1
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Schürmann D, Jackson Rudd D, Schaeffer A, De Lepeleire I, Friedman EJ, Robberechts M, Zhang S, Liu Y, Kandala B, Keicher C, Däumer M, Hofmann J, Grobler JA, Stoch SA, Iwamoto M, Ankrom W. Single Oral Doses of MK-8507, a Novel Non-Nucleoside Reverse Transcriptase Inhibitor, Suppress HIV-1 RNA for a Week. J Acquir Immune Defic Syndr 2022; 89:191-198. [PMID: 34654041 PMCID: PMC8740605 DOI: 10.1097/qai.0000000000002834] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 09/20/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND MK-8507 is a novel HIV-1 non-nucleoside reverse transcriptase inhibitor being developed for treatment of HIV-1 infection. MK-8507 has high antiviral potency in vitro and pharmacokinetic (PK) properties that support once-weekly dosing. SETTING A phase 1, open-label, proof-of-concept study was conducted in treatment-naive adults with HIV-1 infection to assess monotherapy antiviral activity. METHODS In 3 sequential panels, participants aged 18-60 years with baseline plasma HIV-1 RNA ≥10,000 copies/mL and CD4+ T-cell count >200/mm3 received a single oral dose of 40, 80, or 600 mg MK-8507 in the fasted state. Participants were assessed for HIV-1 RNA for at least 7 days, PKs for 14 days, and safety and tolerability for 21 days postdose. RESULTS A total of 18 participants were enrolled (6 per panel). The mean 7-day postdose HIV-1 RNA reduction ranged from ∼1.2 to ∼1.5 log10 copies/mL across the doses assessed. One patient had a viral rebound associated with emergence of an F227C reverse transcriptase variant (per chain-termination method sequencing) 14 days postdose; this variant was found in a second participant by ultra-deep sequencing as an emerging minority variant. MK-8507 PKs were generally dose-proportional and similar to observations in participants without HIV-1 infection in prior studies; mean MK-8507 half life was 56-69 hours in this study. MK-8507 was generally well tolerated at all doses. CONCLUSIONS The robust antiviral activity, PK, and tolerability of MK-8507 support its continued development as part of a complete once weekly oral regimen for HIV-1 treatment; combination therapy could mitigate the emergence of resistance-associated variants.
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Affiliation(s)
- Dirk Schürmann
- Charité Research Organisation GmbH, Berlin, Germany
- Department of Infectious Diseases and Respiratory Medicine, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | | | | | | | | | | | | | - Yang Liu
- Merck & Co., Inc., Kenilworth, NJ
| | | | | | | | - Jörg Hofmann
- Institute of Virology, Charité–Universitätsmedizin Berlin, Berlin, Germany
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Li W, Wang Y, Lohith TG, Zeng Z, Tong L, Mazzola R, Riffel K, Miller P, Purcell M, Holahan M, Haley H, Gantert L, Hesk D, Ren S, Morrow J, Uslaner J, Struyk A, Wai JMC, Rudd MT, Tellers DM, McAvoy T, Bormans G, Koole M, Van Laere K, Serdons K, de Hoon J, Declercq R, De Lepeleire I, Pascual MB, Zanotti-Fregonara P, Yu M, Arbones V, Masdeu JC, Cheng A, Hussain A, Bueters T, Anderson MS, Hostetler ED, Basile AS. The PET tracer [ 11C]MK-6884 quantifies M4 muscarinic receptor in rhesus monkeys and patients with Alzheimer's disease. Sci Transl Med 2022; 14:eabg3684. [PMID: 35020407 DOI: 10.1126/scitranslmed.abg3684] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
[Figure: see text].
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Affiliation(s)
- Wenping Li
- MRL, Merck & Co. Inc., Kenilworth, NJ 07033, USA
| | - Yuchuan Wang
- MRL, Merck & Co. Inc., Kenilworth, NJ 07033, USA
| | | | - Zhizhen Zeng
- MRL, Merck & Co. Inc., Kenilworth, NJ 07033, USA
| | - Ling Tong
- MRL, Merck & Co. Inc., Kenilworth, NJ 07033, USA
| | | | - Kerry Riffel
- MRL, Merck & Co. Inc., Kenilworth, NJ 07033, USA
| | | | - Mona Purcell
- MRL, Merck & Co. Inc., Kenilworth, NJ 07033, USA
| | | | - Hyking Haley
- MRL, Merck & Co. Inc., Kenilworth, NJ 07033, USA
| | - Liza Gantert
- MRL, Merck & Co. Inc., Kenilworth, NJ 07033, USA
| | - David Hesk
- MRL, Merck & Co. Inc., Kenilworth, NJ 07033, USA
| | - Sumei Ren
- MRL, Merck & Co. Inc., Kenilworth, NJ 07033, USA
| | - John Morrow
- MRL, Merck & Co. Inc., Kenilworth, NJ 07033, USA
| | | | - Arie Struyk
- MRL, Merck & Co. Inc., Kenilworth, NJ 07033, USA
| | | | | | | | | | - Guy Bormans
- Laboratory for Radiopharmaceutical Research, KU Leuven, 3001 Leuven, Belgium
| | - Michel Koole
- Nuclear Medicine and Molecular Imaging, KU Leuven and University Hospital Leuven, 3001 Leuven, Belgium
| | - Koen Van Laere
- Nuclear Medicine and Molecular Imaging, KU Leuven and University Hospital Leuven, 3001 Leuven, Belgium
| | - Kim Serdons
- Nuclear Medicine and Molecular Imaging, KU Leuven and University Hospital Leuven, 3001 Leuven, Belgium
| | - Jan de Hoon
- Center for Clinical Pharmacology, KU Leuven, 3001 Leuven, Belgium
| | - Ruben Declercq
- Translational Pharmacology Europe, MSD (Europe) Inc., 1200 Brussels, Belgium
| | - Inge De Lepeleire
- Translational Pharmacology Europe, MSD (Europe) Inc., 1200 Brussels, Belgium
| | - Maria B Pascual
- Nantz National Alzheimer Center, Houston Methodist Neurological Institute, Houston, TX 77030, USA.,Department of Neurology, Weill Cornell Medicine, New York, NY 10065, USA
| | - Paolo Zanotti-Fregonara
- Nantz National Alzheimer Center, Houston Methodist Neurological Institute, Houston, TX 77030, USA.,Department of Neurology, Weill Cornell Medicine, New York, NY 10065, USA
| | - Meixiang Yu
- Nantz National Alzheimer Center, Houston Methodist Neurological Institute, Houston, TX 77030, USA.,Department of Neurology, Weill Cornell Medicine, New York, NY 10065, USA
| | - Victoria Arbones
- Nantz National Alzheimer Center, Houston Methodist Neurological Institute, Houston, TX 77030, USA
| | - Joseph C Masdeu
- Nantz National Alzheimer Center, Houston Methodist Neurological Institute, Houston, TX 77030, USA.,Department of Neurology, Weill Cornell Medicine, New York, NY 10065, USA
| | - Amy Cheng
- MRL, Merck & Co. Inc., Kenilworth, NJ 07033, USA
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Matthews RP, Ankrom W, Friedman E, Jackson Rudd D, Liu Y, Mogg R, Panebianco D, De Lepeleire I, Petkova M, Grobler JA, Stoch SA, Iwamoto M. Safety, tolerability, and pharmacokinetics of single- and multiple-dose administration of islatravir (MK-8591) in adults without HIV. Clin Transl Sci 2021; 14:1935-1944. [PMID: 34463432 PMCID: PMC8504818 DOI: 10.1111/cts.13048] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/02/2021] [Accepted: 03/22/2021] [Indexed: 12/04/2022] Open
Abstract
Islatravir (MK‐8591) is a nucleoside analogue in development for the treatment and prevention of HIV‐1. Two phase 1 trials were conducted during initial evaluation of islatravir: rising single doses (Study 1) and rising multiple doses (Study 2) of oral islatravir in male and female participants without HIV (aged 18–60 years). Safety, tolerability, and pharmacokinetics of islatravir (plasma) and islatravir‐triphosphate (peripheral blood mononuclear cells) were assessed. In Study 1, 24 participants, assigned to 1 of 3 panels, received alternating single doses of islatravir in a fasted state from 5 mg to 400 mg, or placebo, over 3 dosing periods; a 30 mg dose was additionally assessed following a high‐fat meal. In Study 2, 8 participants per dose received 3 once‐weekly doses of 10, 30, or 100 mg islatravir or placebo in a fasted state. For each panel in both trials, 6 participants received active drug and 2 received placebo. Islatravir was generally well‐tolerated, with no serious adverse events or discontinuations due to adverse events. Islatravir was rapidly absorbed (median time to maximum plasma concentration 0.5 hours); plasma half‐life was 49–61 h; intracellular islatravir‐triphosphate half‐life was 118–171 h. Plasma exposure increased in an approximately dose‐proportional manner; there was no meaningful food effect. There was a modest degree of intracellular islatravir‐triphosphate accumulation after multiple weekly dosing. After single oral doses of islatravir greater than or equal to 5 mg, intracellular islatravir‐triphosphate levels were comparable to levels associated with efficacy in preclinical studies. These results warrant continued clinical investigation of islatravir.
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Affiliation(s)
| | | | | | | | - Yang Liu
- Merck & Co., Inc., Kenilworth, New Jersey, USA
| | - Robin Mogg
- Merck & Co., Inc., Kenilworth, New Jersey, USA
| | | | | | - Magdalena Petkova
- SGS Life Science Services, Clinical Pharmacology Unit Antwerpen, Antwerpen, Belgium
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4
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Schürmann D, Rudd DJ, Zhang S, De Lepeleire I, Robberechts M, Friedman E, Keicher C, Hüser A, Hofmann J, Grobler JA, Stoch SA, Iwamoto M, Matthews RP. Safety, pharmacokinetics, and antiretroviral activity of islatravir (ISL, MK-8591), a novel nucleoside reverse transcriptase translocation inhibitor, following single-dose administration to treatment-naive adults infected with HIV-1: an open-label, phase 1b, consecutive-panel trial. Lancet HIV 2020; 7:e164-e172. [PMID: 31911147 DOI: 10.1016/s2352-3018(19)30372-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 10/24/2019] [Accepted: 10/29/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Islatravir (also known as ISL and MK-8591) is a unique nucleoside reverse transcriptase translocation inhibitor in clinical development for treatment of people with HIV-1 infection. In preclinical studies, intracellular islatravir-triphosphate exhibits a long half-life and prolonged virological effects. In this study, we aimed to assess islatravir safety, pharmacokinetics, and antiretroviral activity in treatment-naive adults with HIV-1 infection. METHODS This open-label, consecutive-panel, phase 1b trial was done at Charité Research Organisation (Berlin, Germany) and included men and women (aged 18-60 years, inclusive) with HIV-1 infection who were ART naive. Participants were required to have plasma HIV-1 RNA counts of at least 10 000 copies per mL within 30 days before the trial treatment phase, without evidence of resistance to nucleoside reverse transcriptase inhibitors. Participants were enrolled in one of five consecutive dosing panels, receiving a single oral dose of islatravir (0·5-30 mg). The primary outcomes were safety and tolerability of islatravir and change from baseline in HIV-1 plasma RNA; secondary outcomes were islatravir plasma and islatravir-triphosphate intracellular pharmacokinetics. We obtained descriptive safety and pharmacokinetics statistics, and estimated efficacy results from a longitudinal data analysis model. This study is registered with ClinicalTrials.gov, NCT02217904, and EudraCT, 2014-002192-28. FINDINGS Between Sept 17, 2015, and May 11, 2017, we enrolled 30 participants (six per panel). Islatravir was generally well tolerated. 27 (90%) participants had 60 adverse events after receipt of drug, of which 21 (35%) were deemed to be drug related. The most common (n>1) drug-related adverse events were headache (in nine [30%] participants) and diarrhoea (in two [7%]). No serious adverse events were reported, and no participants discontinued due to an adverse event. Plasma islatravir pharmacokinetics and intracellular islatravir-triphosphate pharmacokinetics were approximately dose proportional. The islatravir-triphosphate intracellular half-life was 78·5-128·0 h. Least-squares mean HIV-1 RNA at 7 days after dose decreased from 1·67 log10 copies per mL (95% CI 1·42-1·92) at 10 mg dose to 1·20 log10 copies per mL (0·95-1·46) at 0·5 mg dose. No genetic changes consistent with development of viral resistance were detected. INTERPRETATION Single doses of islatravir as low as 0·5 mg significantly suppressed HIV-1 RNA by more than 1·0 log at day 7 in treatment-naive adults with HIV-1 infection and were generally well tolerated, supporting the further development of islatravir as a flexible-dose treatment for individuals with HIV-1 infection. FUNDING Merck Sharp & Dohme Corp, a subsidiary of Merck & Co Inc, Kenilworth, NJ, USA.
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Affiliation(s)
- Dirk Schürmann
- Charité Research Organisation, Berlin, Germany; Department of Infectious Diseases and Pulmonary Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | | | | | | | | | | | | | | | - Jörg Hofmann
- Institute of Virology, Charité Universitätsmedizin Berlin, Berlin, Germany; Labor Berlin - Charité Vivantes, Berlin, Germany
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5
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Ravi A, Chang M, van de Pol M, Yang S, Aliprantis A, Thornton B, Carayannopoulos LN, Bautmans A, Robberechts M, De Lepeleire I, Singh D, Hohlfeld JM, Sterk PJ, Krug N, Lutter R. Rhinovirus-16 induced temporal interferon responses in nasal epithelium links with viral clearance and symptoms. Clin Exp Allergy 2019; 49:1587-1597. [PMID: 31400236 PMCID: PMC6972523 DOI: 10.1111/cea.13481] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 06/27/2019] [Accepted: 07/30/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND The temporal in vivo response of epithelial cells to a viral challenge and its association with viral clearance and clinical outcomes has been largely unexplored in asthma. OBJECTIVE To determine gene expression profiles over time in nasal epithelial cells (NECs) challenged in vivo with rhinovirus-16 (RV16) and compare to nasal symptoms and viral clearance. METHODS Patients with stable mild to moderate asthma (n = 20) were challenged intranasally with RV16. Nasal brush samples for RNA sequencing were taken 7 days prior to infection and 3, 6 and 14 days post-infection, and blood samples 4 days prior to infection and day 6 post-infection. Viral load was measured in nasal lavage fluid at day 3, 6 and 14. RESULTS Top differentially (>2.5-fold increase) expressed gene sets in NECs post-RV16 at days 3 and 6, compared with baseline, were interferon alpha and gamma response genes. Patients clearing the virus within 6 days (early resolvers) had a significantly increased interferon response at day 6, whereas those having cleared the virus by day 14 (late resolvers) had significantly increased responses at day 3, 6 and 14. Interestingly, patients not having cleared the virus by day 14 (non-resolvers) had no enhanced interferon responses at any of these days. The daily Cold Symptom Scores (CSS) peaked at days 3 to 5 and correlated positively with interferon response genes at day 3 (R = 0.48), but not at other time-points. Interferon response genes were also enhanced in blood at day 6 after RV16 challenge. CONCLUSION AND CLINICAL RELEVANCE This study shows that viral load and clearance varies markedly over time in mild to moderate asthma patients exposed to a fixed RV16 dose. The host's nasal interferon response to RV16 at day 3 is associated with upper respiratory tract symptoms. The temporal interferon response in nasal epithelium associates with viral clearance in the nasal compartment.
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Affiliation(s)
- Abilash Ravi
- Amsterdam UMC, Department of Respiratory Medicine, University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam UMC, Department of Experimental Immunology, Amsterdam Infection & Immunity Institute, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Marianne van de Pol
- Amsterdam UMC, Department of Respiratory Medicine, University of Amsterdam, Amsterdam, The Netherlands
| | - Shan Yang
- Merck & Co., Inc., Kenilworth, NJ, USA
| | | | | | | | - An Bautmans
- Merck Sharp and Dohme, Europe Inc., Brussels, Belgium
| | | | | | - Dave Singh
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK
| | - Jens M Hohlfeld
- Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany.,German Center for Lung Research (DZL), Hannover, Germany
| | - Peter J Sterk
- Amsterdam UMC, Department of Respiratory Medicine, University of Amsterdam, Amsterdam, The Netherlands
| | - Norbert Krug
- Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany.,German Center for Lung Research (DZL), Hannover, Germany
| | - René Lutter
- Amsterdam UMC, Department of Respiratory Medicine, University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam UMC, Department of Experimental Immunology, Amsterdam Infection & Immunity Institute, University of Amsterdam, Amsterdam, The Netherlands
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6
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Lefaudeux D, De Meulder B, Loza MJ, Peffer N, Rowe A, Baribaud F, Bansal AT, Lutter R, Sousa AR, Corfield J, Pandis I, Bakke PS, Caruso M, Chanez P, Dahlén SE, Fleming LJ, Fowler SJ, Horvath I, Krug N, Montuschi P, Sanak M, Sandstrom T, Shaw DE, Singer F, Sterk PJ, Roberts G, Adcock IM, Djukanovic R, Auffray C, Chung KF, Adriaens N, Ahmed H, Aliprantis A, Alving K, Badorek P, Balgoma D, Barber C, Bautmans A, Behndig AF, Bel E, Beleta J, Berglind A, Berton A, Bigler J, Bisgaard H, Bochenek G, Boedigheimer MJ, Bøonnelykke K, Brandsma J, Braun A, Brinkman P, Burg D, Campagna D, Carayannopoulos L, Carvalho da Purfição Rocha JP, Chaiboonchoe A, Chaleckis R, Coleman C, Compton C, D'Amico A, Dahlén B, De Alba J, de Boer P, De Lepeleire I, Dekker T, Delin I, Dennison P, Dijkhuis A, Draper A, Edwards J, Emma R, Ericsson M, Erpenbeck V, Erzen D, Faulenbach C, Fichtner K, Fitch N, Flood B, Frey U, Gahlemann M, Galffy G, Gallart H, Garret T, Geiser T, Gent J, Gerhardsson de Verdier M, Gibeon D, Gomez C, Gove K, Gozzard N, Guo YK, Hashimoto S, Haughney J, Hedlin G, Hekking PP, Henriksson E, Hewitt L, Higgenbottam T, Hoda U, Hohlfeld J, Holweg C, Howarth P, Hu R, Hu S, Hu X, Hudson V, James AJ, Kamphuis J, Kennington EJ, Kerry D, Klüglich M, Knobel H, Knowles R, Knox A, Kolmert J, Konradsen J, Kots M, Krueger L, Kuo S, Kupczyk M, Lambrecht B, Lantz AS, Larsson L, Lazarinis N, Lone-Satif S, Marouzet L, Martin J, Masefield S, Mathon C, Matthews JG, Mazein A, Meah S, Maiser A, Menzies-Gow A, Metcalf L, Middelveld R, Mikus M, Miralpeix M, Monk P, Mores N, Murray CS, Musial J, Myles D, Naz S, Nething K, Nicholas B, Nihlen U, Nilsson P, Nordlund B, Östling J, Pacino A, Pahus L, Palkonnen S, Pavlidis S, Pennazza G, Petrén A, Pink S, Postle A, Powel P, Rahman-Amin M, Rao N, Ravanetti L, Ray E, Reinke S, Reynolds L, Riemann K, Riley J, Robberechts M, Roberts A, Rossios C, Russell K, Rutgers M, Santini G, Sentoninco M, Schoelch C, Schofield JP, Seibold W, Sigmund R, Sjödin M, Skipp PJ, Smids B, Smith C, Smith J, Smith KM, Söderman P, Sogbesan A, Staykova D, Strandberg K, Sun K, Supple D, Szentkereszty M, Tamasi L, Tariq K, Thörngren JO, Thornton B, Thorsen J, Valente S, van Aalderenm W, van de Pol M, van Drunen K, van Geest M, Versnel J, Vestbo J, Vink A, Vissing N, von Garnier C, Wagerner A, Wagers S, Wald F, Walker S, Ward J, Weiszhart Z, Wetzel K, Wheelock CE, Wiegman C, Williams S, Wilson SJ, Woosdcock A, Yang X, Yeyashingham E, Yu W, Zetterquist W, Zwinderman K. U-BIOPRED clinical adult asthma clusters linked to a subset of sputum omics. J Allergy Clin Immunol 2017; 139:1797-1807. [DOI: 10.1016/j.jaci.2016.08.048] [Citation(s) in RCA: 145] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 07/23/2016] [Accepted: 08/08/2016] [Indexed: 01/20/2023]
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Robberechts M, Friedman EJ, Schürmann D, Jackson Rudd D, De Lepeleire I, Fox-Bosetti S, Zhang S, Huser A, Hazuda D, Iwamoto M, Grobler J. P2 A single monotherapy dose of MK-8591, a novel NRTI, suppresses HIV for 10 days. J Virus Erad 2016. [DOI: 10.1016/s2055-6640(20)31089-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Gotter AL, Forman MS, Harrell CM, Stevens J, Svetnik V, Yee KL, Li X, Roecker AJ, Fox SV, Tannenbaum PL, Garson SL, Lepeleire ID, Calder N, Rosen L, Struyk A, Coleman PJ, Herring WJ, Renger JJ, Winrow CJ. Orexin 2 Receptor Antagonism is Sufficient to Promote NREM and REM Sleep from Mouse to Man. Sci Rep 2016; 6:27147. [PMID: 27256922 PMCID: PMC4891657 DOI: 10.1038/srep27147] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 05/16/2016] [Indexed: 11/26/2022] Open
Abstract
Orexin neuropeptides regulate sleep/wake through orexin receptors (OX1R, OX2R); OX2R is the predominant mediator of arousal promotion. The potential for single OX2R antagonism to effectively promote sleep has yet to be demonstrated in humans. MK-1064 is an OX2R-single antagonist. Preclinically, MK-1064 promotes sleep and increases both rapid eye movement (REM) and non-REM (NREM) sleep in rats at OX2R occupancies higher than the range observed for dual orexin receptor antagonists. Similar to dual antagonists, MK-1064 increases NREM and REM sleep in dogs without inducing cataplexy. Two Phase I studies in healthy human subjects evaluated safety, tolerability, pharmacokinetics and sleep-promoting effects of MK-1064, and demonstrated dose-dependent increases in subjective somnolence (via Karolinska Sleepiness Scale and Visual Analogue Scale measures) and sleep (via polysomnography), including increased REM and NREM sleep. Thus, selective OX2R antagonism is sufficient to promote REM and NREM sleep across species, similarly to that seen with dual orexin receptor antagonism.
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Affiliation(s)
- Anthony L Gotter
- Department of Neuroscience, Merck &Co. Inc., Kenilworth, NJ, USA
| | - Mark S Forman
- Department of Translational Medicine, Merck &Co. Inc., Kenilworth, NJ, USA
| | | | - Joanne Stevens
- Department of in vivo Pharmacology, Merck &Co. Inc., Kenilworth, NJ, USA
| | - Vladimir Svetnik
- Department of Biostatistics and Research Decision Sciences, Merck &Co. Inc., Kenilworth, NJ, USA
| | - Ka Lai Yee
- Department of Pharmacokinetics Pharmacodynamics and Drug Metabolism, Merck &Co. Inc., Kenilworth, NJ, USA
| | - Xiaodong Li
- Department of Pharmacokinetics Pharmacodynamics and Drug Metabolism, Merck &Co. Inc., Kenilworth, NJ, USA
| | - Anthony J Roecker
- Department of Medicinal Chemistry, Merck &Co. Inc., Kenilworth, NJ, USA
| | - Steven V Fox
- Department of in vivo Pharmacology, Merck &Co. Inc., Kenilworth, NJ, USA
| | | | - Susan L Garson
- Department of Neuroscience, Merck &Co. Inc., Kenilworth, NJ, USA
| | - Inge De Lepeleire
- Department of Translational Medicine, Merck &Co. Inc., Kenilworth, NJ, USA
| | - Nicole Calder
- Department of Clinical Neuroscience, Merck &Co. Inc., Kenilworth, NJ, USA
| | - Laura Rosen
- Department of Clinical Neuroscience, Merck &Co. Inc., Kenilworth, NJ, USA
| | - Arie Struyk
- Department of Translational Medicine, Merck &Co. Inc., Kenilworth, NJ, USA
| | - Paul J Coleman
- Department of Medicinal Chemistry, Merck &Co. Inc., Kenilworth, NJ, USA
| | - W Joseph Herring
- Department of Clinical Neuroscience, Merck &Co. Inc., Kenilworth, NJ, USA
| | - John J Renger
- Department of Neuroscience, Merck &Co. Inc., Kenilworth, NJ, USA
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Li CC, Vermeersch S, Denney WS, Kennedy WP, Palcza J, Gipson A, Han TH, Blanchard R, De Lepeleire I, Depré M, Murphy MG, Van Dyck K, de Hoon JN. Characterizing the PK/PD relationship for inhibition of capsaicin-induced dermal vasodilatation by MK-3207, an oral calcitonin gene related peptide receptor antagonist. Br J Clin Pharmacol 2016; 79:831-7. [PMID: 25377933 DOI: 10.1111/bcp.12547] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [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: 05/12/2014] [Accepted: 10/30/2014] [Indexed: 11/28/2022] Open
Abstract
AIMS Calcitonin gene related peptide (CGRP) receptor antagonists are effective acute migraine treatments. A capsaicin-induced dermal vasodilatation (CIDV) model has been developed to provide target-engagement information in healthy volunteers. In the model, CGRP release is provoked after dermal capsaicin application, by activating transient receptor potential vanilloid-type-1 (TRPV1) receptors at peripheral sensory nerves. Laser Doppler imaging is used to quantify CIDV and subsequent inhibition by CGRP receptor antagonists. We sought to evaluate a CGRP receptor antagonist, MK-3207, in the biomarker model and to assess the predictability of the CIDV response to migraine clinical efficacy. METHODS An integrated population pharmacokinetic/pharmacodynamic (PK/PD) model was developed to describe the exposure-response relationship for CIDV inhibition by CGRP and TRPV1 receptor antagonists. MK-3207 dose-response predictions were made based on estimated potency from the PK/PD model and mean plasma concentrations observed at the doses investigated. RESULTS The results suggested that a 20 mg dose of MK-3207 (EC50 of 1.59 nm) would be required to attain the peripheral CIDV response at a target level that was shown previously to correlate with 2 h clinical efficacy based on phase 3 telcagepant clinical data, and that a plateau of the dose-response would be reached around 40-100 mg. These predictions provided a quantitative rationale for dose selection in a phase 2 clinical trial of MK-3207 and helped with interpretation of the efficacy results from the trial. CONCLUSIONS The integrated CIDV PK/PD model provides a useful platform for characterization of PK/PD relationships and predictions of dose-response relationships to aid in future development of CGRP and TRPV1 receptor antagonists.
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Affiliation(s)
- Chi-Chung Li
- Merck Research Laboratories, Merck & Co., Inc., Whitehouse Station, NJ, USA
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Schürmann D, Sobotha C, Gilmartin J, Robberechts M, De Lepeleire I, Yee KL, Guo Y, Liu R, Wagner F, Wagner JA, Butterton JR, Anderson MS. A randomized, double-blind, placebo-controlled, short-term monotherapy study of doravirine in treatment-naive HIV-infected individuals. AIDS 2016; 30:57-63. [PMID: 26372481 DOI: 10.1097/qad.0000000000000876] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To assess the antiviral activity, pharmacokinetics, and safety of doravirine in nonnucleoside reverse transcriptase inhibitor-naïve, HIV-infected men. DESIGN Double-blind, randomized, two-panel, dose-escalation study. METHODS In two sequential panels, 18 individuals received doravirine [25 mg (Panel A) or 200 mg (Panel B)] or matching placebo once daily for 7 days. Plasma samples were collected daily for measurement of HIV-1 RNA levels and doravirine pharmacokinetics. RESULTS For the mean change from baseline in HIV RNA (log10 copies/ml) at 24 h after the day 7 dose, the mean difference (90% confidence interval) between doravirine and placebo was -1.37 (-1.60, -1.14) in the 25-mg group and -1.26 (-1.51, -1.02) in the 200-mg group. None of the participants had viral breakthrough. Increases in mean AUC0-24 h, Cmax, and C24 h were slightly less than dose-proportional, with median Tmax of 1.0-2.0 h. Steady state was achieved after 3-5 days of once-daily dosing. At steady state, accumulation ratios (day 7/day 1) for AUC0-24 h, Cmax, and C24 h were 1.2-1.6. The calculated effective t1/2 (10-16 h) was similar to that in HIV-uninfected individuals. Adverse events were limited in number, transient, and generally mild to moderate in intensity. One participant had a serious adverse event of elevated liver enzymes (judged probably not drug related) in concurrence with a newly acquired hepatitis C infection. CONCLUSION Doravirine monotherapy demonstrated robust antiviral activity at both dose levels, without evidence of viral resistance, and was generally well tolerated. Doravirine pharmacokinetics in HIV-infected individuals were similar to those in uninfected individuals receiving similar doses in prior studies.
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Gheysens O, Postnov A, Deroose CM, Vandermeulen C, de Hoon J, Declercq R, Dennie J, Mixson L, De Lepeleire I, Van Laere K, Klimas M, Chakravarthy MV. Quantification, Variability, and Reproducibility of Basal Skeletal Muscle Glucose Uptake in Healthy Humans Using 18F-FDG PET/CT. J Nucl Med 2015; 56:1520-6. [PMID: 26229142 DOI: 10.2967/jnumed.115.159715] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [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: 05/13/2015] [Accepted: 07/08/2015] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED The quantification and variability of skeletal muscle glucose utilization (SMGU) in healthy subjects under basal (low insulin) conditions are poorly known. This information is essential early in clinical drug development to effectively interrogate novel pharmacologic interventions that modulate glucose uptake. The aim of this study was to determine test-retest characteristics and variability of SMGU within and between healthy subjects under basal conditions. Furthermore, different kinetic modeling strategies were evaluated to find the best-fitting model to assess SMGU studied by 18F-FDG. METHODS Six healthy male volunteers underwent 2 dynamic 18F-FDG PET/CT scans with an interval of 24 h. Subjects were admitted to the clinical unit to minimize variability in daily activities and food intake and restrict physical activity. 18F-FDG PET/CT scans of gluteal and quadriceps muscle area were obtained with arterial input. Regions of interest were drawn over the muscle area to obtain time-activity curves and standardized uptake values (SUVs) between 60 and 90 min. Spectral analysis of the data and kinetic modeling was performed using 2-tissue-irreversible (2T3K), 2-tissue-reversible, and 3-tissue-sequential-irreversible (3T5KS) models. Reproducibility was assessed by intraclass correlation coefficients (ICCs) and within-subject coefficient of variation (WSCV). RESULTS SUVs in gluteal and quadriceps areas were 0.56±0.09 and 0.64±0.07. ICCs (with 90% confidence intervals in parentheses) were 0.88 (0.64-0.96) and 0.96 (0.82-0.99), respectively, for gluteal and quadriceps muscles, and WSCV for gluteal and quadriceps muscles was 2.2% and 3.6%, respectively. The rate of glucose uptake into muscle was 0.0016±0.0004 mL/mL⋅min, with an ICC of 0.94 (0.93-0.95) and WSCV of 6.6% for the 3T5KS model, whereas an ICC of 0.98 (0.92-1.00) and WSCV of 2.8% was obtained for the 2T3K model. 3T5KS demonstrated the best fit to the measured experimental points. CONCLUSION Minimal variability in skeletal muscle glucose uptake was observed under basal conditions in healthy subjects. SUV measurements and rate of glucose uptake values were reproducible, with an average WSCV of less than 5%. Compared with SUV, the 3-tissue model adds information about kinetics between blood, intra- and intercellular compartments, and phosphorylation that may highlight the exact mechanisms of metabolic changes after pharmacologic intervention.
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Affiliation(s)
- Olivier Gheysens
- Nuclear Medicine and Molecular Imaging, University Hospitals Leuven and Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Andrey Postnov
- Nuclear Medicine and Molecular Imaging, University Hospitals Leuven and Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Christophe M Deroose
- Nuclear Medicine and Molecular Imaging, University Hospitals Leuven and Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Corinne Vandermeulen
- Center for Clinical Pharmacology, University Hospitals Leuven and Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Jan de Hoon
- Center for Clinical Pharmacology, University Hospitals Leuven and Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | | | - Justin Dennie
- Merck Research Laboratories, Merck & Co., Kenilworth, New Jersey
| | - Lori Mixson
- Merck Research Laboratories, Merck & Co., Kenilworth, New Jersey
| | | | - Koen Van Laere
- Nuclear Medicine and Molecular Imaging, University Hospitals Leuven and Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Michael Klimas
- Merck Research Laboratories, Merck & Co., Kenilworth, New Jersey
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Zuiker RGJA, Ruddy MK, Morelli N, Mogg R, Rivas VM, van Dyck K, De Lepeleire I, Tanen MRL, Boot JD, Kamerling IMC, Diamant Z. Kinetics of TH2 biomarkers in sputum of asthmatics following inhaled allergen. Eur Clin Respir J 2015; 2:28319. [PMID: 26557261 PMCID: PMC4629766 DOI: 10.3402/ecrj.v2.28319] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 04/22/2015] [Indexed: 01/12/2023] Open
Abstract
Background Allergen-induced late airway response offers important pharmacodynamic targets, including T helper 2 (TH2) biomarkers. However, detection of inflammatory markers has been limited in dithiothreitol-processed sputum. Objectives To test whether allergen-induced TH2 inflammatory markers can be reproducibly quantified by sensitive detection techniques in ultracentrifuged sputum and the effect of fluticasone (FP) on these endpoints. Methods Thirteen allergic asthmatics with dual allergen-induced airway responses, documented during a single-blind placebo run-in period, participated in a double-blind, two-period crossover study. Each period consisted of three consecutive days, separated by ≥3 weeks. Following randomization, subjects inhaled FP (500 µg bid, five doses total) or placebo. On Day 2 in each study period, allergen challenge was performed and airway response measured by forced expiratory volume in 1 sec (FEV1) until 7 h post-challenge. Sputum was induced 24 h pre-allergen and 7 and 24 h post-allergen. Sputum samples were split into two portions: TH2 biomarkers were quantified by Meso Scale multiplex platform following ultracentrifugation, and cell differentials were counted on Giemsa–May-Grünwald-stained cytospins. Allergen-induced changes in inflammatory endpoints were compared between FP and placebo using a mixed model ANCOVA. Results Inhaled allergen induced dual airway responses in all subjects during both placebo periods with reproducible late asthmatic response (LAR) and increased sputum inflammatory biomarkers (IL-2, IL-4, IL-13, and eotaxin-1) and eosinophil counts. FP effectively blunted both the LAR and the inflammatory biomarkers. Conclusions Combining novel, sensitive quantification methods with ultracentrifugation allows reproducible quantification of sputum biomarkers following allergen challenge, reversed by FP. This approach allows non-invasive identification of pharmacodynamic targets for anti-asthma therapies.
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Affiliation(s)
| | | | | | - Robin Mogg
- Janssen Pharmaceutical Companies of Johnson & Johnson, Spring House, PA, USA
| | | | | | | | | | | | | | - Zuzana Diamant
- Skane University Hospital, Department of Respiratory Medicine and Allergology, Institute for Clinical Science, Skane University, Lund, Sweden ; Departments of Clinical Pharmacy & Pharmacology and General Practice, University Medical Center Groningen, Groningen, The Netherlands ; QPS Netherlands, Groningen, The Netherlands
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Anderson MS, Gilmartin J, Cilissen C, De Lepeleire I, Van Bortel L, Dockendorf MF, Tetteh E, Ancona JK, Liu R, Guo Y, Wagner JA, Butterton JR. Safety, tolerability and pharmacokinetics of doravirine, a novel HIV non-nucleoside reverse transcriptase inhibitor, after single and multiple doses in healthy subjects. Antivir Ther 2014; 20:397-405. [PMID: 25470746 DOI: 10.3851/imp2920] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Doravirine is a novel non-nucleoside inhibitor of HIV-1 reverse transcriptase with potent activity against wild-type virus (95% inhibitory concentration 19 nM, 50% human serum). Doravirine has low potential to cause drug-drug interactions since it is primarily eliminated by oxidative metabolism and does not inhibit or significantly induce drug-metabolizing enzymes. METHODS The pharmacokinetics and safety of doravirine were investigated in two double-blind, dose-escalation studies in healthy males. Thirty-two subjects received single doses of doravirine (6-1,200 mg) or matching placebo tablets; 40 subjects received doravirine (30-750 mg) or matching placebo tablets once daily for 10 days. In addition, the effect of doravirine (120 mg for 14 days) on single-dose pharmacokinetics of the CYP3A substrate midazolam was evaluated (10 subjects). RESULTS The maximum plasma concentration (Cmax) of doravirine was achieved within 1-5 h with an apparent terminal half-life of 12-21 h. Consistent with single-dose pharmacokinetics, steady state was achieved after approximately 7 days of once daily administration, with accumulation ratios (day 10/day 1) of 1.1-1.5 in the area under the plasma concentration-time curve during the dosing interval (AUC0-24 h), Cmax and trough plasma concentration (C24 h). All dose levels produced C24 h>19 nM. Administration of 50 mg doravirine with a high-fat meal was associated with slight elevations in AUC time zero to infinity (AUC0-∞) and C24 h with no change in Cmax. Midazolam AUC0-∞ was slightly reduced by coadministration of doravirine (geometric mean ratio 0.82, 90% CI 0.70, 0.97). There was no apparent relationship between adverse event frequency or intensity and doravirine dose. No rash or significant central nervous system events other than headache were reported. CONCLUSIONS Doravirine is generally well tolerated in single doses up to 1,200 mg and multiple doses up to 750 mg once daily for up to 10 days, with a pharmacokinetic profile supportive of once-daily dosing. Doravirine at steady state slightly reduced the exposure of coadministered midazolam, to a clinically unimportant extent.
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Joshi AD, Sanabria-Bohórquez SM, Bormans G, Koole M, De Hoon J, Van Hecken A, Depre M, De Lepeleire I, Van Laere K, Sur C, Hamill TG. Characterization of the novel GlyT1 PET tracer [18F]MK-6577 in humans. Synapse 2014; 69:33-40. [PMID: 25196464 DOI: 10.1002/syn.21782] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [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: 05/05/2014] [Revised: 07/06/2014] [Accepted: 07/26/2014] [Indexed: 01/05/2023]
Abstract
Decreased glutamatergic neurotransmission is hypothesized to be involved in the pathophysiology of schizophrenia. Inhibition of glycine transporter Type-1 (GlyT1) reuptake is expected to increase the glutamatergic neurotransmission and may serve as treatment for cognitive and negative symptoms of schizophrenia. In this article, we present human data from a novel GlyT1 PET tracer, [(18) F]MK-6577. In the process of developing a GlyT1 inhibitor therapeutic, a PET tracer can assist in determining the dose with a high probability of sufficiently testing the mechanism of action. This article reports the human PET studies with [(18) F]MK-6577 for measuring GlyT1 receptor availability at baseline in normal human subjects and occupancy with a GlyT1 inhibitor, MK-2637. Studies were also performed to measure radiation burden and the baseline test-retest (T-RT) variability of the tracer. The effective dose from sequential whole-body dosimetry scans in three male subjects was estimated to be 24.5 ± 2.9 µSV/MBq (mean ± SD). The time-activity curves from T-RT scans modeled satisfactorily using a two tissue compartmental model. The tracer uptake was highest in the pons (VT = 6.7 ± 0.9, BPND = 4.1 ± 0.43) and lowest in the cortex (VT = 2.1 ± 0.5, BPND = 0.60 ± 0.23). VT T-RT variability measured in three subjects was <12% on average. The occupancy scans performed in a cohort of 15 subjects indicated absence of a reference region. The in vivo potency (Occ50 ) of MK-2637 was determined using two methods: A: Lassen plot with a population input function (Occ50 = 106 nM, SE = 20 nM) and B: pseudo reference tissue model using cortex as the pseudo reference region (Occ50 = 141 nM, SE = 21 nM).
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Van Laere KJ, Sanabria-Bohórquez SM, Mozley DP, Burns DH, Hamill TG, Van Hecken A, De Lepeleire I, Koole M, Bormans G, de Hoon J, Depré M, Cerchio K, Plalcza J, Han L, Renger J, Hargreaves RJ, Iannone R. (11)C-MK-8278 PET as a tool for pharmacodynamic brain occupancy of histamine 3 receptor inverse agonists. J Nucl Med 2013; 55:65-72. [PMID: 24263088 DOI: 10.2967/jnumed.113.122515] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
UNLABELLED The histamine 3 (H3) receptor is a presynaptic autoreceptor in the central nervous system that regulates the synthesis and release of histamine and modulates the release of other major neurotransmitters. H3 receptor inverse agonists (IAs) may be efficacious in the treatment of various central nervous system disorders, including excessive daytime sleepiness, attention deficit hyperactivity disorder, Alzheimer disease, ethanol addiction, and obesity. METHODS Using PET and a novel high-affinity and selective radioligand (11)C-MK-8278, we studied the tracer biodistribution, quantification, and brain H3 receptor occupancy (RO) of MK-0249 and MK-3134, 2 potential IA drugs targeting cerebral H3 receptors, in 6 healthy male subjects (age, 19-40 y). The relationship among H3 IA dose, time on target, and peripheral pharmacokinetics was further investigated in 15 healthy male volunteers (age, 18-40 y) with up to 3 PET scans and 3 subjects per dose level. RESULTS The mean effective dose for (11)C-MK-8278 was 5.4 ± 1.1 μSv/MBq. Human brain kinetics showed rapid high uptake and fast washout. Binding potential values can be assessed using the pons as a reference region, with a test-retest repeatability of 7%. Drug RO data showed low interindividual variability per dose (mean RO SD, 2.1%), and a targeted 90% RO can be reached for both IAs at clinically feasible doses. CONCLUSION (11)C-MK-8278 is a useful novel PET radioligand for determination of human cerebral H3 receptor binding and allows highly reproducible in vivo brain occupancy of H3-targeting drugs, hereby enabling the evaluation of novel compounds in early development to select doses and schedules.
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Affiliation(s)
- Koenraad J Van Laere
- Division of Nuclear Medicine, University Hospital and KU Leuven, Leuven, Belgium
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Hostetler ED, Joshi AD, Sanabria-Bohórquez S, Fan H, Zeng Z, Purcell M, Gantert L, Riffel K, Williams M, O’Malley S, Miller P, Selnick HG, Gallicchio SN, Bell IM, Salvatore CA, Kane SA, Li CC, Hargreaves RJ, de Groot T, Bormans G, Van Hecken A, Derdelinckx I, de Hoon J, Reynders T, Declercq R, De Lepeleire I, Kennedy WP, Blanchard R, Marcantonio EE, Sur C, Cook JJ, Van Laere K, Evelhoch JL. In Vivo Quantification of Calcitonin Gene-Related Peptide Receptor Occupancy by Telcagepant in Rhesus Monkey and Human Brain Using the Positron Emission Tomography Tracer [11C]MK-4232. J Pharmacol Exp Ther 2013; 347:478-86. [DOI: 10.1124/jpet.113.206458] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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Addy C, Rothenberg P, Li S, Majumdar A, Agrawal N, Li H, Zhong L, Yuan J, Maes A, Dunbar S, Cote J, Rosko K, Van Dyck K, De Lepeleire I, de Hoon J, Van Hecken A, Depré M, Knops A, Gottesdiener K, Stoch A, Wagner J. Multiple-Dose Pharmacokinetics, Pharmacodynamics, and Safety of Taranabant, a Novel Selective Cannabinoid-1 Receptor Inverse Agonist, in Healthy Male Volunteers. J Clin Pharmacol 2013; 48:734-44. [DOI: 10.1177/0091270008317591] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Garg A, Maes A, Corr C, Jin B, Wadhwa T, Handa N, Van Dyck K, De Lepeleire I, Shah J, Wagner JA, Krishna R. Effect of Diltiazem, a Moderate CYP3A Inhibitor, on the Pharmacokinetics of Anacetrapib, a Potent Cholesteryl Ester Transfer Protein Inhibitor, in Healthy Subjects. J Clin Pharmacol 2013; 51:436-9. [DOI: 10.1177/0091270010368676] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Krishna R, Wong P, Stevens C, De Lepeleire I, Van Dyck K, Rosen RC, Gendrano IN, Peeters M, Wagner JA, Herman GA. Lack of Erectogenic Activity of a Novel Selective Melanocortin-4 Receptor Agonist in a Clinical Experimental Model. J Clin Pharmacol 2013; 48:1237-41. [DOI: 10.1177/0091270008320925] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Van der Schueren BJ, Blanchard R, Murphy MG, Palcza J, De Lepeleire I, Van Hecken A, Depré M, de Hoon JN. The potent calcitonin gene-related peptide receptor antagonist, telcagepant, does not affect nitroglycerin-induced vasodilation in healthy men. Br J Clin Pharmacol 2011; 71:708-17. [PMID: 21480950 DOI: 10.1111/j.1365-2125.2010.03869.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
AIMS To assess the effect of the calcitonin gene-related peptide (CGRP) receptor antagonist, telcagepant, on the haemodynamic response to sublingual nitroglycerin (NTG). METHODS Twenty-two healthy male volunteers participated in a randomized, placebo-controlled, double-blind, two-period, crossover study. Subjects received 500 mg telcagepant or placebo followed, 1.5 h later, by 0.4 mg NTG. To assess the haemodynamic response the following vascular parameters were measured: blood pressure, aortic augmentation index (AIx) and brachial artery diameter (BAD). Data are presented as mean (95% confidence interval, CI). RESULTS The aortic AIx following NTG decreased by -18.50 (-21.02, -15.98) % after telcagepant vs. -17.28 (-19.80, -14.76) % after placebo. The BAD fold increase following NTG was 1.14 (1.12, 1.17) after telcagepant vs. 1.13 (1.10, 1.15) after placebo. For both AIx and BAD, the hypothesis that telcagepant does not significantly affect the changes induced by NTG is supported (P < 0.0001). In addition, no vasoconstrictor effect of telcagepant could be demonstrated. CONCLUSIONS Telcagepant did not affect NTG-induced haemodynamic changes. These data suggest that NTG-induced vasodilation is not CGRP dependent.
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Affiliation(s)
- Bart J Van der Schueren
- Center for Clinical Pharmacology, University Hospital Gasthuisberg (K.U. Leuven), Leuven, Belgium.
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Dallob A, Luo WL, Luk JM, Ratcliffe L, Johnson-Levonas AO, Schwartz JI, Dishy V, Kraft WK, De Hoon JN, Van Hecken A, De Lepeleire I, Radziszewski W, Wagner JA, Lai E. The effects of laropiprant, a selective prostaglandin D₂ receptor 1 antagonist, on the antiplatelet activity of clopidogrel or aspirin. Platelets 2011; 22:495-503. [PMID: 21526889 DOI: 10.3109/09537104.2011.565433] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Laropiprant (LRPT) is being developed in combination with Merck's extended-release niacin (ERN) formulation for the treatment of dyslipidemia. LRPT, an antagonist of the prostaglandin PGD₂ receptor DP1, reduces flushing symptoms associated with ERN. LRPT also has affinity for the thromboxane A₂ receptor TP (approximately 190-fold less potent at TP compared with DP1). Aspirin and clopidogrel are two frequently used anti-clotting agents with different mechanisms of action. Since LRPT may potentially be co-administered with either one of these agents, these studies were conducted to assess the effects of steady-state LRPT on the antiplatelet activity of steady-state clopidogrel or aspirin. Bleeding time at 24 h post-dose (trough) was pre-specified as the primary pharmacodynamic endpoint in both studies. Two separate, double-blind, randomized, placebo-controlled, crossover studies evaluated the effects of multiple-dose LRPT on the pharmacodynamics of multiple-dose clopidogrel or aspirin. Healthy subjects were randomized to once-daily oral doses of LRPT 40 mg or placebo to LRTP co-administered with clopidogrel 75 mg or aspirin 81 mg for 7 days with at least a 21-day washout between treatments. In both studies, bleeding time and platelet aggregation were assessed 4 and 24 hours post-dose on Day 7. Comparability was declared if the 90% confidence interval for the estimated geometric mean ratio ([LRPT+clopidogrel]/clopidogrel alone or [LRPT+aspirin]/aspirin alone) for bleeding time at 24 hours post-dose on Day 7 was contained within (0.66, 1.50). Concomitant daily administration of LRPT 40 mg with clopidogrel 75 mg or aspirin 81 mg resulted in an approximate 4-5% increase in bleeding time at 24 hours after the last dose vs. bleeding time after treatment with clopidogrel or aspirin alone, demonstrating that the treatments had comparable effects on bleeding time. Percent inhibition of platelet aggregation was not significantly different between LRPT co-administered with clopidogrel or aspirin vs. clopidogrel or aspirin alone at 24 hours post-dose at steady state. At 4 hours after the last dose, co-administration of LRPT 40 mg resulted in 3% and 41% increase in bleeding time vs. bleeding time after treatment with aspirin or clopidogrel alone, respectively. Co-administration of LPRT with clopidogrel or aspirin was generally well tolerated in healthy subjects. Co-administration of multiple doses of LRPT 40 mg and clopidogrel 75 mg or aspirin 81 mg had no clinically important effects on bleeding time or platelet aggregation.
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Sanabria-Bohorquez S, Van Laere K, Koole M, Bormans G, Serdons K, Hoon J, Vandenberghe R, De Lepeleire I, Reynders T, Zeng Z, Williams D, Rosen L, Hargreaves R, Sur C, Forman M, Hostetler E. P3‐179: Development of the amyloid PET radioligand [
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F]MK‐3328. Alzheimers Dement 2010. [DOI: 10.1016/j.jalz.2010.05.1677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Koen Van Laere
- Division of Nuclear Medicine University Hospital LeuvenLeuven Belgium
| | - Michel Koole
- Division of Nuclear Medicine University Hospital LeuvenLeuven Belgium
| | - Guy Bormans
- Laboratory for RadiopharmacyK.U. Leuven Leuven Belgium
| | - Kim Serdons
- Laboratory for RadiopharmacyK.U. Leuven Leuven Belgium
| | - Jan Hoon
- Center for Clinical Pharmacology University Hospital LeuvenLeuven Belgium
| | - Rik Vandenberghe
- Department of Neurology University Hospital LeuvenLeuven Belgium
| | | | - Tom Reynders
- Clinical Pharmacology, Merck Sharp & DohmeBrussels Belgium
| | | | | | - Laura Rosen
- Clinical Pharmacology, MerckWest Point PA USA
| | | | | | - Mark Forman
- Clinical Pharmacology, MerckWest Point PA USA
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Sanabria-Bohórquez SM, Hamill TG, Goffin K, De Lepeleire I, Bormans G, Burns HD, Van Laere K. Kinetic analysis of the cannabinoid-1 receptor PET tracer [18F]MK-9470 in human brain. Eur J Nucl Med Mol Imaging 2009; 37:920-33. [DOI: 10.1007/s00259-009-1340-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2009] [Accepted: 11/13/2009] [Indexed: 12/20/2022]
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Van Laere K, Bormans G, Sanabria-Bohórquez SM, de Groot T, Dupont P, De Lepeleire I, de Hoon J, Mortelmans L, Hargreaves RJ, Atack JR, Burns HD. In vivo characterization and dynamic receptor occupancy imaging of TPA023B, an alpha 2/alpha 3/alpha 5 subtype selective gamma-aminobutyric acid-a partial agonist. Biol Psychiatry 2008; 64:153-61. [PMID: 18339360 DOI: 10.1016/j.biopsych.2008.01.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2007] [Revised: 01/09/2008] [Accepted: 01/13/2008] [Indexed: 11/17/2022]
Abstract
BACKGROUND A novel, high-affinity (.7-2.0 nmol) compound that selectively activates the alpha2, alpha 3, and alpha 5 (but not alpha1) gamma-aminobutyric acid-A (GABA(A)) receptor subtypes, TPA023B (2',6-difluoro-5'-[3-(1-hydroxy-1-methylethyl) imidazo[1,2-b][1,2,4]triazin-7-yl][1,1'-biphenyl]-2-carbonitrile) was pharmacologically characterized and studied by means of positron emission tomography (PET) to determine dynamic occupancies of the benzodiazepine binding site of human brain GABA(A) receptors after a single oral dose. METHODS Four healthy male volunteers were studied in a double-blind, randomized placebo-controlled study of which three were given a single dose of 1.5 mg TPA023B and the fourth received placebo. The time course of GABA(A) receptor occupancy was determined with multiple dynamic [(11)C]flumazenil PET studies at pre-dose baseline and 5 and 24 hours after dose. Arterial sampling and full kinetic modeling with a two-compartment model was used to calculate parametric maps of receptor availability (distribution volume V(T)) and of occupancy. RESULTS The GABA(A) receptor occupancy as determined from [(11)C]flumazenil V(T) values in all brain regions was reduced homogeneously, on average by 52.5 +/- 1.2% after 5 hours and 46.4 +/- 6.0% after 24 hours. No serious adverse events were encountered in humans. CONCLUSIONS Single oral doses of 1.5 mg of TPA023B correspond to average receptor occupancies in neocortical regions of 52% and 46% after 5 and 24 hours, respectively. Provided suitable ligands and quantification methods are available for the appropriate target, quantitative PET offers a unique tool for dynamic in vivo measurement of relevant on-site receptor occupancy.
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Van Laere K, Koole M, Sanabria Bohorquez SM, Goffin K, Guenther I, Belanger MJ, Cote J, Rothenberg P, De Lepeleire I, Grachev ID, Hargreaves RJ, Bormans G, Burns HD. Whole-Body Biodistribution and Radiation Dosimetry of the Human Cannabinoid Type-1 Receptor Ligand 18F-MK-9470 in Healthy Subjects. J Nucl Med 2008; 49:439-45. [DOI: 10.2967/jnumed.107.047290] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Addy C, Wright H, Van Laere K, Gantz I, Erondu N, Musser BJ, Lu K, Yuan J, Sanabria-Bohórquez SM, Stoch A, Stevens C, Fong TM, De Lepeleire I, Cilissen C, Cote J, Rosko K, Gendrano IN, Nguyen AM, Gumbiner B, Rothenberg P, de Hoon J, Bormans G, Depré M, Eng WS, Ravussin E, Klein S, Blundell J, Herman GA, Burns HD, Hargreaves RJ, Wagner J, Gottesdiener K, Amatruda JM, Heymsfield SB. The acyclic CB1R inverse agonist taranabant mediates weight loss by increasing energy expenditure and decreasing caloric intake. Cell Metab 2008; 7:68-78. [PMID: 18177726 DOI: 10.1016/j.cmet.2007.11.012] [Citation(s) in RCA: 153] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2007] [Revised: 09/30/2007] [Accepted: 11/20/2007] [Indexed: 11/28/2022]
Abstract
Cannabinoid 1 receptor (CB1R) inverse agonists are emerging as a potential obesity therapy. However, the physiological mechanisms by which these agents modulate human energy balance are incompletely elucidated. Here, we describe a comprehensive clinical research study of taranabant, a structurally novel acyclic CB1R inverse agonist. Positron emission tomography imaging using the selective CB1R tracer [(18)F]MK-9470 confirmed central nervous system receptor occupancy levels ( approximately 10%-40%) associated with energy balance/weight-loss effects in animals. In a 12-week weight-loss study, taranabant induced statistically significant weight loss compared to placebo in obese subjects over the entire range of evaluated doses (0.5, 2, 4, and 6 mg once per day) (p < 0.001). Taranabant treatment was associated with dose-related increased incidence of clinical adverse events, including mild to moderate gastrointestinal and psychiatric effects. Mechanism-of-action studies suggest that engagement of the CB1R by taranabant leads to weight loss by reducing food intake and increasing energy expenditure and fat oxidation.
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Affiliation(s)
- Carol Addy
- Merck Research Laboratories, Boston, MA 02115, USA
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Burns HD, Van Laere K, Sanabria-Bohórquez S, Hamill TG, Bormans G, Eng WS, Gibson R, Ryan C, Connolly B, Patel S, Krause S, Vanko A, Van Hecken A, Dupont P, De Lepeleire I, Rothenberg P, Stoch SA, Cote J, Hagmann WK, Jewell JP, Lin LS, Liu P, Goulet MT, Gottesdiener K, Wagner JA, de Hoon J, Mortelmans L, Fong TM, Hargreaves RJ. [18F]MK-9470, a positron emission tomography (PET) tracer for in vivo human PET brain imaging of the cannabinoid-1 receptor. Proc Natl Acad Sci U S A 2007; 104:9800-5. [PMID: 17535893 PMCID: PMC1877985 DOI: 10.1073/pnas.0703472104] [Citation(s) in RCA: 264] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
[(18)F]MK-9470 is a selective, high-affinity, inverse agonist (human IC(50), 0.7 nM) for the cannabinoid CB1 receptor (CB1R) that has been developed for use in human brain imaging. Autoradiographic studies in rhesus monkey brain showed that [(18)F]MK-9470 binding is aligned with the reported distribution of CB1 receptors with high specific binding in the cerebral cortex, cerebellum, caudate/putamen, globus pallidus, substantia nigra, and hippocampus. Positron emission tomography (PET) imaging studies in rhesus monkeys showed high brain uptake and a distribution pattern generally consistent with that seen in the autoradiographic studies. Uptake was blocked by pretreatment with a potent CB1 inverse agonist, MK-0364. The ratio of total to nonspecific binding in putamen was 4-5:1, indicative of a strong specific signal that was confirmed to be reversible via displacement studies with MK-0364. Baseline PET imaging studies in human research subject demonstrated behavior of [(18)F]MK-9470 very similar to that seen in monkeys, with very good test-retest variability (7%). Proof of concept studies in healthy young male human subjects showed that MK-0364, given orally, produced a dose-related reduction in [(18)F]MK-9470 binding reflecting CB1R receptor occupancy by the drug. Thus, [(18)F]MK-9470 has the potential to be a valuable, noninvasive research tool for the in vivo study of CB1R biology and pharmacology in a variety of neuropsychiatric disorders in humans. In addition, it allows demonstration of target engagement and noninvasive dose-occupancy studies to aid in dose selection for clinical trials of CB1R inverse agonists.
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Affiliation(s)
- H Donald Burns
- Imaging Research, Merck Research Laboratories, West Point, PA 19486, USA.
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Majumdar AK, Howard L, Goldberg MR, Hickey L, Constanzer M, Rothenberg PL, Crumley TM, Panebianco D, Bradstreet TE, Bergman AJ, Waldman SA, Greenberg HE, Butler K, Knops A, De Lepeleire I, Michiels N, Petty KJ. Pharmacokinetics of aprepitant after single and multiple oral doses in healthy volunteers. J Clin Pharmacol 2006; 46:291-300. [PMID: 16490805 DOI: 10.1177/0091270005283467] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aprepitant is the first NK1 receptor antagonist approved for use with corticosteroids and 5HT3 receptor antagonists to prevent chemotherapy-induced nausea and vomiting (CINV). The effective dose to prevent CINV is a 125-mg capsule on day 1 followed by an 80-mg capsule on days 2 and 3. Study 1 evaluated the bioavailability of the capsules and estimated the effect of food. The mean (95% confidence interval [CI]) bioavailabilities of 125-mg and 80-mg final market composition (FMC) capsules, as assessed by simultaneous administration of stable isotope-labeled intravenous (i.v.) aprepitant (2 mg) and FMC capsules, were 0.59 (0.53, 0.65) and 0.67 (0.62, 0.73), respectively. The geometric mean (90% CI) area under the plasma concentration time curve (AUC) ratios (fed/fasted) were 1.2 (1.10, 1.30) and 1.09 (1.00, 1.18) for the 125-mg and 80-mg capsule, respectively, demonstrating that aprepitant can be administered independently of food. Study 2 defined the pharmacokinetics of aprepitant administered following the 3-day regimen recommended to prevent CINV (125 mg/80 mg/80 mg). Consistent daily plasma exposures of aprepitant were obtained following this regimen, which was generally well tolerated.
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Sanabria-Bohórquez SM, Maes A, Dupont P, Bormans G, de Groot T, Coimbra A, Eng W, Laethem T, De Lepeleire I, Gambale J, Vega JM, Burns HD. Image-derived input function for [11C]flumazenil kinetic analysis in human brain. Mol Imaging Biol 2004; 5:72-8. [PMID: 14499147 DOI: 10.1016/s1536-1632(03)00046-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE We describe a method for analysis of [11C]flumazenil data using an input curve directly derived from the positron emission tomography (PET) images. PROCEDURE The shape of the tracer plasma curve was obtained from the product of the intact flumazenil fraction in plasma in six arterial samples and the internal carotid artery time-activity curve (TAC). The resulting curve was calibrated using the [11C]flumazenil concentration in three of the six samples. The curve peak was recovered by adding an exponential function to the scaled curve whose parameters were estimated from simultaneous fittings of several tissue TACs assuming that all regions share the same input. RESULTS Good agreement was found between the image-derived and the experimental plasma curves in six subjects. Distribution volumes were highly correlated with linear regression slope and intercept values between [0.94, 1.03] and [-0.10, 0.16], respectively. CONCLUSION The proposed method is suitable for benzodiazepine receptor quantification requiring only a few blood samples.
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