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Gale JD, Gilbert S, Blumenthal S, Elliott T, Pergola PE, Goteti K, Scheele W, Perros-Huguet C. Effect of PF-04634817, an Oral CCR2/5 Chemokine Receptor Antagonist, on Albuminuria in Adults with Overt Diabetic Nephropathy. Kidney Int Rep 2018; 3:1316-1327. [PMID: 30450458 PMCID: PMC6224665 DOI: 10.1016/j.ekir.2018.07.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 05/22/2018] [Accepted: 07/02/2018] [Indexed: 01/09/2023] Open
Abstract
Introduction Inflammatory cell recruitment, which is potentially mediated by the monocyte chemoattractant protein 1/C-C chemokine receptor type 2 (CCR2) system and by C-C chemokine receptor type 5 (CCR5) activity, may play a role in the development and progression of diabetic nephropathy. PF-04634817 is a dual chemokine CCR2/5 receptor antagonist that is being developed for the treatment of diabetic nephropathy. Methods We evaluated the efficacy of PF-04634817 compared with matching placebo for reduction of albuminuria after 12 weeks of treatment in subjects with type 2 diabetes who received standard of care (SOC; angiotensin-converting enzyme inhibitor or angiotensin receptor blocker therapy), in a randomized, double-blind, placebo-controlled, parallel-group phase 2 study. Results A total of 226 subjects who received SOC with baseline estimated glomerular filtration rates between 20 and 75 ml/min per 1.73 m2 and a baseline urinary albumin-to-creatinine ratio (UACR) of ≥300 mg/g were randomly assigned 3:1 to receive PF-04634817 (150 or 200 mg orally, once daily) or placebo. The primary analysis was Bayesian, with an informative prior for placebo response (equivalent to including an additional 80 subjects in the placebo arm). We observed a placebo-adjusted reduction in UACR of 8.2% (ratio 0.918; 95% credible interval: 0.75–1.09) at week 12 in the PF-04634817 arm. PF-04634817 appeared to be safe and well-tolerated. Conclusion Despite the good safety profile shown by PF-04634817, clinical development for this indication was discontinued in light of the modest efficacy observed.
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Affiliation(s)
- Jeremy D Gale
- Inflammation and Immunology Research Unit, Pfizer Inc, Cambridge, Massachusetts, USA
| | - Steven Gilbert
- Early Clinical Development, Pfizer Inc, Cambridge, Massachusetts, USA
| | - Samuel Blumenthal
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Tom Elliott
- BC Diabetes, Vancouver, British Columbia, Canada
| | | | - Kosalaram Goteti
- Early Clinical Development, Pfizer Inc, Cambridge, Massachusetts, USA
| | - Wim Scheele
- Clinical Development and Operations, Pfizer Inc, Cambridge, Massachusetts, USA
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Gale JD, Berger B, Gilbert S, Popa S, Sultan MB, Schachar RA, Girgenti D, Perros-Huguet C. A CCR2/5 Inhibitor, PF-04634817, Is Inferior to Monthly Ranibizumab in the Treatment of Diabetic Macular Edema. ACTA ACUST UNITED AC 2018; 59:2659-2669. [DOI: 10.1167/iovs.17-22731] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Jeremy D. Gale
- Inflammation and Immunology Research Unit, Pfizer, Inc., Cambridge, Massachusetts, United States
| | - Brian Berger
- Retina Research Center, Austin, Texas, United States
| | - Steven Gilbert
- Early Clinical Development, Pfizer, Inc., Cambridge, Massachusetts, United States
| | - Serghei Popa
- Department of Rheumatology and Nephrology, State University of Medicine and Pharmacy, N. Testemitanu, Chisinau, Moldova
| | - Marla B. Sultan
- Global Product Development, Pfizer, Inc., New York, New York, United States
| | - Ronald A. Schachar
- Clinical Affairs, Pfizer Essential Health, Pfizer, Inc., San Diego, California, United States
| | - Douglas Girgenti
- Global Product Development, Pfizer, Inc., New York, New York, United States
| | - Christelle Perros-Huguet
- Inflammation and Immunology Research Unit, Pfizer, Inc., Cambridge, Massachusetts, United States
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Scheele W, Diamond S, Gale J, Clerin V, Tamimi N, Le V, Walley R, Grover-Páez F, Perros-Huguet C, Rolph T, El Nahas M. Phosphodiesterase Type 5 Inhibition Reduces Albuminuria in Subjects with Overt Diabetic Nephropathy. J Am Soc Nephrol 2016; 27:3459-3468. [PMID: 27113485 DOI: 10.1681/asn.2015050473] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 02/23/2016] [Indexed: 12/31/2022] Open
Abstract
Diabetic nephropathy (DN) is the leading cause of ESRD worldwide. Reduced bioavailability or uncoupling of nitric oxide in the kidney, leading to decreased intracellular levels of the nitric oxide pathway effector molecule cyclic guanosine monophosphate (cGMP), has been implicated in the progression of DN. Preclinical studies suggest that elevating the cGMP intracellular pool through inhibition of the cGMP-hydrolyzing enzyme phosphodiesterase type 5 (PDE5) might exert renoprotective effects in DN. To test this hypothesis, the novel, highly specific, and long-acting PDE5 inhibitor, PF-00489791, was assessed in a multinational, multicenter, randomized, double-blind, placebo-controlled, parallel group trial of subjects with type 2 diabetes mellitus and overt nephropathy receiving angiotensin converting enzyme inhibitor or angiotensin receptor blocker background therapy. In total, 256 subjects with an eGFR between 25 and 60 ml/min per 1.73 m2 and macroalbuminuria defined by a urinary albumin-to-creatinine ratio >300 mg/g, were randomly assigned 3:1, respectively, to receive PF-00489791 (20 mg) or placebo orally, once daily for 12 weeks. Using the predefined primary assessment of efficacy (Bayesian analysis with informative prior), we observed a significant reduction in urinary albumin-to-creatinine ratio of 15.7% (ratio 0.843; 95% credible interval 0.73 to 0.98) in response to the 12-week treatment with PF-00489791 compared with placebo. PF-00489791 was safe and generally well tolerated in this patient population. Most common adverse events were mild in severity and included headache and upper gastrointestinal events. In conclusion, the safety and efficacy profile of PDE5 inhibitor PF-00489791 supports further investigation as a novel therapy to improve renal outcomes in DN.
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Affiliation(s)
| | - Susan Diamond
- San Antonio Kidney Disease Center, San Antonio, Texas
| | | | | | | | - Vu Le
- Pfizer Inc., Cambridge, Massachusetts
| | | | - Fernando Grover-Páez
- Institute of Experimental and Clinical Therapeutics, Universidad de Guadalajara, Guadalajara, México; and
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Singh D, Siew L, Christensen J, Plumb J, Clarke GW, Greenaway S, Perros-Huguet C, Clarke N, Kilty I, Tan L. Oral and inhaled p38 MAPK inhibitors: effects on inhaled LPS challenge in healthy subjects. Eur J Clin Pharmacol 2015; 71:1175-84. [PMID: 26265232 PMCID: PMC4564450 DOI: 10.1007/s00228-015-1920-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 07/28/2015] [Indexed: 11/12/2022]
Abstract
Background Inhaled LPS causes neutrophilic airway inflammation in healthy subjects. We compared the effects of p38 MAPK inhibitors and fluticasone propionate on the LPS response. Methods Three randomised, double-blind, placebo-controlled, single dose crossover studies were performed. Active treatments were the oral p38 MAPK inhibitor PH-797804 30 mg (study 1), PH-797804 30 mg and the inhaled p38 MAPK inhibitor PF-03715455 20 mg (study 2) and inhaled fluticasone propionate 500 μg (study 3). The primary endpoint was sputum neutrophil percentage. Results Sputum neutrophil percentage post-LPS challenge was significantly inhibited (15.1 and 15.3 % reduction) by PH-797804 compared to placebo in studies 1 and 2 (p = 0.0096 and 0.0001, respectively), and by PF-03715455 (8.0 % reduction, p = 0.031); fluticasone propionate had no effect. PH-797804 significantly inhibited the increase in inflammatory mediators (IL-6, MCP-1, MIP1β and CC16) in sputum supernatant, while PF-03715455 had no effect. PH-797804 and PF-03715455 both inhibited IL-6, MCP-1, MIP1β, CC16 and CRP levels in plasma, with PH-797804 having greater effects. Fluticasone propionate had no effect on sputum supernatant or plasma biomarkers. Conclusions PH-797804 had the greatest impact on neutrophilic airway inflammation. Oral administration of p38 MAPK inhibitors may optimise pulmonary anti-inflammatory effects. Electronic supplementary material The online version of this article (doi:10.1007/s00228-015-1920-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Dave Singh
- University Of Manchester, Medicines Evaluation Unit, University Hospital of South Manchester Foundation Trust, Manchester, M23 9QZ, UK.
| | - Leonard Siew
- Quintiles Drug Research Unit, Respiratory and Inflammation Early Clinical Development, Quintiles Ltd, London, SE1 1YR, UK
| | | | - Jonathan Plumb
- University Of Manchester, Medicines Evaluation Unit, University Hospital of South Manchester Foundation Trust, Manchester, M23 9QZ, UK
| | - Graham W Clarke
- Quintiles Drug Research Unit, Respiratory and Inflammation Early Clinical Development, Quintiles Ltd, London, SE1 1YR, UK.,Department of Cardiothoracic Pharmacology, Imperial College, National Heart and Lung Institute, London, UK
| | - Steve Greenaway
- Quintiles Drug Research Unit, Respiratory and Inflammation Early Clinical Development, Quintiles Ltd, London, SE1 1YR, UK
| | | | - Nick Clarke
- Pfizer Inc. Inflammation and Remodeling Unit, Cambridge, MA, USA
| | - Iain Kilty
- Pfizer Inc. Inflammation and Remodeling Unit, Cambridge, MA, USA
| | - Lisa Tan
- Pfizer Inc. Inflammation and Remodeling Unit, Cambridge, MA, USA
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Glossop PA, Watson CAL, Price DA, Bunnage ME, Middleton DS, Wood A, James K, Roberts D, Strang RS, Yeadon M, Perros-Huguet C, Clarke NP, Trevethick MA, Machin I, Stuart EF, Evans SM, Harrison AC, Fairman DA, Agoram B, Burrows JL, Feeder N, Fulton CK, Dillon BR, Entwistle DA, Spence FJ. Inhalation by Design: Novel Tertiary Amine Muscarinic M3 Receptor Antagonists with Slow Off-Rate Binding Kinetics for Inhaled Once-Daily Treatment of Chronic Obstructive Pulmonary Disease. J Med Chem 2011; 54:6888-904. [DOI: 10.1021/jm200884j] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Paul A. Glossop
- Department of Worldwide Medicinal Chemistry, ‡Allergy and Respiratory Research Unit, §Department of Pharmacokinetics, Dynamics and Metabolism, ⊥Department of Pharmaceutical Sciences, and ▽̂Department of Drug Safety, Pfizer Global Research and Development, Sandwich Laboratories, Ramsgate Road, Kent CT13 9NJ, U.K
| | - Christine A. L. Watson
- Department of Worldwide Medicinal Chemistry, ‡Allergy and Respiratory Research Unit, §Department of Pharmacokinetics, Dynamics and Metabolism, ⊥Department of Pharmaceutical Sciences, and ▽̂Department of Drug Safety, Pfizer Global Research and Development, Sandwich Laboratories, Ramsgate Road, Kent CT13 9NJ, U.K
| | - David A. Price
- Department of Worldwide Medicinal Chemistry, ‡Allergy and Respiratory Research Unit, §Department of Pharmacokinetics, Dynamics and Metabolism, ⊥Department of Pharmaceutical Sciences, and ▽̂Department of Drug Safety, Pfizer Global Research and Development, Sandwich Laboratories, Ramsgate Road, Kent CT13 9NJ, U.K
| | - Mark E. Bunnage
- Department of Worldwide Medicinal Chemistry, ‡Allergy and Respiratory Research Unit, §Department of Pharmacokinetics, Dynamics and Metabolism, ⊥Department of Pharmaceutical Sciences, and ▽̂Department of Drug Safety, Pfizer Global Research and Development, Sandwich Laboratories, Ramsgate Road, Kent CT13 9NJ, U.K
| | - Donald S. Middleton
- Department of Worldwide Medicinal Chemistry, ‡Allergy and Respiratory Research Unit, §Department of Pharmacokinetics, Dynamics and Metabolism, ⊥Department of Pharmaceutical Sciences, and ▽̂Department of Drug Safety, Pfizer Global Research and Development, Sandwich Laboratories, Ramsgate Road, Kent CT13 9NJ, U.K
| | - Anthony Wood
- Department of Worldwide Medicinal Chemistry, ‡Allergy and Respiratory Research Unit, §Department of Pharmacokinetics, Dynamics and Metabolism, ⊥Department of Pharmaceutical Sciences, and ▽̂Department of Drug Safety, Pfizer Global Research and Development, Sandwich Laboratories, Ramsgate Road, Kent CT13 9NJ, U.K
| | - Kim James
- Department of Worldwide Medicinal Chemistry, ‡Allergy and Respiratory Research Unit, §Department of Pharmacokinetics, Dynamics and Metabolism, ⊥Department of Pharmaceutical Sciences, and ▽̂Department of Drug Safety, Pfizer Global Research and Development, Sandwich Laboratories, Ramsgate Road, Kent CT13 9NJ, U.K
| | - Dannielle Roberts
- Department of Worldwide Medicinal Chemistry, ‡Allergy and Respiratory Research Unit, §Department of Pharmacokinetics, Dynamics and Metabolism, ⊥Department of Pharmaceutical Sciences, and ▽̂Department of Drug Safety, Pfizer Global Research and Development, Sandwich Laboratories, Ramsgate Road, Kent CT13 9NJ, U.K
| | - Ross S. Strang
- Department of Worldwide Medicinal Chemistry, ‡Allergy and Respiratory Research Unit, §Department of Pharmacokinetics, Dynamics and Metabolism, ⊥Department of Pharmaceutical Sciences, and ▽̂Department of Drug Safety, Pfizer Global Research and Development, Sandwich Laboratories, Ramsgate Road, Kent CT13 9NJ, U.K
| | - Michael Yeadon
- Department of Worldwide Medicinal Chemistry, ‡Allergy and Respiratory Research Unit, §Department of Pharmacokinetics, Dynamics and Metabolism, ⊥Department of Pharmaceutical Sciences, and ▽̂Department of Drug Safety, Pfizer Global Research and Development, Sandwich Laboratories, Ramsgate Road, Kent CT13 9NJ, U.K
| | - Christelle Perros-Huguet
- Department of Worldwide Medicinal Chemistry, ‡Allergy and Respiratory Research Unit, §Department of Pharmacokinetics, Dynamics and Metabolism, ⊥Department of Pharmaceutical Sciences, and ▽̂Department of Drug Safety, Pfizer Global Research and Development, Sandwich Laboratories, Ramsgate Road, Kent CT13 9NJ, U.K
| | - Nicholas P. Clarke
- Department of Worldwide Medicinal Chemistry, ‡Allergy and Respiratory Research Unit, §Department of Pharmacokinetics, Dynamics and Metabolism, ⊥Department of Pharmaceutical Sciences, and ▽̂Department of Drug Safety, Pfizer Global Research and Development, Sandwich Laboratories, Ramsgate Road, Kent CT13 9NJ, U.K
| | - Michael A. Trevethick
- Department of Worldwide Medicinal Chemistry, ‡Allergy and Respiratory Research Unit, §Department of Pharmacokinetics, Dynamics and Metabolism, ⊥Department of Pharmaceutical Sciences, and ▽̂Department of Drug Safety, Pfizer Global Research and Development, Sandwich Laboratories, Ramsgate Road, Kent CT13 9NJ, U.K
| | - Ian Machin
- Department of Worldwide Medicinal Chemistry, ‡Allergy and Respiratory Research Unit, §Department of Pharmacokinetics, Dynamics and Metabolism, ⊥Department of Pharmaceutical Sciences, and ▽̂Department of Drug Safety, Pfizer Global Research and Development, Sandwich Laboratories, Ramsgate Road, Kent CT13 9NJ, U.K
| | - Emilio F. Stuart
- Department of Worldwide Medicinal Chemistry, ‡Allergy and Respiratory Research Unit, §Department of Pharmacokinetics, Dynamics and Metabolism, ⊥Department of Pharmaceutical Sciences, and ▽̂Department of Drug Safety, Pfizer Global Research and Development, Sandwich Laboratories, Ramsgate Road, Kent CT13 9NJ, U.K
| | - Steven M. Evans
- Department of Worldwide Medicinal Chemistry, ‡Allergy and Respiratory Research Unit, §Department of Pharmacokinetics, Dynamics and Metabolism, ⊥Department of Pharmaceutical Sciences, and ▽̂Department of Drug Safety, Pfizer Global Research and Development, Sandwich Laboratories, Ramsgate Road, Kent CT13 9NJ, U.K
| | - Anthony C. Harrison
- Department of Worldwide Medicinal Chemistry, ‡Allergy and Respiratory Research Unit, §Department of Pharmacokinetics, Dynamics and Metabolism, ⊥Department of Pharmaceutical Sciences, and ▽̂Department of Drug Safety, Pfizer Global Research and Development, Sandwich Laboratories, Ramsgate Road, Kent CT13 9NJ, U.K
| | - David A. Fairman
- Department of Worldwide Medicinal Chemistry, ‡Allergy and Respiratory Research Unit, §Department of Pharmacokinetics, Dynamics and Metabolism, ⊥Department of Pharmaceutical Sciences, and ▽̂Department of Drug Safety, Pfizer Global Research and Development, Sandwich Laboratories, Ramsgate Road, Kent CT13 9NJ, U.K
| | - Balaji Agoram
- Department of Worldwide Medicinal Chemistry, ‡Allergy and Respiratory Research Unit, §Department of Pharmacokinetics, Dynamics and Metabolism, ⊥Department of Pharmaceutical Sciences, and ▽̂Department of Drug Safety, Pfizer Global Research and Development, Sandwich Laboratories, Ramsgate Road, Kent CT13 9NJ, U.K
| | - Jane L. Burrows
- Department of Worldwide Medicinal Chemistry, ‡Allergy and Respiratory Research Unit, §Department of Pharmacokinetics, Dynamics and Metabolism, ⊥Department of Pharmaceutical Sciences, and ▽̂Department of Drug Safety, Pfizer Global Research and Development, Sandwich Laboratories, Ramsgate Road, Kent CT13 9NJ, U.K
| | - Neil Feeder
- Department of Worldwide Medicinal Chemistry, ‡Allergy and Respiratory Research Unit, §Department of Pharmacokinetics, Dynamics and Metabolism, ⊥Department of Pharmaceutical Sciences, and ▽̂Department of Drug Safety, Pfizer Global Research and Development, Sandwich Laboratories, Ramsgate Road, Kent CT13 9NJ, U.K
| | - Craig K. Fulton
- Department of Worldwide Medicinal Chemistry, ‡Allergy and Respiratory Research Unit, §Department of Pharmacokinetics, Dynamics and Metabolism, ⊥Department of Pharmaceutical Sciences, and ▽̂Department of Drug Safety, Pfizer Global Research and Development, Sandwich Laboratories, Ramsgate Road, Kent CT13 9NJ, U.K
| | - Barry R. Dillon
- Department of Worldwide Medicinal Chemistry, ‡Allergy and Respiratory Research Unit, §Department of Pharmacokinetics, Dynamics and Metabolism, ⊥Department of Pharmaceutical Sciences, and ▽̂Department of Drug Safety, Pfizer Global Research and Development, Sandwich Laboratories, Ramsgate Road, Kent CT13 9NJ, U.K
| | - David A. Entwistle
- Department of Worldwide Medicinal Chemistry, ‡Allergy and Respiratory Research Unit, §Department of Pharmacokinetics, Dynamics and Metabolism, ⊥Department of Pharmaceutical Sciences, and ▽̂Department of Drug Safety, Pfizer Global Research and Development, Sandwich Laboratories, Ramsgate Road, Kent CT13 9NJ, U.K
| | - Fiona J. Spence
- Department of Worldwide Medicinal Chemistry, ‡Allergy and Respiratory Research Unit, §Department of Pharmacokinetics, Dynamics and Metabolism, ⊥Department of Pharmaceutical Sciences, and ▽̂Department of Drug Safety, Pfizer Global Research and Development, Sandwich Laboratories, Ramsgate Road, Kent CT13 9NJ, U.K
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