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Smith WB, Hall J, Berg JK, Kazimir M, Yamamoto A, Walker S, Lee CA, Shen Z, Wilson DM, Zhou D, Gillen M, Marbury TC. Effect of Renal Impairment on the Pharmacokinetics and Pharmacodynamics of Verinurad, a Selective Uric Acid Reabsorption Inhibitor. Clin Drug Investig 2018; 38:703-713. [PMID: 29949102 PMCID: PMC6061379 DOI: 10.1007/s40261-018-0652-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND AND OBJECTIVE: Verinurad (RDEA3170) is a high-affinity, selective URAT1 transporter inhibitor in development for treating gout and asymptomatic hyperuricemia. This Phase I, single-dose study investigated the pharmacokinetics, pharmacodynamics, and safety of verinurad in adults with renal impairment and controls with normal renal function. METHODS Males aged 18-85 years were enrolled with serum urate (sUA) 4.5-10 mg/dl and creatinine clearance 60- < 90, 30- < 60, 15- < 30, or ≥ 90 ml/min (mild, moderate, severe renal impairment and controls, respectively; n = 7/8). Verinurad 15 mg was administered orally under fasted conditions. Serial plasma/serum and urine samplings were 30 min pre-dose to 72 h post-dose. RESULTS Compared to controls, verinurad maximum observed plasma concentration increased by 53, 73, and 128% and area under the concentration-time curve increased by 24, 148, and 130%, in subjects with mild, moderate, and severe renal impairment, respectively; renal clearance decreased by 5, 42, and 79%. Exposures of major verinurad metabolites also increased with increasing renal impairment. Verinurad decreased sUA in all groups, with greater maximal changes in control and mild renal impairment than moderate and severe impairment groups (- 38.3, - 36.9, - 20.5, - 12.6%, respectively). There were no adverse event-related withdrawals or clinically meaningful changes in laboratory values. CONCLUSION Exposures of verinurad and metabolites increased with decreasing renal function. Consistent with the renal-dependent mechanism of action of verinurad, increasing severity of renal impairment was associated with decreased sUA lowering. Verinurad safety assessments were similar regardless of renal impairment. Continued investigation of verinurad is warranted in patients with gout and renal impairment. CLINICALTRIALS. GOV IDENTIFIER NCT02219516.
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Affiliation(s)
- William B Smith
- Volunteer Research Group, University of TN Medical Center, 1928 Alcoa Highway, Suite 107, Knoxville, TN, 37920, USA.
| | - Jesse Hall
- Ardea Biosciences, Inc, 9390 Towne Centre Drive, San Diego, CA, 92121, USA
| | - Jolene K Berg
- DaVita Clinical Research, 825 S. 8th Street, Suite 300, Minneapolis, MN, 55404, USA
| | - Michal Kazimir
- DaVita Clinical Research, Medical Plaza 1, 11750 West 2nd Place, Suite 300, Lakewood, CO, 80228, USA
| | - Amy Yamamoto
- Ardea Biosciences, Inc, 9390 Towne Centre Drive, San Diego, CA, 92121, USA
| | - Susan Walker
- Ardea Biosciences, Inc, 9390 Towne Centre Drive, San Diego, CA, 92121, USA
| | - Caroline A Lee
- Ardea Biosciences, Inc, 9390 Towne Centre Drive, San Diego, CA, 92121, USA
| | - Zancong Shen
- Ardea Biosciences, Inc, 9390 Towne Centre Drive, San Diego, CA, 92121, USA
| | - David M Wilson
- Ardea Biosciences, Inc, 9390 Towne Centre Drive, San Diego, CA, 92121, USA
| | - Dongmei Zhou
- Ardea Biosciences, Inc, 9390 Towne Centre Drive, San Diego, CA, 92121, USA
| | - Michael Gillen
- AstraZeneca Pharmaceuticals LP, 1 Medimmune Way, Gaithersburg, MD, 20878, USA
| | - Thomas C Marbury
- Orlando Clinical Research Center, 5055 South Orange Ave, Orlando, FL, 32809-3017, USA
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