Evaluation of safety and pharmacokinetics of sodium 2,2 dimethylbutyrate, a novel short chain fatty acid derivative, in a phase 1, double-blind, placebo-controlled, single-dose, and repeat-dose studies in healthy volunteers

Susan P Perrine, William A Wargin, Michael S Boosalis, Wayne J Wallis, Sally Case, Jeffrey R Keefer, Douglas V Faller, William C Welch, Ronald J Berenson, Susan P Perrine, William A Wargin, Michael S Boosalis, Wayne J Wallis, Sally Case, Jeffrey R Keefer, Douglas V Faller, William C Welch, Ronald J Berenson

Abstract

Pharmacologic induction of fetal globin synthesis is an accepted therapeutic strategy for treatment of the beta hemoglobinopathies and thalassemias, as even small increases in hemoglobin F (HbF) levels reduce clinical severity in sickle cell disease (SCD) and reduce anemia in beta thalassemia. Prior generation short chain fatty acid therapeutics, arginine butyrate (AB), and phenylbutyrate, increased fetal and total hemoglobin levels in patients, but were limited by high doses or intravenous (IV) infusion. A fetal globin-inducing therapeutic with convenient oral dosing would be an advance for these classic molecular diseases. Healthy adult human subjects were treated with a novel short chain fatty acids (SCFA) derivative, sodium 2,2 dimethylbutyrate (SDMB), or placebo, with 1 of 4 single dose levels (2, 5, 10, and 20 mg/kg) or daily doses (5, 10, or 15 mg/kg) over 14 days, and monitored for adverse clinical and laboratory events, drug levels, reticulocytes, and HbF assays. SDMB was well-tolerated with no clinically significant adverse events related to study medication. The terminal half-life ranged from 9 to 15 hours. Increases in mean absolute reticulocytes were observed at all dose levels in the 14-day study. The favorable pharmacokinetics (PK) profiles and safety findings indicate that SDMB warrants further investigation for treatment of anemic subjects with beta hemoglobinopathies.

Figures

Figure 1
Figure 1
Mean Concentration-Time Plots with administration of SDMB after fasting or fed conditions (Single Dose Study, 20 mg/kg/dose level)
Figure 2
Figure 2
Mean Sodium 2,2 Dimethylbutyrate Plasma Concentration vs. Time Plots by Treatment Group – Day 13 (Repeat Dose Study)
Figure 3
Figure 3
Mean absolute reticulocytes at baseline (white bars) and with treatment (dark bars). The asterisks demonstrate where significant changes were detected.

Source: PubMed

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