Shashank Joshi1, Girish Gudi2, Vinu C A Menon3, Monika Tandon4, Vikas Joshi5, Sachin Suryawanshi6, Hanmant Barkate6, Nikhil Sawant5, Sagar Katare7, Waseem Siddique6. 1. Joshi Clinic, Lilavati Hospital, Apollo Sugar Clinic and Bhatia Hospital, Mumbai, India. 2. Drug Metabolism and Pharmacokinetics, Glenmark Pharmaceuticals Inc, Paramus, NJ, USA. 3. Drug Metabolism and Pharmacokinetics, Glenmark Pharmaceuticals Ltd, Mumbai, India. 4. Clinical Development, Glenmark Pharmaceuticals Ltd, Mumbai, India. 5. Clinical Research, Glenmark Pharmaceuticals Ltd, Mumbai, India. 6. Medical Services, Glenmark Pharmaceuticals Ltd, Mumbai, India. 7. Medical Services, Glenmark Pharmaceuticals Ltd, Mumbai, India. sagar.katare@glenmarkpharma.com.
Abstract
BACKGROUND AND OBJECTIVE: Remogliflozin etabonate is an orally available prodrug of remogliflozin, an inhibitor of renal sodium glucose co-transporter-2 (SGLT2) with antihyperglycemic activity. The present study was conducted to characterize the pharmacokinetic and safety profile of remogliflozin etabonate under fasting and fed conditions at single oral doses of 100 and 250 mg in healthy Asian Indian adults. METHODS: Sixty-five healthy, adult Asian Indian male subjects were enrolled in an open-label, two-stage, single-period pharmacokinetic study. Remogliflozin was given under fasting and/or fed conditions as a single oral dose of 100 or 250 mg. The plasma concentrations of remogliflozin etabonate, remogliflozin, and the metabolite GSK279782 were quantified by validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. Pharmacokinetic parameters were determined from the plasma concentration-time profile by non-compartmental analysis. Safety was assessed through monitoring of adverse events. Descriptive statistics were calculated and reported for all parameters. RESULTS: The plasma concentration profiles showed rapid absorption of the prodrug remogliflozin etabonate and rapid conversion to the active moiety, remogliflozin, which is then further metabolized to another active metabolite, GSK279782. The geometric mean maximum concentration (Cmax) and area under the plasma concentration-time curve (AUC) were comparable for all three analytes between the fasted and fed state. The fed/fasted ratio for Cmax ranged from 0.77 to 1.44 at the 100 mg dose, and from 0.80 to 1.12 at the 250 mg dose. The fed/fasted ratio for AUC was 1.22 and 1.35 at 100 and 250 mg, respectively. An early time to Cmax (tmax) was observed for all three analytes while being administered in the fasted state. Both the Cmax and AUClast of all the three analytes increased in a dose-proportional manner under the fasted and fed states. The terminal half-life for remogliflozin ranged from 1.53 to 2.07 h. All three analytes had comparable terminal half-lives irrespective of dose levels or dietary conditions. CONCLUSIONS: Following single oral administration at 100 and 250 mg, remogliflozin etabonate showed favorable, linear pharmacokinetics. There were no clinically relevant food effects on the pharmacokinetics at both the 100 and 250 mg dose levels. Remogliflozin etabonate was well-tolerated without any safety concerns or hypoglycemic events. CLINICAL TRIAL REGISTRATION: Clinical Trial Registry-India identifier number CTRI/2017/10/010043.
BACKGROUND AND OBJECTIVE:Remogliflozin etabonate is an orally available prodrug of remogliflozin, an inhibitor of renal sodium glucose co-transporter-2 (SGLT2) with antihyperglycemic activity. The present study was conducted to characterize the pharmacokinetic and safety profile of remogliflozin etabonate under fasting and fed conditions at single oral doses of 100 and 250 mg in healthy Asian Indian adults. METHODS: Sixty-five healthy, adult Asian Indian male subjects were enrolled in an open-label, two-stage, single-period pharmacokinetic study. Remogliflozin was given under fasting and/or fed conditions as a single oral dose of 100 or 250 mg. The plasma concentrations of remogliflozin etabonate, remogliflozin, and the metabolite GSK279782 were quantified by validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. Pharmacokinetic parameters were determined from the plasma concentration-time profile by non-compartmental analysis. Safety was assessed through monitoring of adverse events. Descriptive statistics were calculated and reported for all parameters. RESULTS: The plasma concentration profiles showed rapid absorption of the prodrug remogliflozin etabonate and rapid conversion to the active moiety, remogliflozin, which is then further metabolized to another active metabolite, GSK279782. The geometric mean maximum concentration (Cmax) and area under the plasma concentration-time curve (AUC) were comparable for all three analytes between the fasted and fed state. The fed/fasted ratio for Cmax ranged from 0.77 to 1.44 at the 100 mg dose, and from 0.80 to 1.12 at the 250 mg dose. The fed/fasted ratio for AUC was 1.22 and 1.35 at 100 and 250 mg, respectively. An early time to Cmax (tmax) was observed for all three analytes while being administered in the fasted state. Both the Cmax and AUClast of all the three analytes increased in a dose-proportional manner under the fasted and fed states. The terminal half-life for remogliflozin ranged from 1.53 to 2.07 h. All three analytes had comparable terminal half-lives irrespective of dose levels or dietary conditions. CONCLUSIONS: Following single oral administration at 100 and 250 mg, remogliflozin etabonate showed favorable, linear pharmacokinetics. There were no clinically relevant food effects on the pharmacokinetics at both the 100 and 250 mg dose levels. Remogliflozin etabonate was well-tolerated without any safety concerns or hypoglycemic events. CLINICAL TRIAL REGISTRATION: Clinical Trial Registry-India identifier number CTRI/2017/10/010043.
Authors: Carlos G Santos-Gallego; Alvaro Garcia-Ropero; Donna Mancini; Sean P Pinney; Johanna P Contreras; Icilma Fergus; Vivian Abascal; Pedro Moreno; Farah Atallah-Lajam; Ronald Tamler; Anu Lala; Javier Sanz; Valentin Fuster; Juan Jose Badimon Journal: Cardiovasc Drugs Ther Date: 2019-02 Impact factor: 3.727
Authors: Thomas A Zelniker; Stephen D Wiviott; Itamar Raz; Kyungah Im; Erica L Goodrich; Marc P Bonaca; Ofri Mosenzon; Eri T Kato; Avivit Cahn; Remo H M Furtado; Deepak L Bhatt; Lawrence A Leiter; Darren K McGuire; John P H Wilding; Marc S Sabatine Journal: Lancet Date: 2018-11-10 Impact factor: 79.321
Authors: Stephen D Wiviott; Itamar Raz; Marc P Bonaca; Ofri Mosenzon; Eri T Kato; Avivit Cahn; Michael G Silverman; Thomas A Zelniker; Julia F Kuder; Sabina A Murphy; Deepak L Bhatt; Lawrence A Leiter; Darren K McGuire; John P H Wilding; Christian T Ruff; Ingrid A M Gause-Nilsson; Martin Fredriksson; Peter A Johansson; Anna-Maria Langkilde; Marc S Sabatine Journal: N Engl J Med Date: 2018-11-10 Impact factor: 91.245
Authors: Bernard Zinman; Christoph Wanner; John M Lachin; David Fitchett; Erich Bluhmki; Stefan Hantel; Michaela Mattheus; Theresa Devins; Odd Erik Johansen; Hans J Woerle; Uli C Broedl; Silvio E Inzucchi Journal: N Engl J Med Date: 2015-09-17 Impact factor: 91.245
Authors: Bruce Neal; Vlado Perkovic; Kenneth W Mahaffey; Dick de Zeeuw; Greg Fulcher; Ngozi Erondu; Wayne Shaw; Gordon Law; Mehul Desai; David R Matthews Journal: N Engl J Med Date: 2017-06-12 Impact factor: 91.245
Authors: Carlos G Santos-Gallego; Juan Antonio Requena-Ibanez; Rodolfo San Antonio; Kiyotake Ishikawa; Shin Watanabe; Belen Picatoste; Eduardo Flores; Alvaro Garcia-Ropero; Javier Sanz; Roger J Hajjar; Valentin Fuster; Juan J Badimon Journal: J Am Coll Cardiol Date: 2019-04-23 Impact factor: 24.094
Authors: Viswanathan Mohan; Ambrish Mithal; Shashank R Joshi; S R Aravind; Subhankar Chowdhury Journal: Drug Des Devel Ther Date: 2020-06-24 Impact factor: 4.162