Safety, tolerability, and pharmacokinetics of single and repeat ascending doses of CHF6001, a novel inhaled phosphodiesterase-4 inhibitor: two randomized trials in healthy volunteers

Fabrizia Mariotti, Mirco Govoni, Germano Lucci, Debora Santoro, Marie Anna Nandeuil, Fabrizia Mariotti, Mirco Govoni, Germano Lucci, Debora Santoro, Marie Anna Nandeuil

Abstract

Purpose: The purpose of this study was to evaluate safety, tolerability, and pharmacokinetics (PK) of CHF6001, an inhaled phosphodiesterase-4 inhibitor.

Materials and methods: Two healthy volunteer, randomized, double-blind, placebo-controlled studies were conducted. In each, Part 1 evaluated single ascending doses, with PK sampling up to 48 hours post-dose; Part 2 evaluated multiple ascending doses (Study 1, 7 days; Study 2, 14 days), with PK sampling up to 24 hours post-dose on first and last day of each period. In Study 1, treatments were administered via single-dose dry-powder inhaler (SDDPI; Aerolizer): Part 1, 20, 100, 200, 400, 800, 1,600, and 2,000 µg or placebo; Part 2, 100, 300, 600, 1,200, and 1,600 µg or placebo once daily (OD). In Study 2, treatments were administered via multi-dose dry-powder inhaler (MDDPI; NEXThaler): Part 1, 2,400, 4,000, and 4,800 µg or placebo; Part 2, 1,200, 2,000, or 2,400 µg twice daily (BID) or placebo. Modeling and simulation then compared OD and BID dosing via MDDPI.

Results: There was a clear correlation between CHF6001 dose and plasma concentration, following single and multiple doses and using SDDPI and MDDPI. CHF6001 plasma concentration area under the curve (AUC) was dose proportional, with steady state slopes of the fitted line of 0.95 (90% CI: 0.86, 1.04) for AUC0-24 h in Study 1, and 0.85 (90% CI: 0.38, 1.32) for AUC0-12 h in Study 2. Bioavailability waŝ30% higher with MDDPI than SDDPI. The PK simulation confirmed dose proportionality; the same total daily dose OD or BID via MDDPI resulted in similar 24 hours exposure, with BID dosing providing smaller fluctuation and lower maximum concentration. CHF6001 was well tolerated with no relationship between dose and adverse events.

Conclusion: CHF6001 demonstrated a good safety profile. There was a clear dose proportionality for systemic exposure, with higher bioavailability via MDDPI, suggesting that the MDDPI provides better pulmonary drug deposition. BID dosing was associated with a better exposure profile.

Keywords: chronic obstructive pulmonary disease; healthy volunteers; pharmacokinetics; phosphodiesterase-4 inhibitors.

Conflict of interest statement

Disclosure All authors are employees of Chiesi, the sponsor of the study. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
CHF6001 plasma pharmacokinetic–time profile following single doses (PK population). Notes: Data are mean. PK population is defined as all subjects in the safety population who had at least one valid PK measurement and who had no major PK-related protocol deviations. Abbreviations: PK, pharmacokinetics; MDDPI, study medication administered via multi-dose dry-powder inhaler; SDDPI, study medication administered via single-dose dry-powder inhaler.
Figure 2
Figure 2
CHF6001 plasma pharmacokinetic–time profile following multiple OD administration via SDDPI (PK population). Notes: Data are mean. PK population is defined as all subjects in the safety population who had at least one valid PK measurement and who had no major PK-related protocol deviations. Abbreviations: PK, pharmacokinetics; OD, once daily; SDDPI, study medication administered via single-dose dry-powder inhaler.
Figure 3
Figure 3
CHF6001 plasma pharmacokinetic–time profile following multiple BID administration via MDDPI (PK population). Notes: Data are mean. PK population is defined as all subjects in the safety population who had at least one valid PK measurement and who had no major PK-related protocol deviations. Abbreviations: BID, twice daily; MDDPI, study medication administered via multi-dose dry-powder inhaler; PK, pharmacokinetics.
Figure 4
Figure 4
Plasma concentration of CHF6001 following BID administration via MDDPI: simulation of data from 100 subjects replicated 10 times. Abbreviations: BID, twice daily; MDDPI, study medication administered via multi-dose dry-powder inhaler.
Figure 5
Figure 5
Plasma concentration of CHF6001 following OD or BID administration of the same total daily dose via MDDPI: simulation of data from 100 subjects replicated 10 times. Abbreviations: BID, twice daily; MDDPI, study medication administered via multi-dose dry-powder inhaler; OD, once daily.

References

    1. Global Initiative for Chronic Obstructive Lung Disease Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. 2018. [Accessed September 25, 2018]. Available from: .
    1. Calverley PM, Rabe KF, Goehring UM, et al. Roflumilast in symptomatic chronic obstructive pulmonary disease: two randomised clinical trials. Lancet. 2009;374(9691):685–694.
    1. Fabbri LM, Calverley PM, Izquierdo-Alonso JL, et al. Roflumilast in moderate-to-severe chronic obstructive pulmonary disease treated with longacting bronchodilators: two randomised clinical trials. Lancet. 2009;374(9691):695–703.
    1. Martinez FJ, Rabe KF, Sethi S, et al. Effect of Roflumilast and Inhaled Corticosteroid/Long-Acting β2-Agonist on Chronic Obstructive Pulmonary Disease Exacerbations (RE(2)SPOND). A Randomized Clinical Trial. Am J Respir Crit Care Med. 2016;194(5):559–567.
    1. Agusti A, Edwards LD, Celli B, et al. Characteristics, stability and outcomes of the 2011 GOLD COPD groups in the ECLIPSE cohort. Eur Respir J. 2013;42(3):636–646.
    1. Villetti G, Carnini C, Battipaglia L, et al. CHF6001 II: a novel phosphodiesterase 4 inhibitor, suitable for topical pulmonary administration – in vivo preclinical pharmacology profile defines a potent anti-inflammatory compound with a wide therapeutic window. J Pharmacol Exp Ther. 2015;352(3):568–578.
    1. Moretto N, Caruso P, Bosco R, et al. CHF6001 I: a novel highly potent and selective phosphodiesterase 4 inhibitor with robust anti-inflammatory activity and suitable for topical pulmonary administration. J Pharmacol Exp Ther. 2015;352(3):559–567.
    1. Edwards MR, Facchinetti F, Civelli M, Villetti G, Johnston SL. Anti-inflammatory effects of the novel inhaled phosphodiesterase type 4 inhibitor CHF6001 on virus-inducible cytokines. Pharmacol Res Perspect. 2016;4(1):e00202.
    1. Armani E, Amari G, Rizzi A, et al. Novel class of benzoic acid ester derivatives as potent PDE4 inhibitors for inhaled administration in the treatment of respiratory diseases. J Med Chem. 2014;57(3):793–816.
    1. Cenacchi V, Battaglia R, Cinato F, et al. In vitro and in vivo metabolism of CHF 6001, a selective phosphodiesterase (PDE4) inhibitor. Xenobiotica. 2015;45(8):693–710.

Source: PubMed

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