1
|
Sun D, Liu Y, Zhu L, Xu Z, Zhang Y, Li H, Yang H, Cao X, Gu J. Pharmacokinetic/Pharmacodynamic Assessment of the Structural Refinement of Clopidogrel Focusing on the Balance between Bioactivation and Deactivation. Drug Metab Dispos 2024; 52:654-661. [PMID: 38729662 DOI: 10.1124/dmd.124.001699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 04/24/2024] [Accepted: 05/06/2024] [Indexed: 05/12/2024] Open
Abstract
The delicate balance between ischemic and bleeding risks is a critical factor in antiplatelet therapy administration. Clopidogrel and prasugrel, belonging to the thienopyridine class of antiplatelet drugs, are known for their variability in individual responsiveness and high incidence of bleeding events, respectively. The present study is centered on the development and assessment of a range of deuterated thienopyridine derivatives, leveraging insights from structure-pharmacokinetic relationships of clopidogrel and prasugrel. Our approaches were grounded in the molecular framework of clopidogrel and incorporated the C2-pharmacophore design from prasugrel. The selection of ester or carbamate substituents at the C2-position facilitated the generation of the 2-oxointermediate through hydrolysis, akin to prasugrel, thereby bypassing the issue of CYP2C19 dependency. The bulky C2-pharmacophore in our approach distinguishes itself from prasugrel's acetyloxy substituent by exhibiting a moderated hydrolysis rate, resulting in a more gradual formation of the active metabolite. Excessive and rapid release of the active metabolite, believed to be linked with an elevated risk of bleeding, is thus mitigated. Our proposed structural modification retains the hydrolysis-sensitive methyl ester of clopidogrel but substitutes it with a deuterated methyl group, shown to effectively reduce metabolic deactivation. Three promising compounds demonstrated a pharmacokinetic profile similar to that of clopidogrel at four times the dose, while also augmenting its antiplatelet activity. SIGNIFICANCE STATEMENT: Inspired by the structure-pharmacokinetic relationship of clopidogrel and prasugrel, a range of clopidogrel derivatives were designed, synthesized, and assessed. Among them, three promising compounds have been identified, striking a delicate balance between efficacy and safety for antiplatelet therapy. Additionally, the ozagrel prodrug conjugate was discovered to exert a synergistic therapeutic effect alongside clopidogrel.
Collapse
Affiliation(s)
- Dong Sun
- Research Center for Drug Metabolism, School of Life Science (D.S., L.Z., Y.Z., H.L., H.Y., J.G.), Department of Pharmacology, School of Pharmacy Sciences (Y.L., Z.X., X.C.), and State Key Laboratory of Supramolecular Structure and Materials, Center for Supramolecular Chemical Biology, College of Chemistry (J.G.), Jilin University, Changchun, China; and Beijing Institute of Drug Metabolism, Beijing, China (J.G.)
| | - Yingze Liu
- Research Center for Drug Metabolism, School of Life Science (D.S., L.Z., Y.Z., H.L., H.Y., J.G.), Department of Pharmacology, School of Pharmacy Sciences (Y.L., Z.X., X.C.), and State Key Laboratory of Supramolecular Structure and Materials, Center for Supramolecular Chemical Biology, College of Chemistry (J.G.), Jilin University, Changchun, China; and Beijing Institute of Drug Metabolism, Beijing, China (J.G.)
| | - Lin Zhu
- Research Center for Drug Metabolism, School of Life Science (D.S., L.Z., Y.Z., H.L., H.Y., J.G.), Department of Pharmacology, School of Pharmacy Sciences (Y.L., Z.X., X.C.), and State Key Laboratory of Supramolecular Structure and Materials, Center for Supramolecular Chemical Biology, College of Chemistry (J.G.), Jilin University, Changchun, China; and Beijing Institute of Drug Metabolism, Beijing, China (J.G.)
| | - Zhiping Xu
- Research Center for Drug Metabolism, School of Life Science (D.S., L.Z., Y.Z., H.L., H.Y., J.G.), Department of Pharmacology, School of Pharmacy Sciences (Y.L., Z.X., X.C.), and State Key Laboratory of Supramolecular Structure and Materials, Center for Supramolecular Chemical Biology, College of Chemistry (J.G.), Jilin University, Changchun, China; and Beijing Institute of Drug Metabolism, Beijing, China (J.G.)
| | - Yuyao Zhang
- Research Center for Drug Metabolism, School of Life Science (D.S., L.Z., Y.Z., H.L., H.Y., J.G.), Department of Pharmacology, School of Pharmacy Sciences (Y.L., Z.X., X.C.), and State Key Laboratory of Supramolecular Structure and Materials, Center for Supramolecular Chemical Biology, College of Chemistry (J.G.), Jilin University, Changchun, China; and Beijing Institute of Drug Metabolism, Beijing, China (J.G.)
| | - Haipeng Li
- Research Center for Drug Metabolism, School of Life Science (D.S., L.Z., Y.Z., H.L., H.Y., J.G.), Department of Pharmacology, School of Pharmacy Sciences (Y.L., Z.X., X.C.), and State Key Laboratory of Supramolecular Structure and Materials, Center for Supramolecular Chemical Biology, College of Chemistry (J.G.), Jilin University, Changchun, China; and Beijing Institute of Drug Metabolism, Beijing, China (J.G.)
| | - Huan Yang
- Research Center for Drug Metabolism, School of Life Science (D.S., L.Z., Y.Z., H.L., H.Y., J.G.), Department of Pharmacology, School of Pharmacy Sciences (Y.L., Z.X., X.C.), and State Key Laboratory of Supramolecular Structure and Materials, Center for Supramolecular Chemical Biology, College of Chemistry (J.G.), Jilin University, Changchun, China; and Beijing Institute of Drug Metabolism, Beijing, China (J.G.)
| | - Xia Cao
- Research Center for Drug Metabolism, School of Life Science (D.S., L.Z., Y.Z., H.L., H.Y., J.G.), Department of Pharmacology, School of Pharmacy Sciences (Y.L., Z.X., X.C.), and State Key Laboratory of Supramolecular Structure and Materials, Center for Supramolecular Chemical Biology, College of Chemistry (J.G.), Jilin University, Changchun, China; and Beijing Institute of Drug Metabolism, Beijing, China (J.G.)
| | - Jingkai Gu
- Research Center for Drug Metabolism, School of Life Science (D.S., L.Z., Y.Z., H.L., H.Y., J.G.), Department of Pharmacology, School of Pharmacy Sciences (Y.L., Z.X., X.C.), and State Key Laboratory of Supramolecular Structure and Materials, Center for Supramolecular Chemical Biology, College of Chemistry (J.G.), Jilin University, Changchun, China; and Beijing Institute of Drug Metabolism, Beijing, China (J.G.)
| |
Collapse
|
2
|
Chen J, Qu Y, Jiang M, Li H, Cui C, Liu D. Population Pharmacokinetic/Pharmacodynamic Models for P2Y12 Inhibitors: A Systematic Review and Clinical Appraisal Using Exposure Simulation. Clin Pharmacokinet 2024; 63:303-316. [PMID: 38244191 DOI: 10.1007/s40262-023-01335-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2023] [Indexed: 01/22/2024]
Abstract
BACKGROUND AND OBJECTIVE Recent research indicates a correlation between plasma concentration of P2Y12 inhibitors and clinical events, particularly bleeding, which significantly impeded their clinical therapeutic performance. It is therefore vital to delve into the factors that might affect the plasma concentration. The study aims to summarize population pharmacokinetics/pharmacodynamics (PopPKPD) models for commonly prescribed P2Y12 inhibitors (clopidogrel, prasugrel, and ticagrelor) and assess bleeding risk in specific individual groups. METHODS The PopPKPD models of P2Y12 inhibitors were collected and summarized based on predetermined inclusion and exclusion criteria. The collected models were replicated in simulations, which were used to assess factors affecting plasma concentrations of P2Y12 inhibitors. Simulation results for special populations were compared to therapeutic window based on reported exposure-effect relationships (PK/PD-related bleeding and thrombotic clinical outcomes) to predict bleeding risk in special populations with different dosing regimens and cumulative covariates. RESULT Finally, 12 studies were included for PK simulation, 7 of which that also included PD data were subjected to further analysis, with the majority being based on Phase I or II trials. Simulations showed that several covariates such as female gender, weight, elderly can significantly impact on exposure, with special populations reaching up to 179% of the general population. However, after dose adjustment, blood concentrations for special populations can reach approximately ±20% of general population exposure. Therefore, lowering the maintenance dose of ticagrelor from 90 to 60 mg bid was first recommended to reduce bleeding risk without significantly increasing ischemic risk, particularly in elderly, small-weight Asian females. CONCLUSION Lowering the maintenance dose of ticagrelor from 90 to 60 mg bid effectively reduces bleeding risk without increasing thrombotic infarction risk in elderly, small-weight Asian females.
Collapse
Affiliation(s)
- Jingcheng Chen
- Department of Cardiology, Peking University Third Hospital, Beijing, 100191, China
- Drug Clinical Trial Center, Peking University Third Hospital, Beijing, 100191, China
- Center of Clinical Medical Research, Institute of Medical Innovation and Research, Peking University Third Hospital, Beijing, China
| | - Yuchen Qu
- Department of Pharmacy, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Muhan Jiang
- Drug Clinical Trial Center, Peking University Third Hospital, Beijing, 100191, China
| | - Haiyan Li
- Department of Cardiology, Peking University Third Hospital, Beijing, 100191, China
- Drug Clinical Trial Center, Peking University Third Hospital, Beijing, 100191, China
- Center of Clinical Medical Research, Institute of Medical Innovation and Research, Peking University Third Hospital, Beijing, China
| | - Cheng Cui
- Department of Cardiology, Peking University Third Hospital, Beijing, 100191, China.
- Drug Clinical Trial Center, Peking University Third Hospital, Beijing, 100191, China.
- Center of Clinical Medical Research, Institute of Medical Innovation and Research, Peking University Third Hospital, Beijing, China.
| | - Dongyang Liu
- Drug Clinical Trial Center, Peking University Third Hospital, Beijing, 100191, China.
- Center of Clinical Medical Research, Institute of Medical Innovation and Research, Peking University Third Hospital, Beijing, China.
- Beijing Key Laboratory of Cardiovascular Receptors Research, Peking University Third Hospital, Beijing, China.
| |
Collapse
|
3
|
Wang T, Yang H, Yang J, Guo N, Wu G, Xu X, An M. Quantitative Determination of Four Potential Genotoxic Impurities in the Active Pharmaceutical Ingredients in TSD-1 Using UPLC-MS/MS. Molecules 2022; 27:molecules27134129. [PMID: 35807373 PMCID: PMC9268482 DOI: 10.3390/molecules27134129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/19/2022] [Accepted: 06/25/2022] [Indexed: 11/30/2022] Open
Abstract
A novel method of ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) was developed for the identification and quantification of four potential genotoxic impurities (PGIs) in the active pharmaceutical ingredients of TSD-1, a novel P2Y12 receptor antagonist. Four PGIs were named, 4-nitrobenzenesulfonic acid, methyl 4-nitrobenzenesulfonate, ethyl 4-nitrobenzenesulfonate, and isopropyl 4-nitrobenzenesulfonate. Following the International Conference of Harmonization (ICH) guidelines, this methodology is capable of quantifying four PGIs at 15.0 ppm in samples of 0.5 mg/mL concentration. This validated approach presented very low limits (0.1512−0.3897 ng/mL), excellent linearity (coefficients > 0.9900), and a satisfactory recovery range (94.9−115.5%). The method was sufficient in terms of sensitivity, linearity, precision, accuracy, selectivity, and robustness and, thus, has high practicality in the pharmaceutical quality control of TSD-1.
Collapse
Affiliation(s)
- Taiyu Wang
- Department of Pharmacy, Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou 014060, China; (T.W.); (G.W.)
- Chemical Pharmaceutical Research Center, Tasly Academy, Tasly Holding Group Co., Ltd., Tianjin 300410, China; (H.Y.); (J.Y.)
| | - Hailong Yang
- Chemical Pharmaceutical Research Center, Tasly Academy, Tasly Holding Group Co., Ltd., Tianjin 300410, China; (H.Y.); (J.Y.)
| | - Jie Yang
- Chemical Pharmaceutical Research Center, Tasly Academy, Tasly Holding Group Co., Ltd., Tianjin 300410, China; (H.Y.); (J.Y.)
| | - Ningjie Guo
- School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, China;
| | - Guodong Wu
- Department of Pharmacy, Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou 014060, China; (T.W.); (G.W.)
| | - Xueyu Xu
- Chemical Pharmaceutical Research Center, Tasly Academy, Tasly Holding Group Co., Ltd., Tianjin 300410, China; (H.Y.); (J.Y.)
- Correspondence: (X.X.); (M.A.)
| | - Ming An
- Department of Pharmacy, Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou 014060, China; (T.W.); (G.W.)
- Correspondence: (X.X.); (M.A.)
| |
Collapse
|
4
|
Xu Z, Miao Y, Wu T, Chen L, Gao M, Sun Y, Liu Y, Niu J, Cai D, Li X, Chen C, Liu S, Gu J, Cao X. Evaluation of efficacy and safety after replacement of methyl hydrogen with deuterium at methyl formate of Clopidogrel. Eur J Pharm Sci 2022; 172:106157. [DOI: 10.1016/j.ejps.2022.106157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 02/28/2022] [Accepted: 03/01/2022] [Indexed: 11/03/2022]
|
5
|
Pharmacokinetics, mass balance, and metabolism of [ 14C]vicagrel, a novel irreversible P2Y 12 inhibitor in humans. Acta Pharmacol Sin 2021; 42:1535-1546. [PMID: 33244163 PMCID: PMC8379165 DOI: 10.1038/s41401-020-00547-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/23/2020] [Indexed: 12/12/2022] Open
Abstract
Vicagrel, a novel irreversible P2Y12 receptor inhibitor, is undergoing phase III trials for the treatment of acute coronary syndromes in China. In this study, we evaluated the pharmacokinetics, mass balance, and metabolism of vicagrel in six healthy male Chinese subjects after a single oral dose of 20 mg [14C]vicagrel (120 µCi). Vicagrel absorption was fast (Tmax = 0.625 h), and the mean t1/2 of vicagrel-related components was ~38.0 h in both plasma and blood. The blood-to-plasma radioactivity AUCinf ratio was 0.55, suggesting preferential distribution of drug-related material in plasma. At 168 h after oral administration, the mean cumulative excreted radioactivity was 96.71% of the dose, including 68.03% in urine and 28.67% in feces. A total of 22 metabolites were identified, and the parent vicagrel was not detected in plasma, urine, or feces. The most important metabolic spot of vicagrel was on the thiophene ring. In plasma pretreated with the derivatization reagent, M9-2, which is a methylated metabolite after thiophene ring opening, was the predominant drug-related component, accounting for 39.43% of the radioactivity in pooled AUC0-8 h plasma. M4, a mono-oxidation metabolite upon ring-opening, was the most abundant metabolite in urine, accounting for 16.25% of the dose, followed by M3-1, accounting for 12.59% of the dose. By comparison, M21 was the major metabolite in feces, accounting for 6.81% of the dose. Overall, renal elimination plays a crucial role in vicagrel disposition, and the thiophene ring is the predominant metabolic site.
Collapse
|
6
|
Li X, Liu P, Xu Z, Sun D, Gu J, Miao Y, Zhang J, Cao X. A Pharmacodynamic Study of CN-218, a Novel Antiplatelet and Antithrombotic Agent Primarily Targeting the P2Y 12 Receptor. Cardiovasc Drugs Ther 2020; 34:15-23. [PMID: 32062793 DOI: 10.1007/s10557-019-06930-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE Drugs inhibiting the platelet P2Y12 receptor, such as clopidogrel and prasugrel, are potent antithrombotic agents and are widely used in cardiovascular disease. However, the adverse effects of these drugs have limited their clinical use. For example, clopidogrel resistance occurs in approximately one third of patients, while prasugrel increases the risk of major bleeding. Therefore, new generations of such drugs are of clinical interest. METHODS In this study, the pharmacodynamics of a new P2Y12 antagonist, CN-218, was compared with that of clopidogrel and prasugrel in rats and mice. The differences between CN-218 and clopidogrel include deuteration of the 7-position methyl carboxylate and the introduction of cinnamate in the 2-position of thiophene. RESULTS CN-218 had an antiaggregatory efficacy that was at least five times more potent than that of clopidogrel but not as potent as that of prasugrel. It had a significant impact on activated partial thromboplastin time (APTT), whereby the APTT of CN-218-treated rats was approximately 9 s longer than that of the vehicle- or clopidogrel-treated group, while it had no impact on prothrombin time (PT) in rats. CN-218 had a similar potent antithrombotic effect to that of prasugrel and clopidogrel and also reduced the risk of bleeding compared to prasugrel. CONCLUSION CN-218 may be a promising antithrombotic agent, with potent antiplatelet and significant anticoagulant activity, as well as a lower risk of bleeding compared to clopidogrel and prasugrel.
Collapse
Affiliation(s)
- Xiaohua Li
- Department of Pharmacology, School of Pharmacy, Jilin University, Fujin Road, Changchun, Jilin, 130021, China.,Department of Infectious Diseases, The first hospital of Jilin University, Changchun, Jilin, 130021, China
| | - Peng Liu
- Department of Pharmacology, School of Pharmacy, Jilin University, Fujin Road, Changchun, Jilin, 130021, China
| | - Zhiping Xu
- Department of Pharmacology, School of Pharmacy, Jilin University, Fujin Road, Changchun, Jilin, 130021, China
| | - Dong Sun
- College of Life Sciences, Jilin University, Qianjin Street, Changchun, Jilin, 130012, China.,Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, School of Pharmacy, Yantai University, Yantai, 264005, China
| | - Jingkai Gu
- College of Life Sciences, Jilin University, Qianjin Street, Changchun, Jilin, 130012, China
| | - Yujia Miao
- Department of Pharmacology, School of Pharmacy, Jilin University, Fujin Road, Changchun, Jilin, 130021, China
| | - Jujin Zhang
- Department of Pharmacology, School of Pharmacy, Jilin University, Fujin Road, Changchun, Jilin, 130021, China
| | - Xia Cao
- Department of Pharmacology, School of Pharmacy, Jilin University, Fujin Road, Changchun, Jilin, 130021, China.
| |
Collapse
|
7
|
Belz TF, Bremer PT, Zhou B, Ellis B, Eubanks LM, Janda KD. Enhancement of a Heroin Vaccine through Hapten Deuteration. J Am Chem Soc 2020; 142:13294-13298. [PMID: 32700530 DOI: 10.1021/jacs.0c05219] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The United States is in the midst of an unprecedented epidemic of opioid substance use disorder, and while pharmacotherapies including opioid agonists and antagonists have shown success, they can be inadequate and frequently result in high recidivism. With these challenges facing opioid use disorder treatments immunopharmacotherapy is being explored as an alternative therapy option and is based upon antibody-opioid sequestering to block brain entry. Development of a heroin vaccine has become a major research focal point; however, producing an efficient vaccine against heroin has been particularly challenging because of the need to generate not only a potent immune response but one against heroin and its multiple psychoactive molecules. In this study, we explored the consequence of regioselective deuteration of a heroin hapten and its impact upon the immune response against heroin and its psychoactive metabolites. Deuterium (HdAc) and cognate protium heroin (HAc) haptens were compared head to head in an inclusive vaccine study. Strikingly the HdAc vaccine granted greater efficacy in blunting heroin analgesia in murine behavioral models compared to the HAc vaccine. Binding studies confirmed that the HdAc vaccine elicited both greater quantities and equivalent or higher affinity antibodies toward heroin and 6-AM. Blood-brain biodistribution experiments corroborated these affinity tests. These findings suggest that regioselective hapten deuteration could be useful for the resurrection of previous drug of abuse vaccines that have met limited success in the past.
Collapse
Affiliation(s)
- Tyson F Belz
- Department of Chemistry, Department of Immunology and Microbial Science, The Skaggs Institute for Chemical Biology, The Worm Institute of Research and Medicine (WIRM), The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, California 92037, United States
| | - Paul T Bremer
- Department of Chemistry, Department of Immunology and Microbial Science, The Skaggs Institute for Chemical Biology, The Worm Institute of Research and Medicine (WIRM), The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, California 92037, United States.,Cessation Therapeutics LLC, 3031 Tisch Way Ste 505, San Jose, California 95128, United States
| | - Bin Zhou
- Department of Chemistry, Department of Immunology and Microbial Science, The Skaggs Institute for Chemical Biology, The Worm Institute of Research and Medicine (WIRM), The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, California 92037, United States
| | - Beverly Ellis
- Department of Chemistry, Department of Immunology and Microbial Science, The Skaggs Institute for Chemical Biology, The Worm Institute of Research and Medicine (WIRM), The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, California 92037, United States
| | - Lisa M Eubanks
- Department of Chemistry, Department of Immunology and Microbial Science, The Skaggs Institute for Chemical Biology, The Worm Institute of Research and Medicine (WIRM), The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, California 92037, United States
| | - Kim D Janda
- Department of Chemistry, Department of Immunology and Microbial Science, The Skaggs Institute for Chemical Biology, The Worm Institute of Research and Medicine (WIRM), The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, California 92037, United States
| |
Collapse
|
8
|
Zhang Y, Zhu X, Zhan Y, Li X, Liu C, Zhu Y, Zhang H, Wei H, Xia Y, Sun H, Liu Y, Lai X, Gong Y, Liu X, Li Y, Ding Y, Zhong D. Impacts of CYP2C19 genetic polymorphisms on bioavailability and effect on platelet adhesion of vicagrel, a novel thienopyridine P2Y 12 inhibitor. Br J Clin Pharmacol 2020; 86:1860-1874. [PMID: 32267573 DOI: 10.1111/bcp.14296] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 03/18/2020] [Accepted: 03/21/2020] [Indexed: 12/16/2022] Open
Abstract
AIMS We investigated the impacts of CYP2C19 polymorphisms on pharmacokinetics and pharmacodynamics of vicagrel in healthy Chinese subjects. METHODS CYP2C19 extensive metabolizers (EMs), intermediate metabolizers (IMs) and poor metabolizers (PMs; 16 subjects/group) participated in a randomized, open-label, 2-period cross-over study. Each study period lasted 7 days, with a loading dose of 24 mg of vicagrel or 300 mg of clopidogrel on day 1, and maintenance doses of 6 mg of vicagrel or 75 mg of clopidogrel daily from day 2 to day 7. The pharmacokinetics and pharmacodynamics were assessed on day 1 and day 7. RESULTS After a loading dose, the AUC0-t of the active metabolite H4 by vicagrel was slightly lower in IMs and PMs (decreased by 21 and 27%, respectively) compared to EMs. Similar results were found after maintenance doses. In EMs, the AUC0-t of H4 by vicagrel was somewhat higher than clopidogrel after the loading dose, and comparable with clopidogrel (90% confidence interval 0.94, 1.21) after the maintenance doses. However, it was much higher than clopidogrel in PMs, with a 1.28-fold (loading dose) and a 73% (maintenance doses) increases compared to clopidogrel (P < 0.001). Consequently, the inhibition of platelet aggregation by vicagrel was greater than clopidogrel after both loading dose (28.2 vs 12.4% at 4 hours, P < 0.01) and maintenance doses (42.8 vs 24.6% at 4 hours, P < 0.001) in PMs. CONCLUSIONS CYP2C19 polymorphisms have less impact on vicagrel as compared to clopidogrel. Drug exposure and response to vicagrel in PMs were even higher than to clopidogrel in IMs.
Collapse
Affiliation(s)
- Yifan Zhang
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Xiaoxue Zhu
- Phase I Clinical Trial Unit, First Hospital, Jilin University, Jilin, China
| | - Yan Zhan
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Xiaojiao Li
- Phase I Clinical Trial Unit, First Hospital, Jilin University, Jilin, China
| | - Cai Liu
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Yunting Zhu
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Hong Zhang
- Phase I Clinical Trial Unit, First Hospital, Jilin University, Jilin, China
| | - Haijing Wei
- Phase I Clinical Trial Unit, First Hospital, Jilin University, Jilin, China
| | - Yu Xia
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Hongbin Sun
- State Key Laboratory of Natural Medicines and Center of Drug Discovery, College of Pharmacy, China Pharmaceutical University, Nanjing, China
| | | | - Xiaojuan Lai
- Jiangsu Vcare PharmaTech Co., Ltd., Nanjing, China
| | - Yanchun Gong
- Jiangsu Vcare PharmaTech Co., Ltd., Nanjing, China
| | - Xuefang Liu
- Jiangsu Vcare PharmaTech Co., Ltd., Nanjing, China
| | | | - Yanhua Ding
- Phase I Clinical Trial Unit, First Hospital, Jilin University, Jilin, China
| | - Dafang Zhong
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| |
Collapse
|
9
|
|
10
|
Xu Z, Gu J, Gao M, Du N, Liu P, Xu X, Wang J, Cao X. Study on antiplatelet effect of a new thiophenopyridine platelets P2Y 12 receptor antagonist DV-127. Thromb Res 2018; 170:192-199. [PMID: 30199785 DOI: 10.1016/j.thromres.2018.08.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 08/03/2018] [Accepted: 08/31/2018] [Indexed: 12/22/2022]
Abstract
P2Y12 receptor antagonists are a class of drugs that act on platelet P2Y12 receptors and inhibit adenosine diphosphate-induced platelet aggregation. As a thienopyridine antiplatelet agent which is approved by the US Food and Drug Administration for the treatment of cardiovascular diseases, currently, clopidogrel was once considered to be the most safe and effective antiplatelet drug in the P2Y12 receptor antagonists, however, it has become increasingly clear that clopidogrel does not satisfactorily inhibit the platelets of approximately one-third of patients. This is in part due to clopidogrel is a prodrug and reliance on multiple cytochrome P450 enzymes for conversion into its active metabolite. Prasugrel and ticagrelor reduces the risk of adverse cardiovascular events compared to clopidogrel in acute coronary syndromes patients, however, the cardiovascular benefit of both drugs is counter-balanced by increased rates of spontaneous bleeding. Unlike clopidogrel, which is a prodrug, cangrelor is an active drug not requiring metabolic conversion, despite fewer bleeding events during cardiac surgery, cangrelor carries the risk of potential autoimmune reactions manifesting as breathlessness. DV-127 was synthesized by using three generations of thienopyridine P2Y12 receptor antagonists as research models, using high resolution mass spectrometry, selective deuteration, and 2,7-position replacement groups technologies in order to maximize cardiovascular benefit while minimizing adverse effects on hemostasis. Our results show that although the dose of DV-127 is greatly reduced, it can achieve similar anticoagulant and antiplatelet effects as clopidogrel, and DV-127 can more strongly inhibit the release of α-granules even though the inhibitory effect of dense granules is similar to clopidogrel.
Collapse
Affiliation(s)
- Zhiping Xu
- Department of Pharmacology, School of Pharmacy, Jilin University, Fujin Road, Changchun 130021, Jilin, China
| | - Jingkai Gu
- College of Life Sciences, Jilin University, Qianjin Street, Changchun 130012, Jilin, China.
| | - Mingyue Gao
- Department of Pharmacology, School of Pharmacy, Jilin University, Fujin Road, Changchun 130021, Jilin, China
| | - Na Du
- Department of Pharmacology, School of Pharmacy, Jilin University, Fujin Road, Changchun 130021, Jilin, China
| | - Peng Liu
- Department of Pharmacology, School of Pharmacy, Jilin University, Fujin Road, Changchun 130021, Jilin, China
| | - Xueyu Xu
- College of Life Sciences, Jilin University, Qianjin Street, Changchun 130012, Jilin, China; Tasly Academy, Tasly Holding Group Co.,Ltd., Tianjin 300410, China
| | - Jiayu Wang
- Department of Pharmacology, School of Pharmacy, Jilin University, Fujin Road, Changchun 130021, Jilin, China
| | - Xia Cao
- Department of Pharmacology, School of Pharmacy, Jilin University, Fujin Road, Changchun 130021, Jilin, China.
| |
Collapse
|
11
|
Abstract
Clopidogrel is one of the most frequently prescribed drugs worldwide; however, the presence of clopidogrel resistance and high susceptibility to genetic variations and drug interactions are facilitating the development of other antiplatelet drugs. To overcome clopidogrel resistance, several promising clopidogrel analogues have been developed in China, such as vicagrel (and its deuterated analogues), PLD-301, and W1. These novel chemical analogues are all characterized by much faster and more efficient bioconversion to clopidogrel thiolactone (or 2-oxo-clopidogrel, the precursor of clopidogrel active metabolite) in the intestine than clopidogrel itself through bypassing the first-step P450-mediated oxidation of clopidogrel in the liver. Of them, metabolic conversion of vicagrel and PLD-301 to 2-oxo-clopidogrel is catalyzed by intestinal carboxylesterase 2 and alkaline phosphatase, respectively. In this review article, we summarized all evidence on highly efficient bioconversion to their shared precursor of clopidogrel active metabolite and the mechanisms underlying such a pronounced improvement. These drugs in the pipeline would be promising antiplatelet drugs that could be superior to clopidogrel in future patient care.
Collapse
|
12
|
Li X, Liu C, Zhu X, Wei H, Zhang H, Chen H, Chen G, Yang D, Sun H, Shen Z, Zhang Y, Li W, Yang J, Liu Y, Lai X, Gong Y, Liu X, Li Y, Zhong D, Niu J, Liu B, Ding Y. Evaluation of Tolerability, Pharmacokinetics and Pharmacodynamics of Vicagrel, a Novel P2Y12 Antagonist, in Healthy Chinese Volunteers. Front Pharmacol 2018; 9:643. [PMID: 29973877 PMCID: PMC6019484 DOI: 10.3389/fphar.2018.00643] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 05/29/2018] [Indexed: 01/26/2023] Open
Abstract
Background: Vicagrel is a novel anti-platelet drug and hydrolyzed to the same intermediate as clopidogrel via esterase, instead of CYP2C19. Here we report the first clinical trial on the tolerability, pharmacokinetics and pharmacodynamics of different doses of vicagrel, and comparison with clopidogrel in healthy Chinese volunteers. Methods: This study was conducted in two parts. Study I was a dose-escalating (5-15 mg) study. For each dose, 15 participants were randomized into three groups (total n = 45); nine participants were given vicagrel, three were given clopidogrel, and three were given a placebo. Study II was conducted to assess interactions between vicagrel and aspirin in 15 healthy participants. The plasma concentrations of the metabolites of vicagrel and clopidogrel were determined using a LC-MS/MS method. Platelet aggregation was assessed using the VerifyNow-P2Y12 assay. Results: Vicagrel (5-15 mg per day) dosing for 10 days or addition of aspirin was well tolerated in healthy volunteers. The exposure of the active metabolite increased proportionally across the dose range and was higher (~10-fold) than clopidogrel. The levels of IPA dosing 75 mg clopidogrel were between the responses of 5 mg and 10 mg vicagrel. After a single loading dose of vicagrel (30 mg) and a once-daily maintenance dose (7.5 mg) for 8 days, the maximum inhibition of platelet aggregation was similar to that seen with the combined use of vicagrel and aspirin (100 mg/day). Conclusion: Oral vicagrel demonstrated a favorable safety profile and excellent anti-platelet activity, which could be a promising P2Y12 antagonist as anti-platelet drug and can be further developed in phase II/III studies, and marketing for the unmet medical needs of cardiovascular diseases. The study was registered at http://www.chictr.org.cn (ChiCTR-IIR-16009260).
Collapse
Affiliation(s)
- Xiaojiao Li
- Phase I Clinical Trial Unit, First Hospital, Jilin University, Jilin, China
| | - Cai Liu
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Xiaoxue Zhu
- Phase I Clinical Trial Unit, First Hospital, Jilin University, Jilin, China
| | - Haijing Wei
- Phase I Clinical Trial Unit, First Hospital, Jilin University, Jilin, China
| | - Hong Zhang
- Phase I Clinical Trial Unit, First Hospital, Jilin University, Jilin, China
| | - Hong Chen
- Phase I Clinical Trial Unit, First Hospital, Jilin University, Jilin, China
| | - Guiling Chen
- Phase I Clinical Trial Unit, First Hospital, Jilin University, Jilin, China
| | - Deming Yang
- Phase I Clinical Trial Unit, First Hospital, Jilin University, Jilin, China
| | - Hongbin Sun
- State Key Laboratory of Natural Medicines and Center of Drug Discovery, College of Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Zhenwei Shen
- First Hospital and Institute of Immunology, First Hospital, Jilin University, Jilin, China
| | - Yifan Zhang
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Wei Li
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Jin Yang
- Center of Drug Metabolism and Pharmacokinetics, China Pharmaceutical University, Nanjing, China
| | | | - Xiaojuan Lai
- Jiangsu Vcare PharmaTech Co. Ltd., Nanjing, China
| | - Yanchun Gong
- Jiangsu Vcare PharmaTech Co. Ltd., Nanjing, China
| | - Xuefang Liu
- Jiangsu Vcare PharmaTech Co. Ltd., Nanjing, China
| | | | - Dafang Zhong
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Junqi Niu
- Department of Hepatology, First Hospital, Jilin University, Jilin, China
| | - Bin Liu
- Department of Hand Surgery, First Hospital, Jilin University, Jilin, China
| | - Yanhua Ding
- Phase I Clinical Trial Unit, First Hospital, Jilin University, Jilin, China
| |
Collapse
|
13
|
Zhou SF, Zhong WZ. Drug Design and Discovery: Principles and Applications. Molecules 2017; 22:molecules22020279. [PMID: 28208821 PMCID: PMC6155886 DOI: 10.3390/molecules22020279] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 02/08/2017] [Accepted: 02/09/2017] [Indexed: 12/23/2022] Open
Affiliation(s)
- Shu-Feng Zhou
- Department of Bioengineering and Biotechnology, College of Chemical Engineering, Huaqiao University, Xiamen 361021, Fujian, China.
| | - Wei-Zhu Zhong
- Gordon Life Science Institute, Belmont, MA 02478, USA.
| |
Collapse
|