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Kifuji T, Inoue S, Furukawa M, Perez Madera B, Goto T, Kumagai H, Mair SJ, Kawaguchi A. Absorption, disposition and metabolic pathway of amiselimod (MT-1303) in healthy volunteers in a mass balance study. Xenobiotica 2018; 49:1033-1043. [PMID: 30231665 DOI: 10.1080/00498254.2018.1525508] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The absorption, metabolism and excretion of MT-1303 were investigated in healthy male subjects after a single oral dose of 0.4 mg [14C]-MT-1303 (ClinicalTrials.gov NCT02293967). The MT-1303 concentration in the plasma reached a maximum at 12 h after administration. Thereafter, the concentration declined with a half-life of 451 h. At the final assessment on Day 57, 91.16% of the administered radioactivity was excreted, and the cumulative excretion in the urine and faeces was 35.32% and 55.84%, respectively. The most abundant metabolite in plasma was MT-1303-P, which accounted for 42.6% of the area under the plasma concentration-time curve (AUC) of the total radioactivity. The major component excreted in urine was Human Urine (HU)4 (3066434), accounting for 28.1% of radioactivity in the sample (4.05% of the dose), whereas MT-1303 was a major component in the faeces, accounting for 89.8% of radioactivity in the sample (25.49% of the dose) up to 240 h after administration. This study indicates that multiple metabolic pathways are involved in the elimination of MT-1303 from the human body and the excretion of MT-1303 and MT-1303-P via the kidney is low. Therefore, MT-1303 is unlikely to cause conspicuous drug interactions or alter pharmacokinetics in patients with renal impairment.
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Affiliation(s)
- Takayuki Kifuji
- a Data Science Department, Ikuyaku. Integrated Value Development Division , Mitsubishi Tanabe Pharma Corporation , Chuo-ku , Tokyo , Japan
| | - Shinsuke Inoue
- a Data Science Department, Ikuyaku. Integrated Value Development Division , Mitsubishi Tanabe Pharma Corporation , Chuo-ku , Tokyo , Japan
| | - Megumi Furukawa
- a Data Science Department, Ikuyaku. Integrated Value Development Division , Mitsubishi Tanabe Pharma Corporation , Chuo-ku , Tokyo , Japan
| | | | - Takahiro Goto
- c DMPK Research Laboratories, Sohyaku. Innovative Research Division , Mitsubishi Tanabe Pharma Corporation , Yokohama , Kanagawa , Japan
| | - Hiroshi Kumagai
- c DMPK Research Laboratories, Sohyaku. Innovative Research Division , Mitsubishi Tanabe Pharma Corporation , Yokohama , Kanagawa , Japan
| | | | - Atsuhiro Kawaguchi
- a Data Science Department, Ikuyaku. Integrated Value Development Division , Mitsubishi Tanabe Pharma Corporation , Chuo-ku , Tokyo , Japan
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White RE, Evans DC, Hop CECA, Moore DJ, Prakash C, Surapaneni S, Tse FLS. Radiolabeled mass-balance excretion and metabolism studies in laboratory animals: a commentary on why they are still necessary. Xenobiotica 2012; 43:219-25; discussion 226-7. [DOI: 10.3109/00498254.2012.706724] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Michalsen BT, Gherezghiher TB, Choi J, Chandrasena REP, Qin Z, Thatcher GRJ, Bolton JL. Selective estrogen receptor modulator (SERM) lasofoxifene forms reactive quinones similar to estradiol. Chem Res Toxicol 2012; 25:1472-83. [PMID: 22642258 DOI: 10.1021/tx300142h] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The bioactivation of both endogenous and equine estrogens to electrophilic quinoid metabolites has been postulated as a contributing factor in carcinogenic initiation and/or promotion in hormone sensitive tissues. Bearing structural resemblance to estrogens, extensive studies have shown that many selective estrogen receptor modulators (SERMs) are subject to similar bioactivation pathways. Lasofoxifene (LAS), a third generation SERM which has completed phase III clinical trials for the prevention and treatment of osteoporosis, is currently approved in the European Union for this indication. Previously, Prakash et al. (Drug Metab. Dispos. (2008) 36, 1218-1226) reported that similar to estradiol, two catechol regioisomers of LAS are formed as primary oxidative metabolites, accounting for roughly half of the total LAS metabolism. However, the potential for further oxidation of these catechols to electrophilic o-quinones has not been reported. In the present study, LAS was synthesized and its oxidative metabolism investigated in vitro under various conditions. Incubation of LAS with tyrosinase, human liver microsomes, or rat liver microsomes in the presence of GSH as a trapping reagent resulted in the formation of two mono-GSH and two di-GSH catechol conjugates which were characterized by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Similar conjugates were also detected in incubations with P450 3A4, P450 2D6, and P450 1B1 supersomes. Interestingly, these conjugates were also detected as major metabolites when compared to competing detoxification pathways such as glucuronidation and methylation. The 7-hydroxylasofoxifene (7-OHLAS) catechol regioisomer was also synthesized and oxidized either chemically or enzymatically to an o-quinone that was shown to form depurinating adducts with DNA. Collectively, these data show that analogous to estrogens, LAS is oxidized to catechols and o-quinones which could potentially contribute to in vivo toxicity for this SERM.
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Affiliation(s)
- Bradley T Michalsen
- Department of Medicinal Chemistry and Pharmacognosy, College of Pharmacy, University of Illinois at Chicago, 833 S. Wood Street, M/C 781, Chicago, IL 60612-7231, USA
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Penner N, Xu L, Prakash C. Radiolabeled Absorption, Distribution, Metabolism, and Excretion Studies in Drug Development: Why, When, and How? Chem Res Toxicol 2012; 25:513-31. [DOI: 10.1021/tx300050f] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Natalia Penner
- Department
of Drug Metabolism and Preclinical Safety, Biogen Idec, Cambridge, Massachusetts 02142
| | - Lin Xu
- Department
of Drug Metabolism and Preclinical Safety, Biogen Idec, Cambridge, Massachusetts 02142
| | - Chandra Prakash
- Department
of Drug Metabolism and Preclinical Safety, Biogen Idec, Cambridge, Massachusetts 02142
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Peterson GM, Naunton M, Tichelaar LK, Gennari L. Lasofoxifene: selective estrogen receptor modulator for the prevention and treatment of postmenopausal osteoporosis. Ann Pharmacother 2011; 45:499-509. [PMID: 21467260 DOI: 10.1345/aph.1p604] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE To review literature evaluating the pharmacology, pharmacokinetics, clinical efficacy, and adverse effects of lasofoxifene (CP-336156), a selective estrogen receptor modulator (SERM) that is not approved for use in the US. DATA SOURCES Literature was accessed through the MEDLINE and EMBASE databases (1985-June 2010) using the terms lasofoxifene and selective estrogen receptor modulators. Reference lists from retrieved articles were also manually reviewed. The Food and Drug Administration and Pfizer provided additional information. STUDY SELECTION AND DATA EXTRACTION All clinical trials evaluating lasofoxifene were included in this review. In addition, all articles evaluating the pharmacology, pharmacokinetics, and safety of lasofoxifene in humans were reviewed. DATA SYNTHESIS Lasofoxifene is a third-generation SERM with markedly higher in vitro and in vivo potency and oral bioavailability than other SERMs. The drug has produced significant improvements in bone density and biochemical markers of bone turnover in preclinical studies and in Phase 2 and 3 clinical trials. In these trials, lasofoxifene has shown a favorable safety profile, with adverse events including hot flushes, leg cramps, and increased vaginal moisture. One 2-year major comparative study in postmenopausal women determined that lasofoxifene and raloxifene were equally effective at increasing total hip bone mineral density (BMD), while lasofoxifene had a significantly greater effect on lumbar spine BMD. CONCLUSIONS Osteoporosis is a significant health problem. While the results of further clinical trials are needed to define the risks and benefits of treatment, particularly relating to fractures, lasofoxifene may prove to be an effective and well-tolerated therapeutic option for the prevention of bone loss in postmenopausal women.
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Ramírez J, Ratain MJ, Innocenti F. Uridine 5'-diphospho-glucuronosyltransferase genetic polymorphisms and response to cancer chemotherapy. Future Oncol 2010; 6:563-85. [PMID: 20373870 PMCID: PMC3102300 DOI: 10.2217/fon.10.17] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Pharmacogenetics aims to elucidate how genetic variation affects the efficacy and side effects of drugs, with the ultimate goal of personalizing medicine. Clinical studies of the genetic variation in the uridine 5'-diphosphoglucuronosyltransferase gene have demonstrated how reduced-function allele variants can predict the risk of severe toxicity and help identify cancer patients who could benefit from reduced-dose schedules or alternative chemotherapy. Candidate polymorphisms have also been identified in vitro, although the functional consequences of these variants still need to be tested in the clinical setting. Future approaches in uridine 5'-diphosphoglucuronosyltransferase pharmacogenetics include genetic testing prior to drug treatment, genotype-directed dose-escalation studies, study of genetic variation at the haplotype level and genome-wide studies.
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Affiliation(s)
- Jacqueline Ramírez
- Department of Medicine, The University of Chicago, 5841 S. Maryland Avenue, MC2115, Chicago, IL, USA 60637, Tel.: +1 773 834 2451, Fax: +1 773 702 9268,
| | - Mark J Ratain
- Department of Medicine, Committee on Clinical Pharmacology & Pharmacogenomics, Cancer Research Center, The University of Chicago, 5841 S. Maryland Avenue, MC2115, Chicago, IL, USA 60637, Tel.: +1 773 702 4400, Fax: +1 773 702 3969,
| | - Federico Innocenti
- Department of Medicine, Committee on Clinical Pharmacology & Pharmacogenomics, Cancer Research Center, The University of Chicago, 5841 S. Maryland Avenue, MC2115, Chicago, IL, USA 60637, Tel.: +1 773 834 2452, Fax: +1 773 702 9268,
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Wang B, Yang LP, Zhang XZ, Huang SQ, Bartlam M, Zhou SF. New insights into the structural characteristics and functional relevance of the human cytochrome P450 2D6 enzyme. Drug Metab Rev 2010; 41:573-643. [PMID: 19645588 DOI: 10.1080/03602530903118729] [Citation(s) in RCA: 122] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
To date, the crystal structures of at least 12 human CYPs (1A2, 2A6, 2A13, 2C8, 2C9, 2D6, 2E1, 2R1, 3A4, 7A1, 8A1, and 46A1) have been determined. CYP2D6 accounts for only a small percentage of all hepatic CYPs (< 2%), but it metabolizes approximately 25% of clinically used drugs with significant polymorphisms. CYP2D6 also metabolizes procarcinogens and neurotoxins, such as 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine, 1,2,3,4-tetrahydroquinoline, and indolealkylamines. Moreover, the enzyme utilizes hydroxytryptamines and neurosteroids as endogenous substrates. Typical CYP2D6 substrates are usually lipophilic bases with an aromatic ring and a nitrogen atom, which can be protonated at physiological pH. Substrate binding is generally followed by oxidation (5-7 A) from the proposed nitrogen-Asp301 interaction. A number of homology models have been constructed to explore the structural features of CYP2D6, while antibody studies also provide useful structural information. Site-directed mutagenesis studies have demonstrated that Glu216, Asp301, Phe120, Phe481, and Phe483 play important roles in determining the binding of ligands to CYP2D6. The structure of human CYP2D6 has been recently determined and shows the characteristic CYP fold observed for other members of the CYP superfamily. The lengths and orientations of the individual secondary structural elements in the CYP2D6 structure are similar to those seen in other human CYP2 members, such as CYP2C9 and 2C8. The 2D6 structure has a well-defined active-site cavity located above the heme group with a volume of approximately 540 A(3), which is larger than equivalent cavities in CYP2A6 (260 A(3)), 1A2 (375 A(3)), and 2E1 (190 A(3)), but smaller than those in CYP3A4 (1385 A(3)) and 2C8 (1438 A(3)). Further studies are required to delineate the molecular mechanisms involved in CYP2D6 ligand interactions and their implications for drug development and clinical practice.
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Affiliation(s)
- Bo Wang
- Department of Pediatrics, Guangdong Women and Children's Hospital, Guangzhou, China
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Lewiecki EM. Lasofoxifene for the prevention and treatment of postmenopausal osteoporosis. Ther Clin Risk Manag 2009; 5:817-27. [PMID: 19898646 PMCID: PMC2773750 DOI: 10.2147/tcrm.s5645] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2009] [Indexed: 01/23/2023] Open
Abstract
Lasofoxifene is a selective estrogen receptor modulator (estrogen agonist/antagonist) that has completed phase III trials to evaluate safety and efficacy for the prevention and treatment of osteoporosis and for the treatment of vaginal atrophy in postmenopausal women. In postmenopausal women with low or normal bone mineral density (BMD), lasofoxifene increased BMD at the lumbar spine and hip and reduced bone turnover markers compared with placebo. In women with postmenopausal osteoporosis, lasofoxifene increased BMD, reduced bone turnover markers, reduced the risk of vertebral and nonvertebral fractures, and decreased the risk of estrogen receptor-positive breast cancer. In postmenopausal women with low bone mass, lasofoxifene improved the signs and symptoms of vulvovaginal atrophy. Clinical trials show that lasofoxifene is generally well tolerated with mild to moderate adverse events that commonly resolve even with drug continuation. Lasofoxifene has been associated with an increase in the incidence of venous thromboembolic events, hot flushes, muscle spasm, and vaginal bleeding. It is approved for the treatment of postmenopausal women at increased risk for fracture in some countries and is in the regulatory review process in others.
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Affiliation(s)
- E Michael Lewiecki
- New Mexico Clinical Research & Osteoporosis Center, Albuquerque, NM, USA
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Penner N, Klunk LJ, Prakash C. Human radiolabeled mass balance studies: objectives, utilities and limitations. Biopharm Drug Dispos 2009; 30:185-203. [PMID: 19544285 DOI: 10.1002/bdd.661] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The determination of metabolic pathways of a drug candidate through the identification of circulating and excreted metabolites is vitally important to understanding its physical and biological effects. Knowledge of metabolite profiles of a drug candidate in animals and humans is essential to ensure that animal species used in toxicological evaluations of new drug candidates are appropriate models of humans. The recent FDA final guidance recommends that human oxidative metabolites whose exposure exceeds 10% of the parent AUC at steady-state should be assessed in at least one of the preclinical animal species used in toxicological assessment. Additional toxicological testing on metabolites that have higher exposure in humans than in preclinical species may be required. The metabolite profiles in laboratory animals and humans are generally accomplished by mass balance and excretion studies in which radiolabeled drugs are administered to these species. The biological fluids are collected, analysed for total radioactivity and evaluated for a quantitative profile of metabolites. Thus, these studies not only determine the rates and routes of excretion but also provide very critical information on the metabolic pathways of drugs in preclinical species and humans. In addition, these studies are required by regulatory agencies for the new drug approval process. Despite the usefulness of these radiolabeled mass balance studies, there is little concrete guidance on how to perform or assess these complex studies. This article examines the objectives, utilities and limitations of these studies and how these studies could be used for the determination of the metabolite exposure in animals and humans.
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Affiliation(s)
- Natalia Penner
- Department of Drug Metabolism and Pharmacokinetics, Biogen Idec, Cambridge, MA 02142, USA
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Gennari L. Lasofoxifene, a new selective estrogen receptor modulator for the treatment of osteoporosis and vaginal atrophy. Expert Opin Pharmacother 2009; 10:2209-20. [DOI: 10.1517/14656560903127241] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Dalvie D, Obach RS, Kang P, Prakash C, Loi CM, Hurst S, Nedderman A, Goulet L, Smith E, Bu HZ, Smith DA. Assessment of Three Human in Vitro Systems in the Generation of Major Human Excretory and Circulating Metabolites. Chem Res Toxicol 2009; 22:357-68. [DOI: 10.1021/tx8004357] [Citation(s) in RCA: 152] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Deepak Dalvie
- Pharmacokinetics, Dynamics and Metabolism, Pfizer Global Research and Development, San Diego California 92121, Pfizer Global Research and Development, Groton Connecticut 06340, and Pfizer Global Research and Development, Sandwich, Kent, United Kingdom
| | - R. Scott Obach
- Pharmacokinetics, Dynamics and Metabolism, Pfizer Global Research and Development, San Diego California 92121, Pfizer Global Research and Development, Groton Connecticut 06340, and Pfizer Global Research and Development, Sandwich, Kent, United Kingdom
| | - Ping Kang
- Pharmacokinetics, Dynamics and Metabolism, Pfizer Global Research and Development, San Diego California 92121, Pfizer Global Research and Development, Groton Connecticut 06340, and Pfizer Global Research and Development, Sandwich, Kent, United Kingdom
| | - Chandra Prakash
- Pharmacokinetics, Dynamics and Metabolism, Pfizer Global Research and Development, San Diego California 92121, Pfizer Global Research and Development, Groton Connecticut 06340, and Pfizer Global Research and Development, Sandwich, Kent, United Kingdom
| | - Cho-Ming Loi
- Pharmacokinetics, Dynamics and Metabolism, Pfizer Global Research and Development, San Diego California 92121, Pfizer Global Research and Development, Groton Connecticut 06340, and Pfizer Global Research and Development, Sandwich, Kent, United Kingdom
| | - Susan Hurst
- Pharmacokinetics, Dynamics and Metabolism, Pfizer Global Research and Development, San Diego California 92121, Pfizer Global Research and Development, Groton Connecticut 06340, and Pfizer Global Research and Development, Sandwich, Kent, United Kingdom
| | - Angus Nedderman
- Pharmacokinetics, Dynamics and Metabolism, Pfizer Global Research and Development, San Diego California 92121, Pfizer Global Research and Development, Groton Connecticut 06340, and Pfizer Global Research and Development, Sandwich, Kent, United Kingdom
| | - Lance Goulet
- Pharmacokinetics, Dynamics and Metabolism, Pfizer Global Research and Development, San Diego California 92121, Pfizer Global Research and Development, Groton Connecticut 06340, and Pfizer Global Research and Development, Sandwich, Kent, United Kingdom
| | - Evan Smith
- Pharmacokinetics, Dynamics and Metabolism, Pfizer Global Research and Development, San Diego California 92121, Pfizer Global Research and Development, Groton Connecticut 06340, and Pfizer Global Research and Development, Sandwich, Kent, United Kingdom
| | - Hai-Zhi Bu
- Pharmacokinetics, Dynamics and Metabolism, Pfizer Global Research and Development, San Diego California 92121, Pfizer Global Research and Development, Groton Connecticut 06340, and Pfizer Global Research and Development, Sandwich, Kent, United Kingdom
| | - Dennis A. Smith
- Pharmacokinetics, Dynamics and Metabolism, Pfizer Global Research and Development, San Diego California 92121, Pfizer Global Research and Development, Groton Connecticut 06340, and Pfizer Global Research and Development, Sandwich, Kent, United Kingdom
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Prakash C, Johnson KA, Schroeder CM, Potchoiba MJ. Metabolism, distribution, and excretion of a next generation selective estrogen receptor modulator, lasofoxifene, in rats and monkeys. Drug Metab Dispos 2008; 36:1753-69. [PMID: 18515329 DOI: 10.1124/dmd.108.021808] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Disposition of lasofoxifene (LAS; 6-phenyl-5-[4-(2-pyrrolidin-1-yl-ethoxy)-phenyl]-5,6,7,8-tetrahydro-naphthalen-2-ol. tartrate) was investigated in rats and monkeys after oral administration of a single oral dose of [(14)C]LAS. Total mean recoveries of the radiocarbon were 96.7 and 94.3% from rats and monkeys, respectively. The major route of excretion in both species was the feces, and based on a separate study in the bile duct-cannulated rat, this likely reflects excretion in bile rather than incomplete absorption. Whole-body autoradioluminography suggested that [(14)C]LAS radioequivalents distributed rapidly in the rat with most tissues achieving maximal concentrations at 1 h. Half-life of radioactivity was longest in the uvea (124 h) and shortest in the spleen ( approximately 3 h). LAS was extensively metabolized in both rats and monkeys because no unchanged drug was detected in urine and/or bile. Based on area under the curve((0-24)) values, >78% of the circulating radioactivity was due to the metabolites. A total of 22 metabolites were tentatively identified by liquid chromatography-tandem mass spectrometry. Based on the structures of the metabolites, six metabolic pathways of LAS were identified: hydroxylation at the tetraline ring, hydroxylation at the aromatic ring attached to tetraline, methylation of the catechol intermediates by catechol-O-methyl transferase, oxidation at the pyrrolidine ring, and direct conjugation with glucuronic acid and sulfuric acid. LAS and its glucuronide conjugate (M7) were the major circulating drug-related moieties in both rats and monkeys. However, there were notable species-related qualitative and quantitative differences in the metabolic profiles. The catechol (M21) and its sulfate conjugate (M10) were observed only in monkeys, whereas the glucuronide conjugate of the methylated catechol (M8) and hydroxy-LAS (M9) were detected only in rats.
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Affiliation(s)
- Chandra Prakash
- Pharmacokinetics, Dynamics, and Metabolism, Pfizer Global Research and Development, Groton, CT 06340, USA.
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