Background and Objective <p>Deutetrabenazine is approved as a treatment in adults for tardive dyskinesia and chorea associated with Huntington’s disease. A once-daily tablet (Austedo XR<sup>®</sup> Teva) was recently approved in addition to the twice-daily tablet (Austedo<sup>®</sup>), and studies were conducted to evaluate dosage strength proportionality and food effect of the once-daily formulation.</p> Methods <p>In a randomized cross-over study of dosage strength proportionality, healthy participants (<i>n</i> = 116) received single doses of the once-daily deutetrabenazine formulation and a power model was fitted to describe the relationship between dose and pharmacokinetic parameters (maximum observed plasma drug concentration [<i>C</i><sub>max</sub>], area under the plasma concentration–time curve from time 0 to 36 h [AUC<sub>0–36h</sub>], and area under the plasma concentration–time curve from time 0 extrapolated to infinity [AUC<sub>0–∞</sub>]). In the second cross-over study, a single 24-mg dose of the once-daily formulation was given in fasted and fed conditions to healthy participants (<i>n</i> = 84) and the effect of food was evaluated by constructing 90% confidence intervals of the geometric mean ratios for <i>C</i><sub>max</sub>, AUC<sub>0–<i>t</i>,</sub> and AUC<sub>0–∞.</sub></p> Results <p>Dosage strength proportionality for the once-daily formulation was demonstrated for the dosage strengths 6 mg, 12 mg, and 24 mg; and across the approved dose range up to 48 mg for the pharmacokinetic parameters of all analytes (deutetrabenazine, and metabolites; deuterated alpha-dihydrotetrabenazine and beta-dihydrotetrabenazine), individually and as a sum). In the food effect study, the <i>C</i><sub>max,</sub> AUC<sub>0–<i>t</i>,</sub> and AUC<sub>0–∞</sub> geometric mean ratios for deutetrabenazine and deuterated metabolites all fell within the 90% confidence interval of 80–125.</p> Conclusions <p>The once-daily formulation of deutetrabenazine exhibited dosage strength proportional pharmacokinetics for doses up to 48 mg and there was no observed effect of food.</p>

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Assessment of Dose Proportionality and the Effect of Food on a Once-Daily Extended-Release Tablet Formulation of Deutetrabenazine in Healthy Participants

  • Eva-Maria Sunzel,
  • Giulia Ghibellini,
  • Maria Gutierrez,
  • Debra Ruffo,
  • Shailendra Chavan,
  • Nagnath G. Birajdar,
  • Frank Schneider,
  • Pippa Loupe,
  • Mark Forrest Gordon,
  • Laura Rabinovich-Guilatt

摘要

Background and Objective

Deutetrabenazine is approved as a treatment in adults for tardive dyskinesia and chorea associated with Huntington’s disease. A once-daily tablet (Austedo XR® Teva) was recently approved in addition to the twice-daily tablet (Austedo®), and studies were conducted to evaluate dosage strength proportionality and food effect of the once-daily formulation.

Methods

In a randomized cross-over study of dosage strength proportionality, healthy participants (n = 116) received single doses of the once-daily deutetrabenazine formulation and a power model was fitted to describe the relationship between dose and pharmacokinetic parameters (maximum observed plasma drug concentration [Cmax], area under the plasma concentration–time curve from time 0 to 36 h [AUC0–36h], and area under the plasma concentration–time curve from time 0 extrapolated to infinity [AUC0–∞]). In the second cross-over study, a single 24-mg dose of the once-daily formulation was given in fasted and fed conditions to healthy participants (n = 84) and the effect of food was evaluated by constructing 90% confidence intervals of the geometric mean ratios for Cmax, AUC0–t, and AUC0–∞.

Results

Dosage strength proportionality for the once-daily formulation was demonstrated for the dosage strengths 6 mg, 12 mg, and 24 mg; and across the approved dose range up to 48 mg for the pharmacokinetic parameters of all analytes (deutetrabenazine, and metabolites; deuterated alpha-dihydrotetrabenazine and beta-dihydrotetrabenazine), individually and as a sum). In the food effect study, the Cmax, AUC0–t, and AUC0–∞ geometric mean ratios for deutetrabenazine and deuterated metabolites all fell within the 90% confidence interval of 80–125.

Conclusions

The once-daily formulation of deutetrabenazine exhibited dosage strength proportional pharmacokinetics for doses up to 48 mg and there was no observed effect of food.