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Liu J, Nagapudi K, Chiang PC. Evaluating Utilization of Tiny-TIM to Assess the Effect of Food on the Absorptions of Oral Drugs and Its Application on Biopharmaceutical Modeling. J Pharm Sci 2024; 113:1586-1596. [PMID: 38266915 DOI: 10.1016/j.xphs.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/12/2024] [Accepted: 01/12/2024] [Indexed: 01/26/2024]
Abstract
Safety and efficacy are the most critical factors for the development of modern medications. For oral drugs, evaluating drug exposure under various conditions is one of the most important outcomes for clinical trials. These data will help to better understand the safety and efficacy of new drugs. Studies involving potential drug-drug interactions, proton pump inhibitors, and intake of food are often conducted to assess the above. Among the above, the influence of food on exposure to the drug is one of the key data sets for regulatory submission. Since food may have either a positive or negative effect on drug exposure, it is important to obtain an early assessment of the food effect. To better forecast and plan for clinical studies, substantial efforts have been made in the industry to develop modeling and in-vitro and in-vivo assays. Despite the efforts, predicting the effect of food on exposure without integrating the dynamic of the gastrointestinal tract in the assessment remains challenging. In this study, we evaluated the utilization of the dynamic Gastro-Intestinal Model (Tiny-TIM) for the food effect of over 20 drugs/formulations in development or on the market that covers all BCS classes. In general, the Tiny-TIM predicted food effects were in good agreement with the reported data in humans. This suggests that Tiny-TIM can successfully capture the impact of physicochemical properties on absorption under the influence of food.
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Affiliation(s)
- Jia Liu
- Small Molecule Pharmaceutical Sciences, Genentech, 1 DNA Way, South San Francisco, CA 94080, USA.
| | - Karthik Nagapudi
- Small Molecule Pharmaceutical Sciences, Genentech, 1 DNA Way, South San Francisco, CA 94080, USA
| | - Po-Chang Chiang
- Small Molecule Pharmaceutical Sciences, Genentech, 1 DNA Way, South San Francisco, CA 94080, USA
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2
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Papasouliotis O, Mitchell D, Girard P, Dangond F, Dyroff M. Determination of a clinically effective evobrutinib dose: Exposure-response analyses of a phase II relapsing multiple sclerosis study. Clin Transl Sci 2022; 15:2888-2898. [PMID: 36126241 PMCID: PMC9747124 DOI: 10.1111/cts.13407] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/28/2022] [Accepted: 08/30/2022] [Indexed: 01/26/2023] Open
Abstract
The pharmacometric analysis of the double-blind, randomized, phase II study (NCT02975349) investigating the safety and efficacy of evobrutinib, explored exposure-response relationships and suitable dosing regimens of evobrutinib for relapsing multiple sclerosis. Population pharmacokinetic (PK)/pharmacodynamic modeling was applied to data collected in fasted patients treated with placebo or evobrutinib (25 mg once-daily [q.d.], 75 mg q.d., or 75 mg twice-daily [b.i.d.]) for 24 weeks, followed by a 24-week blinded extension (placebo patients switched to 25 mg q.d.). Model-based exposures for PK and Bruton's tyrosine kinase occupancy (BTKO) were used for exposure-response analyses (maximum 207 patients). PK, BTKO profiles, and annualized relapse rate (ARR) after 48 weeks of treatment under alternative dosing regimens were simulated. Exposure-response modeling identified a relationship between evobrutinib exposure and clinical response for total number of T1 Gd+ and new/enlarging T2 lesions at weeks 12-24, and ARR at week 48. Area under the concentration-time curve over 24 h at steady-state (AUC0-24,SS ) of 468 and ≥400 ng/ml h was associated with T1 Gd+/T2 lesion reduction and ARR improvement, respectively. These exposures were associated with steady-state (SS) predose BTKO ≥95%. Based on PK and BTKO profile simulations, evobrutinib 75 mg b.i.d. while fasted is predicted to maintain SS predose BTKO >95% in 92% of patients. Evobrutinib 45 mg b.i.d. with food is predicted to achieve similar exposure as 75 mg b.i.d. while fasted (predose BTKO >95% in 93% of patients). Evobrutinib 45 mg b.i.d. with food is predicted to have comparable exposure and BTKO to 75 mg b.i.d. without food (phase II) and will be pharmacologically effective and appropriate for clinical use in phase III multiple sclerosis studies.
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Affiliation(s)
- Orestis Papasouliotis
- Merck Institute for PharmacometricsLausanneSwitzerland, an affiliate of Merck KGaA, Darmstadt, Germany
| | | | - Pascal Girard
- Merck Institute for PharmacometricsLausanneSwitzerland, an affiliate of Merck KGaA, Darmstadt, Germany
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3
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Chan P, Peskov K, Song X. Applications of Model-Based Meta-Analysis in Drug Development. Pharm Res 2022; 39:1761-1777. [PMID: 35174432 PMCID: PMC9314311 DOI: 10.1007/s11095-022-03201-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/11/2022] [Indexed: 12/13/2022]
Abstract
Model-based meta-analysis (MBMA) is a quantitative approach that leverages published summary data along with internal data and can be applied to inform key drug development decisions, including the benefit-risk assessment of a treatment under investigation. These risk-benefit assessments may involve determining an optimal dose compared against historic external comparators of a particular disease indication. MBMA can provide a flexible framework for interpreting aggregated data from historic reference studies and therefore should be a standard tool for the model-informed drug development (MIDD) framework.In addition to pairwise and network meta-analyses, MBMA provides further contributions in the quantitative approaches with its ability to incorporate longitudinal data and the pharmacologic concept of dose-response relationship, as well as to combine individual- and summary-level data and routinely incorporate covariates in the analysis.A common application of MBMA is the selection of optimal dose and dosing regimen of the internal investigational molecule to evaluate external benchmarking and to support comparator selection. Two case studies provided examples in applications of MBMA in biologics (durvalumab + tremelimumab for safety) and small molecule (fenebrutinib for efficacy) to support drug development decision-making in two different but well-studied disease areas, i.e., oncology and rheumatoid arthritis, respectively.Important to the future directions of MBMA include additional recognition and engagement from drug development stakeholders for the MBMA approach, stronger collaboration between pharmacometrics and statistics, expanded data access, and the use of machine learning for database building. Timely, cost-effective, and successful application of MBMA should be part of providing an integrated view of MIDD.
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Affiliation(s)
- Phyllis Chan
- Clinical Pharmacology, Genentech, 1 DNA Way, South San Francisco, CA, 94080, USA.
| | - Kirill Peskov
- M&S Decisions LLC, Moscow, Russia
- Sechenov First Moscow State Medical University, Moscow, Russia
- STU 'Sirius', Sochi, Russia
| | - Xuyang Song
- Clinical Pharmacology and Quantitative Pharmacology, AstraZeneca, 1 Medimmune Way, Gaithersburg, MD, 20878, USA
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4
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Hopkins BT, Bame E, Bajrami B, Black C, Bohnert T, Boiselle C, Burdette D, Burns JC, Delva L, Donaldson D, Grater R, Gu C, Hoemberger M, Johnson J, Kapadnis S, King K, Lulla M, Ma B, Marx I, Magee T, Meissner R, Metrick CM, Mingueneau M, Murugan P, Otipoby KL, Polack E, Poreci U, Prince R, Roach AM, Rowbottom C, Santoro JC, Schroeder P, Tang H, Tien E, Zhang F, Lyssikatos J. Discovery and Preclinical Characterization of BIIB091, a Reversible, Selective BTK Inhibitor for the Treatment of Multiple Sclerosis. J Med Chem 2022; 65:1206-1224. [PMID: 34734694 DOI: 10.1021/acs.jmedchem.1c00926] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Multiple Sclerosis is a chronic autoimmune neurodegenerative disorder of the central nervous system (CNS) that is characterized by inflammation, demyelination, and axonal injury leading to permeant disability. In the early stage of MS, inflammation is the primary driver of the disease progression. There remains an unmet need to develop high efficacy therapies with superior safety profiles to prevent the inflammation processes leading to disability. Herein, we describe the discovery of BIIB091, a structurally distinct orthosteric ATP competitive, reversible inhibitor that binds the BTK protein in a DFG-in confirmation designed to sequester Tyr-551, an important phosphorylation site on BTK, into an inactive conformation with excellent affinity. Preclinical studies demonstrated BIB091 to be a high potency molecule with good drug-like properties and a safety/tolerability profile suitable for clinical development as a highly selective, reversible BTKi for treating autoimmune diseases such as MS.
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Affiliation(s)
- Brian T Hopkins
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Eris Bame
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Bekim Bajrami
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Cheryl Black
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Tonika Bohnert
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Carrie Boiselle
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Doug Burdette
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Jeremy C Burns
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Luisette Delva
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Douglas Donaldson
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Richard Grater
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Chungang Gu
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Marc Hoemberger
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Josh Johnson
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Sudarshan Kapadnis
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Kris King
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Mukesh Lulla
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Bin Ma
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Isaac Marx
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Tom Magee
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Robert Meissner
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Claire M Metrick
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Michael Mingueneau
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Paramasivam Murugan
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Kevin L Otipoby
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Evelyne Polack
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Urjana Poreci
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Robin Prince
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Allie M Roach
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Chris Rowbottom
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Joseph C Santoro
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Patricia Schroeder
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Hao Tang
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Eric Tien
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Fengmei Zhang
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
| | - Joseph Lyssikatos
- Research & Development, Biogen, Cambridge, Massachusetts 02142, United States
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5
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Optimization of a novel piperazinone series as potent selective peripheral covalent BTK inhibitors. Bioorg Med Chem Lett 2022; 60:128549. [PMID: 35041943 DOI: 10.1016/j.bmcl.2022.128549] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 01/04/2022] [Accepted: 01/11/2022] [Indexed: 11/23/2022]
Abstract
BTK is a tyrosine kinase playing an important role in B cell and myeloid cell functions through B cell receptor (BCR) signaling and Fc receptor (FcR) signaling. Selective inhibition of BTK has the potential to provide therapeutical benefits to patients suffering from autoimmune diseases. Here we report the design, optimization, and characterization of novel potent and highly selective covalent BTK inhibitors. Starting from a piperazinone hit derived from a selective reversible inhibitor, we solved the whole blood cellular potency issue by introducing an electrophilic warhead to reach Cys481. This design led to a covalent irreversible BTK inhibitor series with excellent kinase selectivity as well as excellent CD69 cellular potency. Optimization of metabolic stability led to representative compound like 42, which demonstrated strong cellular potency based on BTK target occupancy and the inhibition of B-cell proliferation as readouts of proximal and distal functional activity.
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6
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De Novellis D, Cacace F, Caprioli V, Wierda WG, Mahadeo KM, Tambaro FP. The TKI Era in Chronic Leukemias. Pharmaceutics 2021; 13:2201. [PMID: 34959482 PMCID: PMC8709313 DOI: 10.3390/pharmaceutics13122201] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 12/12/2022] Open
Abstract
Tyrosine kinases are proteins involved in physiological cell functions including proliferation, differentiation, and survival. However, the dysregulation of tyrosine kinase pathways occurs in malignancy, including hematological leukemias such as chronic myeloid leukemia (CML) and chronic lymphocytic leukemia (CLL). Particularly, the fusion oncoprotein BCR-ABL1 in CML and the B-cell receptor (BCR) signaling pathway in CLL are critical for leukemogenesis. Therapeutic management of these two hematological conditions was fundamentally changed in recent years, making the role of conventional chemotherapy nearly obsolete. The first, second, and third generation inhibitors (imatinib, dasatinib, nilotinib, bosutinib, and ponatinib) of BCR-ABL1 and the allosteric inhibitor asciminib showed deep genetic and molecular remission rates in CML, leading to the evaluation of treatment discontinuation in prospective trials. The irreversible BTK inhibitors (ibrutinib, acalabrutinib, zanubrutinib, tirabrutinib, and spebrutinib) covalently bind to the C481 amino acid of BTK. The reversible BTK inhibitor pirtobrutinib has a different binding site, overcoming resistance associated with mutations at C481. The PI3K inhibitors (idelalisib and duvelisib) are also effective in CLL but are currently less used because of their toxicity profiles. These tyrosine kinase inhibitors are well-tolerated, do have some associated in-class side effects that are manageable, and have remarkably improved outcomes for patients with hematologic malignancies.
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Affiliation(s)
- Danilo De Novellis
- Hematology and Transplant Center, University “Hospital San Giovanni di Dio e Ruggi D’Aragona”, 84131 Salerno, Italy
| | - Fabiana Cacace
- Unità Operativa di Trapianto di Cellule Staminali Ematopoietiche e Terapie Cellulari, Azienda Ospedaliera di Rilievo Nazionale Santobono-Pausilipon, 80123 Napoli, Italy; (F.C.); (V.C.); (F.P.T.)
| | - Valeria Caprioli
- Unità Operativa di Trapianto di Cellule Staminali Ematopoietiche e Terapie Cellulari, Azienda Ospedaliera di Rilievo Nazionale Santobono-Pausilipon, 80123 Napoli, Italy; (F.C.); (V.C.); (F.P.T.)
| | - William G. Wierda
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Kris M. Mahadeo
- Pediatric Stem Cell Transplantation and Cellular Therapy, CARTOX Program, University of Texas at MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Francesco Paolo Tambaro
- Unità Operativa di Trapianto di Cellule Staminali Ematopoietiche e Terapie Cellulari, Azienda Ospedaliera di Rilievo Nazionale Santobono-Pausilipon, 80123 Napoli, Italy; (F.C.); (V.C.); (F.P.T.)
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7
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McDonald C, Xanthopoulos C, Kostareli E. The role of Bruton's tyrosine kinase in the immune system and disease. Immunology 2021; 164:722-736. [PMID: 34534359 PMCID: PMC8561098 DOI: 10.1111/imm.13416] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 08/30/2021] [Accepted: 09/10/2021] [Indexed: 12/12/2022] Open
Abstract
Bruton's tyrosine kinase (BTK) is a TEC kinase with a multifaceted role in B-cell biology and function, highlighted by its position as a critical component of the B-cell receptor signalling pathway. Due to its role as a therapeutic target in several haematological malignancies including chronic lymphocytic leukaemia, BTK has been gaining tremendous momentum in recent years. Within the immune system, BTK plays a part in numerous pathways and cells beyond B cells (i.e. T cells, macrophages). Not surprisingly, BTK has been elucidated to be a driving factor not only in lymphoproliferative disorders but also in autoimmune diseases and response to infection. To extort this role, BTK inhibitors such as ibrutinib have been developed to target BTK in other diseases. However, due to rising levels of resistance, the urgency to develop new inhibitors with alternative modes of targeting BTK is high. To meet this demand, an expanding list of BTK inhibitors is currently being trialled. In this review, we synopsize recent discoveries regarding BTK and its role within different immune cells and pathways. Additionally, we discuss the broad significance and relevance of BTK for various diseases ranging from haematology and rheumatology to the COVID-19 pandemic. Overall, BTK signalling and its targetable nature have emerged as immensely important for a wide range of clinical applications. The development of novel, more specific and less toxic BTK inhibitors could be revolutionary for a significant number of diseases with yet unmet treatment needs.
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Affiliation(s)
- Charlotte McDonald
- The Wellcome‐Wolfson Institute for Experimental MedicineSchool of Medicine Dentistry and Biomedical SciencesQueen's University BelfastBelfastUK
| | - Charalampos Xanthopoulos
- The Wellcome‐Wolfson Institute for Experimental MedicineSchool of Medicine Dentistry and Biomedical SciencesQueen's University BelfastBelfastUK
| | - Efterpi Kostareli
- The Wellcome‐Wolfson Institute for Experimental MedicineSchool of Medicine Dentistry and Biomedical SciencesQueen's University BelfastBelfastUK
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8
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Tambaro FP, De Novellis D, Wierda WG. The Role of BTK Inhibition in the Treatment of Chronic Lymphocytic Leukemia: A Clinical View. J Exp Pharmacol 2021; 13:923-935. [PMID: 34744463 PMCID: PMC8565990 DOI: 10.2147/jep.s265284] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 10/08/2021] [Indexed: 01/08/2023] Open
Abstract
The B cell receptor (BCR) signaling pathway is functional and has critical cell survival implications in B cell malignancies, such as chronic lymphocytic leukemia (CLL). Orally administered small molecule tyrosine kinase inhibitors of members of the BCR signaling pathway have proven to be transformational in treatment of CLL. The first-generation inhibitor, ibrutinib, covalently binds to the C481 amino acid of Bruton's tyrosine kinase (BTK), thereby irreversibly inhibiting its kinase activity, and interferes with the biology of the cells, ultimately resulting in CLL cell death and therapeutic response. Remissions are not deep to the point of considering discontinuation for most patients, but BTK-inhibitor-based therapy provides exceptional long-term disease control with continuous treatment. There are in-class toxicities and more selective second- and subsequent-generation agents and reversible inhibitors have been developed with the intent of reducing toxicities. Also, strategies to subvert resistance have included tighter or alternative, non-covalent, inhibitor binding. Furthermore, other strategies to deplete BTK protein, such as degraders, are in development and being tested in the clinic. Ultimately, the development and approval of these agents targeting BTK have ushered in a new era of chemotherapy-free treatments with remarkably improved survival outcomes for patients with CLL.
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Affiliation(s)
- Francesco Paolo Tambaro
- Unità Operativa di Trapianto di Midollo Osseo e Servizio Trasfusionale, Azienda Ospedaliera di Rilievo Nazionale Santobono-Pausilipon, Napoli, Italy
| | - Danilo De Novellis
- Unità Operativa di Trapianto di Midollo Osseo e Servizio Trasfusionale, Azienda Ospedaliera di Rilievo Nazionale Santobono-Pausilipon, Napoli, Italy
- Department of Precision Medicine, University of Campania “L. Vanvitelli”, Napoli, Italy
| | - William G Wierda
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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9
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Xing Y, Chu KA, Wadhwa J, Chen W, Zhu J, Bradshaw JM, Shu J, Foulke MC, Loewenstein N, Nunn P, By K, Phiasivongsa P, Goldstein DM, Langrish CL. Preclinical Mechanisms of Topical PRN473, a Bruton Tyrosine Kinase Inhibitor, in Immune-Mediated Skin Disease Models. Immunohorizons 2021; 5:581-589. [PMID: 34326199 DOI: 10.4049/immunohorizons.2100063] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 07/02/2021] [Indexed: 11/19/2022] Open
Abstract
The expression of Bruton tyrosine kinase (BTK) in B cells and innate immune cells provides essential downstream signaling for BCR, Fc receptors, and other innate immune cell pathways. The topical covalent BTK inhibitor PRN473 has shown durable, reversible BTK occupancy with rapid on-rate and slow off-rate binding kinetics and long residence time, resulting in prolonged, localized efficacy with low systemic exposure in vivo. Mechanisms of PRN473 include inhibition of IgE (FcεR)-mediated activation of mast cells and basophils, IgG (FcγR)-mediated activation of monocytes, and neutrophil migration. In vivo, oral PRN473 was efficacious and well tolerated in the treatment of canine pemphigus foliaceus. In this study, we evaluated in vitro selectivity and functionality, in vivo skin Ab inflammatory responses, and systemic pharmacology with topically administered PRN473. Significant dose-dependent inhibition of IgG-mediated passive Arthus reaction in rats was observed with topical PRN473 and was maintained when given 16 h prior to challenge, reinforcing extended activity with once-daily administration. Similarly, topical PRN473 resulted in significant dose-dependent inhibition of the mouse passive cutaneous anaphylaxis IgE-mediated reaction. Multiday treatment with topical PRN473 in rodents resulted in low-to-no systemic accumulation, suggesting that efficacy was mainly due to localized exposure. Reduced skin Ab inflammatory activity was also confirmed with oral PRN473. These preclinical studies provide a strong biologic basis for targeting innate immune cell responses locally in the skin, with rapid onset of action following once-daily topical PRN473 administration and minimal systemic exposure. Dose-dependent inhibition in these preclinical models of immune-mediated skin diseases support future clinical studies.
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Affiliation(s)
- Yan Xing
- Principia Biopharma Inc., a Sanofi Company, South San Francisco, CA
| | - Katherine A Chu
- Principia Biopharma Inc., a Sanofi Company, South San Francisco, CA
| | - Jyoti Wadhwa
- Principia Biopharma Inc., a Sanofi Company, South San Francisco, CA
| | - Wei Chen
- Principia Biopharma Inc., a Sanofi Company, South San Francisco, CA
| | - Jiang Zhu
- Principia Biopharma Inc., a Sanofi Company, South San Francisco, CA
| | | | - Jin Shu
- Principia Biopharma Inc., a Sanofi Company, South San Francisco, CA
| | - Matthew C Foulke
- Principia Biopharma Inc., a Sanofi Company, South San Francisco, CA
| | | | - Philip Nunn
- Principia Biopharma Inc., a Sanofi Company, South San Francisco, CA
| | - Kolbot By
- Principia Biopharma Inc., a Sanofi Company, South San Francisco, CA
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10
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Ma B, Bohnert T, Otipoby KL, Tien E, Arefayene M, Bai J, Bajrami B, Bame E, Chan TR, Humora M, MacPhee JM, Marcotte D, Mehta D, Metrick CM, Moniz G, Polack E, Poreci U, Prefontaine A, Sheikh S, Schroeder P, Smirnakis K, Zhang L, Zheng F, Hopkins BT. Discovery of BIIB068: A Selective, Potent, Reversible Bruton's Tyrosine Kinase Inhibitor as an Orally Efficacious Agent for Autoimmune Diseases. J Med Chem 2020; 63:12526-12541. [PMID: 32696648 DOI: 10.1021/acs.jmedchem.0c00702] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Autoreactive B cell-derived antibodies form immune complexes that likely play a pathogenic role in autoimmune diseases. In systemic lupus erythematosus (SLE), these antibodies bind Fc receptors on myeloid cells and induce proinflammatory cytokine production by monocytes and NETosis by neutrophils. Bruton's tyrosine kinase (BTK) is a non-receptor tyrosine kinase that signals downstream of Fc receptors and plays a transduction role in antibody expression following B cell activation. Given the roles of BTK in both the production and sensing of autoreactive antibodies, inhibitors of BTK kinase activity may provide therapeutic value to patients suffering from autoantibody-driven immune disorders. Starting from an in-house proprietary screening hit followed by structure-based rational design, we have identified a potent, reversible BTK inhibitor, BIIB068 (1), which demonstrated good kinome selectivity with good overall drug-like properties for oral dosing, was well tolerated across preclinical species at pharmacologically relevant doses with good ADME properties, and achieved >90% inhibition of BTK phosphorylation (pBTK) in humans.
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Affiliation(s)
- Bin Ma
- Research & Development, Biogen, 225 Binney Street, Cambridge, Massachusetts 02142, United States
| | - Tonika Bohnert
- Research & Development, Biogen, 225 Binney Street, Cambridge, Massachusetts 02142, United States
| | - Kevin L Otipoby
- Research & Development, Biogen, 225 Binney Street, Cambridge, Massachusetts 02142, United States
| | - Eric Tien
- Research & Development, Biogen, 225 Binney Street, Cambridge, Massachusetts 02142, United States
| | - Million Arefayene
- Research & Development, Biogen, 225 Binney Street, Cambridge, Massachusetts 02142, United States
| | - Judy Bai
- Research & Development, Biogen, 225 Binney Street, Cambridge, Massachusetts 02142, United States
| | - Bekim Bajrami
- Research & Development, Biogen, 225 Binney Street, Cambridge, Massachusetts 02142, United States
| | - Eris Bame
- Research & Development, Biogen, 225 Binney Street, Cambridge, Massachusetts 02142, United States
| | - Timothy R Chan
- Research & Development, Biogen, 225 Binney Street, Cambridge, Massachusetts 02142, United States
| | - Michael Humora
- Research & Development, Biogen, 225 Binney Street, Cambridge, Massachusetts 02142, United States
| | - J Michael MacPhee
- Research & Development, Biogen, 225 Binney Street, Cambridge, Massachusetts 02142, United States
| | - Douglas Marcotte
- Research & Development, Biogen, 225 Binney Street, Cambridge, Massachusetts 02142, United States
| | - Devangi Mehta
- Research & Development, Biogen, 225 Binney Street, Cambridge, Massachusetts 02142, United States
| | - Claire M Metrick
- Research & Development, Biogen, 225 Binney Street, Cambridge, Massachusetts 02142, United States
| | - George Moniz
- Research & Development, Biogen, 225 Binney Street, Cambridge, Massachusetts 02142, United States
| | - Evelyne Polack
- Research & Development, Biogen, 225 Binney Street, Cambridge, Massachusetts 02142, United States
| | - Urjana Poreci
- Research & Development, Biogen, 225 Binney Street, Cambridge, Massachusetts 02142, United States
| | - Annick Prefontaine
- Research & Development, Biogen, 225 Binney Street, Cambridge, Massachusetts 02142, United States
| | - Sarah Sheikh
- Research & Development, Biogen, 225 Binney Street, Cambridge, Massachusetts 02142, United States
| | - Patricia Schroeder
- Research & Development, Biogen, 225 Binney Street, Cambridge, Massachusetts 02142, United States
| | - Karen Smirnakis
- Research & Development, Biogen, 225 Binney Street, Cambridge, Massachusetts 02142, United States
| | - Lei Zhang
- Research & Development, Biogen, 225 Binney Street, Cambridge, Massachusetts 02142, United States
| | - Fengmei Zheng
- Research & Development, Biogen, 225 Binney Street, Cambridge, Massachusetts 02142, United States
| | - Brian T Hopkins
- Research & Development, Biogen, 225 Binney Street, Cambridge, Massachusetts 02142, United States
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Cohen S, Tuckwell K, Katsumoto TR, Zhao R, Galanter J, Lee C, Rae J, Toth B, Ramamoorthi N, Hackney JA, Berman A, Damjanov N, Fedkov D, Jeka S, Chinn LW, Townsend MJ, Morimoto AM, Genovese MC. Fenebrutinib versus Placebo or Adalimumab in Rheumatoid Arthritis: A Randomized, Double-Blind, Phase II Trial (ANDES Study). Arthritis Rheumatol 2020; 72:1435-1446. [PMID: 32270926 PMCID: PMC7496340 DOI: 10.1002/art.41275] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 03/26/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To evaluate fenebrutinib, an oral and highly selective non-covalent inhibitor of Bruton's tyrosine kinase (BTK), in patients with active rheumatoid arthritis (RA). METHODS Patients with RA and inadequate response to methotrexate (cohort 1, n=480) were randomized to fenebrutinib (50 mg once daily, 150 mg once daily, 200 mg twice daily), 40 mg adalimumab every other week, or placebo. Patients with RA and inadequate response to tumor necrosis factor inhibitors (cohort 2, n=98) received fenebrutinib (200 mg twice daily) or placebo. Both cohorts continued methotrexate therapy. RESULTS In cohort 1, American College of Rheumatology scores (ACR50) at week 12 were similar for fenebrutinib 50 mg once daily and placebo, and higher for fenebrutinib 150 mg once daily (28%) and 200 mg twice daily (35%) than placebo (15%) (p=0.017; p=0.0003). Fenebrutinib 200 mg twice daily and adalimumab (36%) were comparable (p=0.81). In cohort 2, more patients achieved ACR50 with fenebrutinib 200 mg twice daily (25%) than placebo (12%) (p=0.072). The most common adverse events for fenebrutinib included nausea, headache, anemia, and upper respiratory tract infections. Fenebrutinib had significant effects on myeloid and B cell biomarkers (CCL4 and rheumatoid factor). Fenebrutinib and adalimumab caused overlapping as well as distinct changes in B cell and myeloid biomarkers. CONCLUSION Fenebrutinib demonstrated efficacy comparable to adalimumab in patients with an inadequate response to methotrexate, and safety consistent with existing immunomodulatory therapies for RA. These data support targeting both B and myeloid cells via this novel mechanism for potential efficacy in the treatment of RA.
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Affiliation(s)
| | | | | | - Rui Zhao
- Genentech, Inc.South San FranciscoCalifornia
| | | | - Chin Lee
- Genentech, Inc.South San FranciscoCalifornia
| | - Julie Rae
- Genentech, Inc.South San FranciscoCalifornia
| | - Balazs Toth
- Genentech, Inc.South San FranciscoCalifornia
| | | | | | | | | | | | - Slawomir Jeka
- Collegium Medicum Jan Biziel University Hospital no 2BydgoszczPoland
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