Josh D Kaullen1, Joel S Owen, Kim L R Brouwer, Paul M Heerdt, Cynthia A Lien, John J Savarese, Virginia D Schmith. 1. From the Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (J.D.K., K.L.R.B.) Union University, Jackson, Tennessee (J.S.O.) Yale Medical School, New Haven, Connecticut (P.M.H.) Weill Cornell Medical College, New York, New York (C.A.L., J.J.S.) Nuventra Pharma Sciences, Durham, North Carolina (V.D.S.).
Abstract
BACKGROUND: CW002 is an investigational nondepolarizing, neuromuscular blocking agent with a rapid onset and intermediate duration of action in animals. This is a single ascending dose, healthy subject study exploring tolerability, pharmacokinetics, and potency. METHODS: Population pharmacokinetic and pharmacokinetic/pharmacodynamic models were developed using plasma drug concentration data from a previously published dose-response study in 28 healthy subjects receiving single doses of CW002 during sevoflurane anesthesia. Subjects included in the models were from five different dose cohorts (cohorts 3, 4, 5, 6, and 8 receiving 0.04, 0.06, 0.08, 0.10, and 0.14 mg/kg, respectively). Serial arterial plasma concentrations and muscle twitch heights were monitored. RESULTS: A four-compartment model was fit to the concentration-time data, whereas a transit compartment with a sigmoid Emax model was fit to the pharmacokinetic/pharmacodynamic data. The population pharmacokinetics of CW002 was linear with very low interindividual variability in clearance (10.8%). Simulations were conducted to predict the onset and offset of effect at 2×, 3×, and 4× ED95. The time to 80% block was predicted to be 1.5, 0.8, and 0.7 min for 2×, 3×, and 4× ED95 doses, respectively. The simulated 25 to 75% recovery index was independent of dose. CONCLUSIONS: CW002 has predictable pharmacokinetics and is likely to have a rapid onset with an intermediate duration of action at 3× ED95. This model provides information to inform critical decisions (e.g., dose, study design) for continued development of CW002.
BACKGROUND: CW002 is an investigational nondepolarizing, neuromuscular blocking agent with a rapid onset and intermediate duration of action in animals. This is a single ascending dose, healthy subject study exploring tolerability, pharmacokinetics, and potency. METHODS: Population pharmacokinetic and pharmacokinetic/pharmacodynamic models were developed using plasma drug concentration data from a previously published dose-response study in 28 healthy subjects receiving single doses of CW002 during sevoflurane anesthesia. Subjects included in the models were from five different dose cohorts (cohorts 3, 4, 5, 6, and 8 receiving 0.04, 0.06, 0.08, 0.10, and 0.14 mg/kg, respectively). Serial arterial plasma concentrations and muscle twitch heights were monitored. RESULTS: A four-compartment model was fit to the concentration-time data, whereas a transit compartment with a sigmoid Emax model was fit to the pharmacokinetic/pharmacodynamic data. The population pharmacokinetics of CW002 was linear with very low interindividual variability in clearance (10.8%). Simulations were conducted to predict the onset and offset of effect at 2×, 3×, and 4× ED95. The time to 80% block was predicted to be 1.5, 0.8, and 0.7 min for 2×, 3×, and 4× ED95 doses, respectively. The simulated 25 to 75% recovery index was independent of dose. CONCLUSIONS: CW002 has predictable pharmacokinetics and is likely to have a rapid onset with an intermediate duration of action at 3× ED95. This model provides information to inform critical decisions (e.g., dose, study design) for continued development of CW002.
Authors: Marcus A Björnsson; Ake Norberg; Sigridur Kalman; Mats O Karlsson; Ulrika S H Simonsson Journal: J Pharmacokinet Pharmacodyn Date: 2010-04-23 Impact factor: 2.745
Authors: Paul M Heerdt; Hiroshi Sunaga; Joel S Owen; Matthew T Murrell; Jaideep K Malhotra; Deena Godfrey; Michelle Steinkamp; Peter Savard; John J Savarese; Cynthia A Lien Journal: Anesthesiology Date: 2016-12 Impact factor: 7.892
Authors: Hiroshi Sunaga; John J Savarese; Jeff D McGilvra; Paul M Heerdt; Matthew R Belmont; Scott G Van Ornum; Matthew T Murrell; Jaideep K Malhotra; Peter M Savard; Erin Jeannotte; Bryce J Petty; Erica Allen; Gilbert W Carnathan Journal: Anesthesiology Date: 2016-10 Impact factor: 7.892