hepatic impairment.</p>","PeriodicalId":50610,"journal":{"name":"Cts-Clinical and Translational Science","volume":"18 2","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cts.70159","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143396834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Emapalumab in Patients With Macrophage Activation Syndrome Associated With Still's Disease: A Population Pharmacokinetic/Pharmacodynamic Analysis 埃马帕鲁单抗在与斯蒂尔病相关的巨噬细胞活化综合征患者中的应用:群体药代动力学/药效学分析
IF 3.1 3区 医学
Cts-Clinical and Translational Science Pub Date : 2025-02-13 DOI: 10.1111/cts.70163
Patrick Brossard
{"title":"Emapalumab in Patients With Macrophage Activation Syndrome Associated With Still's Disease: A Population Pharmacokinetic/Pharmacodynamic Analysis","authors":"Patrick Brossard","doi":"10.1111/cts.70163","DOIUrl":"https://doi.org/10.1111/cts.70163","url":null,"abstract":"<p>Macrophage activation syndrome (MAS) is a life-threatening form of secondary haemophagocytic lymphohistiocytosis (HLH) associated with rheumatic diseases, most commonly Still's disease. This study aimed to develop a population pharmacokinetic (PK)/pharmacodynamic (PD) model for emapalumab, a fully human monoclonal antibody that targets interferon-gamma (IFNγ), in patients with MAS associated with Still's disease. A two-compartment disposition model based on data from patients with primary HLH administered emapalumab (1 mg/kg every 3 days, with possible increases to 3, 6 or 10 mg/kg) was re-estimated for patients with MAS administered emapalumab (6 mg/kg, then 3 mg/kg every 3 days until day 15 and twice weekly until day 28). An exploratory population PK/PD analysis comprising patients' PD data for total IFNγ, chemokine C-X-C motif ligand 9 (CXCL9) and ferritin was performed. Emapalumab clearance was generally linear and independent of total IFNγ levels in patients with MAS (<i>n</i> = 14). Estimated baseline levels of CXCL9 (a marker of IFNγ activity), soluble interleukin-2 receptor α (sIL-2Rα; a marker of hyperinflammation) and ferritin (a clinical marker of MAS disease activity) were 8400, 6550 and 15,300 μg/L, respectively. All three PD markers responded rapidly to changes in emapalumab concentration. Emapalumab almost completely suppressed CXCL9, sIL2-Rα, and ferritin production (estimated reduction in synthesis rate: 98.3%, 87%, and 99.6%, respectively). Population PK/PD modeling indicated that emapalumab rapidly suppresses markers of hyperinflammation in patients with MAS associated with Still's disease. Emapalumab dosing regimen used in clinical trials in patients with MAS is unlikely to need adjustment.</p>","PeriodicalId":50610,"journal":{"name":"Cts-Clinical and Translational Science","volume":"18 2","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cts.70163","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143396835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bioequivalence of Aripiprazole Oral Soluble Films and Orally Disintegrating Tablets in Healthy Participants: A Crossover Study
IF 3.1 3区 医学
Cts-Clinical and Translational Science Pub Date : 2025-02-12 DOI: 10.1111/cts.70142
Ruoming Li, Shaojie Yang, Guigang Yang, Xingli Gu, Zuokai Zhang, Taixin Wang, Yunlong Tan, Song Chen
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