Rizwan Qaisar, Asima Karim, Shaea A Alkahtani, Imran Ullah Khan, Firdos Ahmad
{"title":"The improvement in muscle function following statin withdrawal might involve the repair of the neuromuscular junction.","authors":"Rizwan Qaisar, Asima Karim, Shaea A Alkahtani, Imran Ullah Khan, Firdos Ahmad","doi":"10.1002/bcp.70065","DOIUrl":"https://doi.org/10.1002/bcp.70065","url":null,"abstract":"<p><strong>Aims: </strong>The effects and relative mechanisms of statin usage and withdrawal on subjective and objective muscle functions are poorly known. We investigated the associations of neuromuscular junction (NMJ) degradation to muscle impairment in older adults taking statins.</p><p><strong>Methods: </strong>We recruited male controls (n = 82) and statin users (n = 76) for measuring handgrip strength (HGS), body composition, gait speed, short physical performance battery (SPPB), statin-associated muscle symptoms (SAMS) and plasma c-terminal agrin fragment-22 (CAF22; a marker of NMJ degradation). The statin users were evaluated at baseline, 1 year after statin usage and 6 months after statin withdrawal.</p><p><strong>Results: </strong>One year of statin usage was associated with lower HGS, gait speed, SPPB scores and higher SAMS scores and plasma CAF22 levels (all P < .05). Conversely, 6 months after statin withdrawal, gait speed and SPPB scores were restored with a concurrent reduction in SAMS and CAF22 levels (all P < .05). Correlation analysis revealed significant correlations of plasma CAF22 with HGS, SPPB and SAMS after statin usage and withdrawal (all P < .05). Lastly, statin withdrawal also reduced the plasma creatine kinase levels (P < .05).</p><p><strong>Conclusion: </strong>Altogether, statin usage was associated with muscle and physical decline and an increase in CAF22 and SAMS, which were partly restored after statin withdrawal. Our findings suggest a role for NMJ plasticity in muscle restoration following statin withdrawal.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yuhan Jiang, Ju Guo, Xueming Yao, Zixuan Wang, Yifan Wang, Ruiwen Xia, Shaoqian Zhang, Hongxi Yang, Yingxue Zou
{"title":"The impact of early-life and prolonged antibiotics exposure on 78 common diseases: Evidence from epidemiology.","authors":"Yuhan Jiang, Ju Guo, Xueming Yao, Zixuan Wang, Yifan Wang, Ruiwen Xia, Shaoqian Zhang, Hongxi Yang, Yingxue Zou","doi":"10.1002/bcp.70055","DOIUrl":"https://doi.org/10.1002/bcp.70055","url":null,"abstract":"<p><strong>Background: </strong>Early-life and prolonged exposure to antibiotics has been associated with various health issues. This study aimed to explore the relationship between early-life antibiotic exposure and different health outcomes from the perspective of epidemiology.</p><p><strong>Methods: </strong>Using electronic hospital records, questionnaire data and genotype information from the UK Biobank, this study analysed 158 391 individuals with early-life and prolonged antibiotics exposure to investigate its association with 78 common diseases. After adjusting for covariates, we conducted an observational study to explore the relationships between antibiotic use and various diseases. Subsequently, a genome-wide association analysis was performed on early-life and prolonged antibiotics use, and eight Mendelian randomization methods were applied with instrumental variables to account for confounding factors and explore potential causal relationships.</p><p><strong>Results: </strong>In our observational study involving 78 common diseases, our findings revealed significant associations between exposure to antibiotics during early life and 42 diseases, after correcting the false discovery rate. Among these, 8 diseases demonstrated causal evidence. These diseases include type-2 diabetes (odds ratio [OR] with 95% confidence interval [95% CI] = 1.27 [1.18, 1.36], P = 4.8 × 10<sup>-11</sup>), depression (OR = 1.77 [1.67, 1.89], P = 2.2 × 10<sup>-72</sup>), inflammatory bowel disease (OR = 1.28 [1.14, 1.45], P = 6.2 × 10<sup>-5</sup>), polymyalgia rheumatica (OR = 1.28 [1.07, 1.53], P = 6.4 × 10<sup>-3</sup>), giant cell arteritis (OR = 1.55 [1.12, 2.14], P = 7.5 × 10<sup>-3</sup>), sciatica (OR = 1.54 [1.35, 1.76], P = 8.3 × 10<sup>-11</sup>), cystitis (OR = 1.51 [1.31, 1.74], P = 8.1 × 10<sup>-9</sup>) and bronchiectasis (OR = 2.70 [2.37, 3.06], P = 9.7 × 10<sup>-52</sup>).</p><p><strong>Conclusion: </strong>This study revealed the enduring and detrimental effects of prolonged antibiotic usage during early life, which can potentially result in the development of diseases across multiple bodily systems.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joshua T Myers, Alyson Yamaguchi, April Toledo Vo, Anvesh Dasari, Archana Battiwala, Nidhi Patel, Leonard C Fung, Ofer M Gonen, Mir Imran, Jacques Van Dam, Mir A Hashim, Arvinder K Dhalla, John P Bilezikian
{"title":"An oral robotic pill reliably and safely delivers teriparatide with high bioavailability in healthy volunteers: A phase 1 study.","authors":"Joshua T Myers, Alyson Yamaguchi, April Toledo Vo, Anvesh Dasari, Archana Battiwala, Nidhi Patel, Leonard C Fung, Ofer M Gonen, Mir Imran, Jacques Van Dam, Mir A Hashim, Arvinder K Dhalla, John P Bilezikian","doi":"10.1002/bcp.70064","DOIUrl":"https://doi.org/10.1002/bcp.70064","url":null,"abstract":"<p><strong>Aims: </strong>The incidence of osteoporosis is projected to exceed 70 million people over the age of 65 years by 2030. Osteoanabolic agents, such as teriparatide and abaloparatide, are not only effective in reducing fracture incidence but also improve skeletal microstructure-an important need not met by antiresorptive agents. However, anabolic agents must be administered by daily subcutaneous injections which can be a challenge in older women. To address this need, we have developed an oral robotic pill (RP) designed to deliver biotherapeutics safely and painlessly.</p><p><strong>Methods: </strong>This report describes the results of a 2-part Phase 1 study conducted to evaluate the safety, tolerability and pharmacokinetics of single (Part 1) and repeat doses (Part 2) of teriparatide delivered via the RP (RT-102) in healthy and postmenopausal women.</p><p><strong>Results: </strong>Teriparatide, administered by the RP, was measurable in 26/29 and 63/69 of participants in Part 1 and Part 2, respectively. RT-102 at the 20-μg dose yielded a lower maximum observed serum concentration (98 ± 10 vs. 128 ± 20 pg mL<sup>-1</sup>), delayed time to reach maximum observed serum concentration (68 ± 15 vs. 13 ± 2 min) and higher area under the curve to infinity (342 ± 44 vs. 126 ± 29 h pg mL<sup>-1</sup>) resulting in a 3-fold higher bioavailability than subcutaneous injection. RT-102 was well tolerated with only 5 mild to moderate adverse events (AEs) related to the RP that resolved without intervention and no serious AEs. Drug-related AEs were similar in severity and frequency between RT-102 and subcutaneous teriparatide.</p><p><strong>Conclusion: </strong>These data demonstrate that RT-102 can safely and reliably deliver therapeutic levels of teriparatide.</p><p><strong>Clinicaltrials: </strong>GOV: NCT#05164614.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ida M Heerfordt, Ditte Resendal Gotfredsen, Henrik Horwitz, Anette Kirstine Stark, Jon Trærup Andersen, Christina Gade, Ulrik Lausten-Thomsen, Rasmus Huan Olsen
{"title":"EudraVigilance insights: Suspected adverse drug reactions in infants through breastfeeding.","authors":"Ida M Heerfordt, Ditte Resendal Gotfredsen, Henrik Horwitz, Anette Kirstine Stark, Jon Trærup Andersen, Christina Gade, Ulrik Lausten-Thomsen, Rasmus Huan Olsen","doi":"10.1002/bcp.70063","DOIUrl":"https://doi.org/10.1002/bcp.70063","url":null,"abstract":"<p><strong>Aims: </strong>We aimed to describe suspected adverse drug reactions (ADRs) in infants resulting from medications transmitted through mothers' milk, as reported to the European ADR database, EudraVigilance. The research sought to understand the frequency, seriousness and nature of these ADRs to assess potential risks associated with maternal medication use during breastfeeding.</p><p><strong>Methods: </strong>Data from EudraVigilance were analysed. The study included all reported ADRs suspected to be related to medications transmitted through mothers' milk from 1 January 2013 to 1 July 2023. The data were categorized by reporting time, infant age and sex, seriousness and type of ADR, and the medications involved.</p><p><strong>Results: </strong>A total of 922 suspected ADRs were reported in breastfed infants. Serious ADRs accounted for 133 cases (14%), with 15 reported fatalities, primarily associated with methadone (n = 11) and diamorphine (n = 3). COVID-19 vaccines were linked to half of the suspected ADR reports (n = 479, 52%), while serious ADRs were mainly associated with nervous system drugs (n = 73, 43%), particularly anticonvulsants and opioids. Most cases (n = 511, 55%) occurred in infants aged between 1 month and 1 year.</p><p><strong>Conclusions: </strong>The reporting of 922 ADRs in breastfed infants over a decade, compared to the estimated millions of infants exposed to medications via mothers' milk annually in Europe, suggests a very low reporting rate of suspected ADRs. This finding emphasizes the significant challenges in postmarketing surveillance and suggests that underreporting remains a critical concern in pharmacovigilance.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Space travel-associated motion sickness and its treatment.","authors":"Jay C Buckey, Mimi Lan, Lionel D Lewis","doi":"10.1002/bcp.70056","DOIUrl":"https://doi.org/10.1002/bcp.70056","url":null,"abstract":"<p><p>On Earth, motion sickness is often just a nuisance that can spoil a car ride, fishing trip, or visit to an amusement park. In space, however, motion sickness can be hazardous. Vomiting due to motion sickness while in a space suit could lead to aspiration, poor visibility and damage to space suit systems. The effects motion sickness has on alertness and mental performance are undesirable when critical operations are underway. Although motion sickness has been an issue for space travellers since the beginning of human space exploration, the range of medications and routes of administration have not changed appreciably since the early days of spaceflight, which spans more than 40 years. This review presents the main therapeutics available for space-induced motion sickness, the routes of administration available, and the challenges for administering them in space while minimizing major side effects.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evaluation of the acute effects of single-dose TPN171 on semen quality in healthy Chinese male volunteers.","authors":"Yuzhuo Yang, Zhe Zhang, Lei Li, Zhicheng Jiang, Jiaxiang Juan, Huaqing Duan, Zhen Wang, Hui Jiang","doi":"10.1002/bcp.70049","DOIUrl":"https://doi.org/10.1002/bcp.70049","url":null,"abstract":"<p><strong>Aims: </strong>TPN171 is a novel phosphodiesterase type 5 inhibitor for the treatment of erectile dysfunction. This study aimed to assess the immediate impact of a single dose of TPN171 (10 mg) on semen quality in healthy male Chinese volunteers. Additionally, the study investigated the exposure of TPN171 in seminal plasma and observed the safety of TPN171 in the participants.</p><p><strong>Methods: </strong>Eighteen healthy male volunteers were enrolled in this double-blind, randomized, placebo-controlled, 2-period, 2-sequence, crossover study. Semen samples were collected to compare semen parameters between the TPN171 and placebo groups. The concentrations of TPN171 were measured in seminal plasma and blood plasma to calculate the ratio of TPN171 concentration in seminal plasma to that in blood plasma, along with the exposure level and percentage of TPN171 in the seminal plasma.</p><p><strong>Results: </strong>The administration of a single 10-mg dose of TPN171 did not result in statistically significant effects on sperm motility, count, density, morphology, viscosity or volume in healthy male Chinese volunteers. The ratio of TPN171 concentration in seminal plasma to that in blood plasma was 0.72, with the amount of TPN171 in the seminal plasma measured at 78.5 ng. The percentage of exposure to the administered dose (10 mg) was 0.00085%. No adverse events were reported in the TPN171 group.</p><p><strong>Conclusion: </strong>The findings indicate that a single oral dose of 10 mg TPN171 did not induce acute effects on semen quality in healthy male Chinese volunteers. The exposure of seminal plasma to TPN171 was <0.001% of the administered dose.</p><p><strong>Clinical trial registration number: </strong>NCT05585931.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bo-Hao Tang, Shu-Meng Fu, Li-Yuan Tian, Xin-Fang Zhang, Bu-Fan Yao, Wei Zhang, Yue-E Wu, Yue Zhou, Ya-Kun Wang, Guo-Xiang Hao, John van den Anker, Yi Zheng, Wei Zhao
{"title":"Machine learning approach for dosage individualization of azithromycin in children with community-acquired pneumonia.","authors":"Bo-Hao Tang, Shu-Meng Fu, Li-Yuan Tian, Xin-Fang Zhang, Bu-Fan Yao, Wei Zhang, Yue-E Wu, Yue Zhou, Ya-Kun Wang, Guo-Xiang Hao, John van den Anker, Yi Zheng, Wei Zhao","doi":"10.1002/bcp.70050","DOIUrl":"https://doi.org/10.1002/bcp.70050","url":null,"abstract":"<p><strong>Aims: </strong>The uncertainty about the efficacy and safety of currently used azithromycin dosing regimens in children warrants individualized therapy. The area under the plasma concentration-time curve over 24 h (AUC<sub>0-24</sub>) of azithromycin correlates best with its effectiveness. The aim of this study was to evaluate the ability of machine learning (ML) to predict the AUC<sub>0-24</sub> of azithromycin in children with community-acquired pneumonia.</p><p><strong>Methods: </strong>Various ML algorithms were used to build ML models based on simulated pharmacokinetic profiles from a published population pharmacokinetic model. A priori-ML model predicted AUC<sub>0-24</sub> using patients' characteristics and after the trough concentration (C<sub>0</sub>) became available, a posteriori-ML model was built for improved prediction. Statistical methods and pharmacodynamic (PD) evaluation methods were used to evaluate the ML model's predictive accuracy in a real-world study. ML-optimized doses were evaluated by calculating the probability of PD target attainment in virtual trials compared with guideline-recommended doses.</p><p><strong>Results: </strong>The AUC<sub>0-24</sub> can be predicted by priori-ML model using the CatBoost algorithm with dosing regimen and two covariates as predictors (weight, alanine aminotransferase) before initial administration. A posteriori-ML model using CatBoost algorithm was built with adding C<sub>0</sub> as a predictor. In real-world validation, the mean absolute prediction error of the priori-ML and posteriori-ML models was less than 30%. The accuracy (determining whether the PD target is met) of the priori-ML model was 76.3%, whereas that of the posteriori-ML model increased to 90.4%.</p><p><strong>Conclusions: </strong>ML models were established to predict the AUC<sub>0-24</sub> of azithromycin successfully and could be used for individual dose adjustment in children before treatment and after obtaining C<sub>0</sub>.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Soyoung Park, Ah Young Lee, Jonghyun Jeong, Kyu-Nam Heo, Ji Min Han, Young-Mi Ah, Ju-Yeun Lee
{"title":"Incidence and spectrum of typical complications associated with immunosuppressant use in rheumatic disease: A nationwide retrospective study.","authors":"Soyoung Park, Ah Young Lee, Jonghyun Jeong, Kyu-Nam Heo, Ji Min Han, Young-Mi Ah, Ju-Yeun Lee","doi":"10.1002/bcp.70054","DOIUrl":"https://doi.org/10.1002/bcp.70054","url":null,"abstract":"<p><strong>Aim: </strong>To estimate the incidence and characteristics of typical complications associated with immunosuppressant therapy across various types of rheumatic disease (RD).</p><p><strong>Methods: </strong>We conducted a retrospective analysis using Korean claims data, including patients who were first diagnosed with rheumatic disease (rheumatoid arthritis, spondyloarthrosis, lupus erythematosus, vasculitis, sclerosis, Sjögren's syndrome, and polymyalgia rheumatica) and initiated immunosuppressant therapy between 2015 and 2018. We focused on several typical complications, including infections, cancer, cardiovascular complications, bone marrow suppression, gastrointestinal complications, diabetes, interstitial lung disease, demyelinating disease, acute kidney injury, and hepatotoxicity.</p><p><strong>Results: </strong>Among 464 753 patients prescribed immunosuppressants, 59 548 initiated treatment following their RD diagnosis. The most prevalent complications included opportunistic infections (60.6 events per 1000 person-years), serious infections (41.1), hypertension (31.5), diabetes (18.3), and cancer (14.1). Most complications peaked in the first month after treatment initiation. While the risk of serious infections and cancer increased with age, the incidence of opportunistic infections did not significantly vary. Furthermore, risk of serious infection or cancer did not significantly differ among RD types.</p><p><strong>Conclusions: </strong>This investigation elucidated the incidence and spectrum of typical complications associated with immunosuppressants among patients with RD, using a vast real-world dataset to highlight key safety concerns.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Best fit framework synthesis of qualitative studies on factors associated with medication nonadherence in people with type 2 diabetes using the COM-B model.","authors":"Vivien Teo, John Weinman, Kai Zhen Yap","doi":"10.1002/bcp.70059","DOIUrl":"https://doi.org/10.1002/bcp.70059","url":null,"abstract":"<p><p>This review aimed to synthesize factors associated with medication nonadherence among people with type 2 diabetes (PwT2D), using the Capability, Opportunity, Motivation and Behaviour (COM-B) model as the a priori model. Studies published between January 2014 and April 2024 were searched on five databases. Studies were included if they recruited PwT2D aged >18 years, investigated factors associated with adherence to oral and/or nonoral medications for diabetes, used qualitative research methods, were conducted in a community setting, were in English language and had accessible full-text articles. Best fit framework synthesis was undertaken, which led to the development of a hypothesized COM-B variant model specific to medication nonadherence among PwT2D. Study quality was assessed using published criteria to evaluate whether the study was adequately reported. Twenty-two studies were included. Factors were mapped onto the COM-B model: physical capability (e.g., difficulty injecting insulin independently), psychological capability (e.g., understanding about diabetes), physical opportunity (e.g., cost of medication), social opportunity (e.g., quality of communication and relationship with healthcare providers), automatic motivation (e.g., habit formation) and reflective motivation (e.g., perceived necessity and effectiveness of medications). Reflective motivation had the most themes, while physical capability only had one theme. Personality was a theme that could not be mapped onto the model. Interactions between some COM-B components (e.g., capability and motivation) were observed. This theoretically grounded synthesis may facilitate future intervention development by formulating a programme theory and identifying behaviour change techniques to address the identified factors.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yuhao Wang, Chao Yu, Mengyue Hu, Lu Wang, Meixia Chen, Hanmo Liu, Nan Wu, Jie Hou
{"title":"Safety, tolerability, pharmacokinetics and pharmacodynamics of HSK31858, a novel oral dipeptidyl peptidase-1 inhibitor, in healthy volunteers: An integrated phase 1, randomized, double-blind, placebo-controlled, single- and multiple-ascending dose study.","authors":"Yuhao Wang, Chao Yu, Mengyue Hu, Lu Wang, Meixia Chen, Hanmo Liu, Nan Wu, Jie Hou","doi":"10.1002/bcp.70027","DOIUrl":"https://doi.org/10.1002/bcp.70027","url":null,"abstract":"<p><strong>Aim: </strong>Dipeptidyl peptidase-1 (DPP-1) inhibitors have been studied for the treatment of neutrophil-mediated inflammatory diseases including bronchiectasis, bronchial asthma and cystic fibrosis. This study evaluated the pharmacokinetics, pharmacodynamics, safety and tolerability of DPP-1 inhibitor HSK31858 in healthy Chinese volunteers.</p><p><strong>Methods: </strong>Volunteers in Part A randomly received single doses of HSK31858 (15, 40, 60 and 80 mg) or placebo in fasted states. The 40-mg cohort also received HSK31858 40 mg or placebo in fed states. In Part B, volunteers randomly received HSK31858 10, 20 and 40 mg or placebo once daily for 28 days in fasted states. The primary endpoints were safety and tolerability of HSK31858.</p><p><strong>Results: </strong>Among 38 volunteers in Part A and 36 in Part B, HSK31858 was well tolerated; no deaths, serious adverse events, or discontinuations due to adverse events occurred. The median T<sub>max</sub> was 0.75 to 1.0 h and the mean terminal t<sub>1/2</sub> was 16.5 to 21.0 h in the fasted state with single doses of HSK31858. Both C<sub>max</sub> and AUC<sub>0-t</sub> exhibited a dose-dependent rise. Food had no effect on AUC. Multiple doses of HSK31858 demonstrated a similar pharmacokinetics profile, with about 2-fold accumulation in AUC. HSK31858 dose-dependently inhibited neutrophil count-normalized neutrophil elastase (NE<sub>norm</sub>) activity. The maximal percentage decrease in NE<sub>norm</sub> activity relative to baseline during 28 days of HSK31858 treatments was 13.6% and 76.4% with HSK31858 10 and 40 mg once-daily, respectively.</p><p><strong>Conclusion: </strong>HSK31858 was safe and well tolerated. The pharmacokinetics and pharmacodynamics profile of HSK31858 supports further clinical development for the treatment of neutrophil-mediated inflammatory diseases.</p><p><strong>Trial registration: </strong>NCT05663593.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}