Literature DB >> 17230596

Oral-intravenous crossover study of fingolimod pharmacokinetics, lymphocyte responses and cardiac effects.

John M Kovarik1, Stefan Hartmann, Michael Bartlett, Gilles-Jacques Riviere, Daniel Neddermann, Yibin Wang, Andreas Port, Robert L Schmouder.   

Abstract

OBJECTIVE: The pharmacokinetics and lymphocyte responses to the immunomodulator fingolimod (FTY720) were characterized after oral and intravenous administration.
METHODS: In this randomized, two-period crossover study 11 evaluable healthy subjects received single doses of fingolimod 1.25 mg orally and 1 mg intravenously infused over 2 h. The pharmacokinetics of fingolimod, blood lymphocyte counts and heart rate were characterized for 28 days after each dose.
RESULTS: After oral administration, Cmax was 1.1+/-0.2 ng/ml occurring at 12 h postdose and the AUC was 201+/-31 ng.h/ml. After intravenous infusion, Cmax was 4.9+/-0.8 ng/ml, AUC was 175+/-50 ng. h/ml, clearance was 6.3+/-2.3 l/h and distribution volume was 1199+/-260 l. The oral/intravenous ratio of dose-normalized AUCs was 0.94 (95%CI: 0.78-1.12). The pharmacologically active metabolite fingolimod-phosphate was quantifiable near its peak after oral administration but not after intravenous administration. The mean lymphocyte nadir occurred on day 1 and was 35% lower after oral (0.74x10(9)/l) than after intravenous (1.15x10(9)/l) administration. Lymphocytes recovered to the normal range by day 15 for both treatments. The mean heart rate nadir occurred 3-4 h postdose and was 11% lower after oral administration (47 bpm) versus intravenous administration (53 bpm).
CONCLUSIONS: Average systemic exposure to fingolimod was similar after oral and intravenous administration. However, the acute decrease in lymphocyte counts was weaker after intravenous administration, likely because of lower blood levels of the active metabolite fingolimod-phosphate compared with oral administration. Copyright (c) 2007 John Wiley & Sons, Ltd.

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Year:  2007        PMID: 17230596     DOI: 10.1002/bdd.535

Source DB:  PubMed          Journal:  Biopharm Drug Dispos        ISSN: 0142-2782            Impact factor:   1.627


  16 in total

Review 1.  Clinical pharmacokinetics of fingolimod.

Authors:  Olivier J David; John M Kovarik; Robert L Schmouder
Journal:  Clin Pharmacokinet       Date:  2012-01-01       Impact factor: 6.447

2.  Placebo-controlled study of the effects of fingolimod on cardiac rate and rhythm and pulmonary function in healthy volunteers.

Authors:  Robert Schmouder; Sam Hariry; Olivier J David
Journal:  Eur J Clin Pharmacol       Date:  2011-11-10       Impact factor: 2.953

Review 3.  Fingolimod (FTY720): discovery and development of an oral drug to treat multiple sclerosis.

Authors:  Volker Brinkmann; Andreas Billich; Thomas Baumruker; Peter Heining; Robert Schmouder; Gordon Francis; Shreeram Aradhye; Pascale Burtin
Journal:  Nat Rev Drug Discov       Date:  2010-10-29       Impact factor: 84.694

4.  Deliberate fingolimod overdose presenting with delayed hypotension and bradycardia responsive to atropine.

Authors:  M Stephenson; A Wong; J A Rotella; N Crump; F Kerr; S L Greene
Journal:  J Med Toxicol       Date:  2014-06

Review 5.  Signaling and regulatory functions of bioactive sphingolipids as therapeutic targets in multiple sclerosis.

Authors:  Maria Podbielska; Hubert Krotkiewski; Edward L Hogan
Journal:  Neurochem Res       Date:  2012-03-27       Impact factor: 3.996

Review 6.  Fingolimod: a review of its use in the management of relapsing-remitting multiple sclerosis.

Authors:  Lesley J Scott
Journal:  CNS Drugs       Date:  2011-08       Impact factor: 5.749

7.  FTY720 (fingolimod) increases vascular tone and blood pressure in spontaneously hypertensive rats via inhibition of sphingosine kinase.

Authors:  Léon J A Spijkers; Astrid E Alewijnse; Stephan L M Peters
Journal:  Br J Pharmacol       Date:  2012-06       Impact factor: 8.739

8.  Evaluation of the lymphocyte trafficking drug FTY720 in vaginal tissues.

Authors:  Ai Tsuiki; Wei Luo; Tara Henning; Sundaram Vishwanathan; Chuong Dinh; Debra Adams; Elizabeth Sweeney; James Mitchell; Shannon Bachman; Prachi Sharma; Nathaniel Powell; Michael Hendry; Janet McNicholl; Ellen Kersh
Journal:  J Med Primatol       Date:  2013-01-12       Impact factor: 0.667

Review 9.  "Inside-out" signaling of sphingosine-1-phosphate: therapeutic targets.

Authors:  Kazuaki Takabe; Steven W Paugh; Sheldon Milstien; Sarah Spiegel
Journal:  Pharmacol Rev       Date:  2008-06-13       Impact factor: 25.468

Review 10.  Development of oral immunomodulatory agents in the management of multiple sclerosis.

Authors:  Richard Nicholas; Paolo Giannetti; Ali Alsanousi; Tim Friede; Paolo A Muraro
Journal:  Drug Des Devel Ther       Date:  2011-05-10       Impact factor: 4.162

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