RESUMEN
(R,S)-Ketamine (ketamine) is a dissociative anesthetic that also possesses analgesic and antidepressant activity. Undesirable dissociative side effects and misuse potential limit expanded use of ketamine in several mental health disorders despite promising clinical activity and intensifying medical need. (2R,6R)-Hydroxynorketamine (RR-HNK) is a metabolite of ketamine that lacks anesthetic and dissociative activity but maintains antidepressant and analgesic activity in multiple preclinical models. To enable future assessments in selected human indications, we report the safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) of RR-HNK in a Phase 1 study in healthy volunteers (NCT04711005). A six-level single-ascending dose (SAD) (0.1-4 mg/kg) and a two-level multiple ascending dose (MAD) (1 and 2 mg/kg) study was performed using a 40-minute IV administration emulating the common practice for ketamine administration for depression. Safety assessments showed RR-HNK possessed a minimal adverse event profile and no serious adverse events at all doses examined. Evaluations of dissociation and sedation demonstrated that RR-HNK did not possess anesthetic or dissociative characteristics in the doses examined. RR-HNK PK parameters were measured in both the SAD and MAD studies and exhibited dose-proportional increases in exposure. Quantitative electroencephalography (EEG) measurements collected as a PD parameter based on preclinical findings and ketamine's established effect on gamma-power oscillations demonstrated increases of gamma power in some participants at the lower/mid-range doses examined. Cerebrospinal fluid examination confirmed RR-HNK exposure within the central nervous system (CNS). Collectively, these data demonstrate RR-HNK is well tolerated with an acceptable PK profile and promising PD outcomes to support the progression into Phase 2.
RESUMEN
Acalabrutinib is a covalent Bruton tyrosine kinase (BTK) inhibitor approved for relapsed/refractory mantle cell lymphoma and chronic lymphocytic leukemia/small lymphocytic lymphoma. A major metabolite of acalabrutinib (M27, ACP-5862) was observed in human plasma circulation. Subsequently, the metabolite was purified from an in vitro biosynthetic reaction and shown by nuclear magnetic resonance spectroscopy to be a pyrrolidine ring-opened ketone/amide. Synthesis confirmed its structure, and covalent inhibition of wild-type BTK was observed in a biochemical kinase assay. A twofold lower potency than acalabrutinib was observed but with similar high kinase selectivity. Like acalabrutinib, ACP-5862 was the most selective toward BTK relative to ibrutinib and zanubrutinib. Because of the potency, ACP-5862 covalent binding properties, and potential contribution to clinical efficacy of acalabrutinib, factors influencing acalabrutinib clearance and ACP-5862 formation and clearance were assessed. rCYP (recombinant cytochrome P450) reaction phenotyping indicated that CYP3A4 was responsible for ACP-5862 formation and metabolism. ACP-5862 formation Km (Michaelis constant) and Vmax were 2.78 µM and 4.13 pmol/pmol CYP3A/min, respectively. ACP-5862 intrinsic clearance was 23.6 µL/min per mg. Acalabrutinib weakly inhibited CYP2C8, CYP2C9, and CYP3A4, and ACP-5862 weakly inhibited CYP2C9 and CYP2C19; other cytochrome P450s, UGTs (uridine 5'-diphospho-glucuronosyltransferases), and aldehyde oxidase were not inhibited. Neither parent nor ACP-5862 strongly induced CYP1A2, CYP2B6, or CYP3A4 mRNA. Acalabrutinib and ACP-5862 were substrates of multidrug resistance protein 1 and breast cancer resistance protein but not OATP1B1 or OATP1B3. Our work indicates that ACP-5862 may contribute to clinical efficacy in acalabrutinib-treated patients and illustrates how proactive metabolite characterization allows timely assessment of drug-drug interactions and potential contributions of metabolites to pharmacological activity. SIGNIFICANCE STATEMENT: This work characterized the major metabolite of acalabrutinib, ACP-5862. Its contribution to the pharmacological activity of acalabrutinib was assessed based on covalent Bruton tyrosine kinase binding kinetics, kinase selectivity, and potency in cellular assays. The metabolic clearance and in vitro drug-drug interaction potential were also evaluated for both acalabrutinib and ACP-5862. The current data suggest that ACP-5862 may contribute to the clinical efficacy observed in acalabrutinib-treated patients and demonstrates the value of proactive metabolite identification and pharmacological characterization.
Asunto(s)
Citocromo P-450 CYP3A , Humanos , Adulto , Agammaglobulinemia Tirosina Quinasa , Transportador de Casetes de Unión a ATP, Subfamilia G, Miembro 2 , Citocromo P-450 CYP2C9 , Proteínas de Neoplasias , Inhibidores de Proteínas Quinasas/uso terapéuticoRESUMEN
The interaction between many proteins and hydrophobic functionalized surfaces is known to induce ß-sheet and amyloid fibril formation. In particular, insulin has served as a model peptide to understand such fibrillation, but the early stages of insulin misfolding and the influence of the surface have not been followed in detail under the acidic conditions relevant to the synthesis and purification of insulin. Here we compare the adsorption of human insulin on a hydrophobic (-CH3-terminated) silane self-assembled monolayer to a hydrophilic (-NH3(+)-terminated) layer. We monitor the secondary structure of insulin with Fourier transform infrared attenuated total reflection and side-chain orientation with sum frequency spectroscopy. Adsorbed insulin retains a close-to-native secondary structure on both hydrophobic and hydrophilic surfaces for extended periods at room temperature and converts to a ß-sheet-rich structure only at elevated temperature. We propose that the known acid stabilization of human insulin and the protection of the aggregation-prone hydrophobic domains on the insulin monomer by adsorption on the hydrophobic surface work together to inhibit fibril formation at room temperature.
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Insulina/química , Silanos/síntesis química , Adsorción , Interacciones Hidrofóbicas e Hidrofílicas , Modelos Moleculares , Proteínas/química , Silanos/química , Propiedades de Superficie , TemperaturaRESUMEN
The purpose of the study was to evaluate the long-term changes in refractive error in children with congenital ptosis managed with unilateral levator resection, and to provide a brief literature review and discuss the possible mechanisms for refractive change in the post-operative period. We present a retrospective consecutive case series of children (4-11 years old) who underwent unilateral levator resection, performed by a single ophthalmic surgeon to manage congenital ptosis between 1998 and 2001 at Maidstone Hospital, Kent. Cycloplegic refraction data were obtained prior to surgery and at the last clinic visit post surgery (minimum follow-up 12 months). The refractive changes in the non-operated contralateral eye were used as age-matched controls. Data were analysed for changes in refractive sphere and cylinder. Forty-three patients underwent levator resection during this 3-year period. Complete refraction data were available for 13 patients. The mean age at the time of levator resection was 6.7 years. The refractive error was greater on the side with the ptosis (61 %). At the last clinical follow up (mean 36.3 months; SD 34 months), the mean spherical change in the operated eye was 0.41D (range 0.12-1.50D), compared to a mean change of 0.40D (range 0.25-2.00D) in the non-operated eye. The mean cylindrical change in the operated eyes was 0.38D (range 0.25-1.00D), compared to a mean of 0.21D (range 0.50-1.75D) in the non-operated eye. In conclusion, this study did not show a significant change in refractive error following levator resection surgery for congenital ptosis.
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Blefaroptosis/cirugía , Errores de Refracción/etiología , Blefaroptosis/congénito , Blefaroptosis/fisiopatología , Estudios de Casos y Controles , Niño , Preescolar , Humanos , Masculino , Músculos Oculomotores/cirugía , Refracción Ocular/fisiología , Estudios RetrospectivosRESUMEN
The properties of nitrogen centres acting either as hydrogen-bond or Brønsted acceptors in solid molecular acid-base complexes have been probed by N 1s X-ray photoelectron spectroscopy (XPS) as well as (15)N solid-state nuclear magnetic resonance (ssNMR) spectroscopy and are interpreted with reference to local crystallographic structure information provided by X-ray diffraction (XRD). We have previously shown that the strong chemical shift of the N 1s binding energy associated with the protonation of nitrogen centres unequivocally distinguishes protonated (salt) from hydrogen-bonded (co-crystal) nitrogen species. This result is further supported by significant ssNMR shifts to low frequency, which occur with proton transfer from the acid to the base component. Generally, only minor chemical shifts occur upon co-crystal formation, unless a strong hydrogen bond is formed. CASTEP density functional theory (DFT) calculations of (15)N ssNMR isotropic chemical shifts correlate well with the experimental data, confirming that computational predictions of H-bond strengths and associated ssNMR chemical shifts allow the identification of salt and co-crystal structures (NMR crystallography). The excellent agreement between the conclusions drawn by XPS and the combined CASTEP/ssNMR investigations opens up a reliable avenue for local structure characterization in molecular systems even in the absence of crystal structure information, for example for non-crystalline or amorphous matter. The range of 17 different systems investigated in this study demonstrates the generic nature of this approach, which will be applicable to many other molecular materials in organic, physical, and materials chemistry.
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Protones , Bencenosulfonatos/química , Benzoatos/química , Ácido Cítrico/química , Cristalografía por Rayos X , Fumaratos/química , Glutaratos/química , Ácido Clorhídrico/química , Enlace de Hidrógeno , Malonatos/química , Modelos Moleculares , Estructura Molecular , Ácido Oxálico/química , Teoría Cuántica , Salicilatos/química , Espectrofotometría , Rayos XRESUMEN
The so-called pharmaceutical solid chain, which encompasses drug substance micronisation to the final tablet production, at pilot plant scale is presented as a case study for a novel, highly potent, pharmaceutical compound: SAR114137. Various solid-state analytical methods, such as solid-state Nuclear Magnetic Resonance (ssNMR), Differential Scanning Calorimetry (DSC), Dynamic Water Vapour Sorption Gravimetry (DWVSG), hot-stage Raman spectroscopy and X-ray Powder Diffraction (XRPD) were applied and evaluated to characterise and quantify amorphous content during the course of the physical treatment of crystalline active pharmaceutical ingredient (API). DSC was successfully used to monitor the changes in amorphous content during micronisation of the API, as well as during stability studies. (19)F solid-state NMR was found to be the method of choice for the detection and quantification of low levels of amorphous API, even in the final drug product (DP), since compaction during tablet manufacture was identified as a further source for the formation of amorphous API. The application of different jet milling techniques was a critical factor with respect to amorphous content formation. In the present case, the change from spiral jet milling to loop jet milling led to a decrease in amorphous API content from 20-30 w/w% to nearly 0 w/w% respectively. The use of loop jet milling also improved the processability of the API. Stability investigations on both the milled API and the DP showed a marked tendency for recrystallisation of the amorphous API content on exposure to elevated levels of relative humidity. No significant impact of amorphous API on either the chemical stability or the dissolution rate of the API in drug formulation was observed. Therefore, the presence of amorphous content in the oral formulation was of no consequence for the clinical trial phases I and II.
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Analgésicos/síntesis química , Descubrimiento de Drogas/métodos , Espectrometría Raman/métodos , Difracción de Rayos X/métodos , Química Farmacéutica/métodosRESUMEN
The dehydration/desolvation of two hydrate solvates of the pharmaceutically important compound finasteride (namely, bisfinasteride monohydrate monotetrahydrofuran and bisfinasteride monohydrate mono-1,4-dioxane) has been studied by solid-state nuclear magnetic resonance, powder X-ray diffraction, thermogravimetric analysis (including coupling with mass spectrometry) and dynamic vapour sorption. The structure is unusual in that water holds the host finasteride molecules together by hydrogen bonding to form channels in which the solvent is sited. Whilst the solvent guest molecules are not strongly bound to the host, their presence is essential for structural stability. Desolvation is not found to occur at a well-defined temperature or even to consistently produce the same anhydrous form (form I vs. form II), but is instead highly dependent on the physical environment and, therefore, on the technique used. This behaviour complicates investigations, but the combination of complementary methods does allow the desolvation to be understood. Water and solvent are shown to be lost simultaneously, with no evidence of an intermediate form or increased mobility of the hydrogen-bonded water molecules. The results are consistent with a model in which structural collapse and rearrangement follows the loss of a small fraction of the solvent molecules from the channel structure, with the final form produced being very sensitive to the presence of water vapour during desolvation.
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Finasterida/química , Agua/química , Cristalización/métodos , Dioxanos/química , Enlace de Hidrógeno , Espectroscopía de Resonancia Magnética/métodos , Solventes/química , Temperatura , Termogravimetría/métodos , Difracción de Rayos X/métodosRESUMEN
Black occlusive intraocular devices have been used successfully for intractable binocular diplopia. We describe a novel technique of implanting both a black occlusive device and a clear poly(methyl methacrylate) intraocular lens (IOL) in the capsular bag during phacoemulsification surgery. If the need should arise at a later date, this approach will allow safer and easier explantation of the black occlusive device, avoiding the need for IOL exchange.
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Diplopía/cirugía , Implantación de Lentes Intraoculares/métodos , Lentes Intraoculares , Coloración de Prótesis , Adulto , Humanos , Masculino , Facoemulsificación , Polimetil Metacrilato , Seudofaquia/fisiopatología , Visión Binocular , Agudeza Visual/fisiologíaRESUMEN
Ionic bond or hydrogen bridge? Brønsted proton transfer to nitrogen acceptors in organic crystals causes strong N1s core-level binding energy shifts. A study of 15 organic cocrystal and salt systems shows that standard X-ray photoelectron spectroscopy (XPS) can be used as a complementary method to X-ray crystallography for distinguishing proton transfer from H-bonding in organic condensed matter.
RESUMEN
Yellow discoloration was observed at the surface of normally white crystals of a development pharmaceutical fumarate salt, tentatively ascribed to the presence of trace amounts of free base. The impact of impurities on sample properties and behavior can be significant, especially if localized at the surface. No conventional bulk analytical technique could readily provide an explanation for the yellow color, so a surface-sensitive technique, X-ray photoelectron spectroscopy (XPS), was employed to characterize the salt. XPS reveals the presence of free base at the surface through the HN(+)/N ratio. A free radical decarboxylation mechanism is proposed to account for the alterations observed with extended irradiation. The lower intensity carboxyl signal and significantly lower HN(+)/N ratio for the yellow surface samples reveal a higher level of free base at the surface than the white samples. The samples with yellow surfaces could not be successfully milled, which was an important part of the production process for providing material of the required physical quality for product formulation. Identification of residual free base at the surface of the crystalline material, by XPS, was significant for optimization of the crystallization process to yield material of required quality for successful milling at plant scale.
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Fumaratos/análisis , Espectroscopía de Fotoelectrones/métodos , Cristalización , Descarboxilación , Composición de Medicamentos , Contaminación de Medicamentos/prevención & control , Radicales Libres/química , Control de Calidad , Sales (Química) , Propiedades de SuperficieRESUMEN
Recent studies suggested that X-ray photoelectron spectroscopy (XPS) sensitively determines the protonation state of nitrogen functional groups in the solid state, providing a means for distinguishing between co-crystals and salts of organic compounds. Here we describe how a new theophylline complex with 5-sulfosalicylic acid dihydrate was established as a salt by XPS prior to assignment with conventional methods. The presence of a C=NH(+) (N9) N1s peak in XPS allows assignment as a salt, while this peak is clearly absent for a theophylline co-crystal. The large low frequency shift for N9 observed by (15)N solid-state nuclear magnetic resonance spectroscopy (ssNMR) and corresponding density functional theory (DFT) calculations confirm that protonation has occurred. The crystal structure and further analytical studies confirm the conclusions reached with XPS and ssNMR. This study demonstrates XPS as an alternative technique for determining whether proton transfer has occurred in acid-base complexes.
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Espectroscopía de Resonancia Magnética/métodos , Modelos Moleculares , Espectroscopía de Fotoelectrones , Protones , Teoría Cuántica , Teofilina/química , Cristalografía por Rayos X , Conformación Molecular , Sales (Química)/químicaRESUMEN
Combined (15)N ssNMR and X-ray photoelectron spectroscopy (XPS) investigations for theophylline, a theophylline co-crystal, and a theophyllinium salt demonstrate that XPS allows direct observation of the degree of proton transfer, and thus identification of whether a salt or a co-crystal has been formed. The presence of a strongly binding-energy-shifted N 1s XPS peak with protonation indicates a salt (C==NH(+)), while this peak is unmistakably absent in the co-crystal. XPS should be considered as an alternative and complementary technique to single crystal X-ray diffraction and solid-state nuclear magnetic resonance spectroscopy (ssNMR).
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Espectroscopía de Fotoelectrones/métodos , Sales (Química)/química , Teofilina/química , Cristalización , ProtonesRESUMEN
Recognition of bone mineral by bisphosphonates is crucial to their targeting, efficacy, therapeutic and diagnostic applications, and pharmacokinetics. In a search for rapid and simple NMR approaches to assessing the bone recognition characteristics of bisphosphonates, we have studied alendronate, pamidronate, neridronate, zoledronate and tiludronate, in crystalline form and bound to the surface of pure bone mineral stripped of its organic matrix by a simple chemical process. (31)P NMR chemical shift anisotropies and asymmetries in the crystalline compounds cluster strongly into groupings corresponding to fully protonated, monoprotonated, and deprotonated phosphonate states. All the mineral-bound bisphosphonates cluster in the same anisotropy-asymmetry space as the deprotonated phosphonates. In (13)C{(31)P} rotational echo double resonance (REDOR) experiments, which are sensitive to carbon-phosphorus interatomic distances, the strongly mineral-bound alendronate displays very similar conformational and side chain dynamics to its crystalline state. Pamidronate and neridronate, with shorter and longer sidechains, respectively, and generally weaker mineral binding, display more dynamical sidechains in the mineral-bound state. The REDOR experiment provides a simple rationalization of bisphosphonate-mineral affinity in terms of molecular structure and dynamics, consistent with findings from much more labour- and time-intensive isotope labelling approaches.
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Conservadores de la Densidad Ósea/química , Conservadores de la Densidad Ósea/farmacología , Densidad Ósea/efectos de los fármacos , Difosfonatos/química , Difosfonatos/farmacología , Espectroscopía de Resonancia Magnética , Tecnología Farmacéutica/métodos , Alendronato/química , Alendronato/farmacología , Animales , Cristalización , Caballos , Imidazoles/química , Imidazoles/farmacología , Estructura Molecular , Pamidronato , Relación Estructura-Actividad , Ácido ZoledrónicoRESUMEN
The crystallinity and amorphous content of a micronized pharmaceutical development drug substance have been independently determined. An evaluation of different techniques for this purpose has been carried out, and it was found that solid-state nuclear magnetic resonance (ss NMR) and X-ray powder diffraction (XRPD) were suitable for the former and latter, respectively. The baseline intensities of X-ray powder diffractograms, associated with the amorphous component of the sample, have been used to detect levels of non-crystalline material greater than 5%w/w with an absolute accuracy of +/-3%. ss NMR has been employed to quantify crystalline defects at levels of greater than 3%w/w with an estimated uncertainty of +/-2%. It is proposed that such crystalline defects arise from molecular conformational differences that only have a small effect on crystal lattice parameters and, by implication, only have small effects on X-ray powder diffractograms. In both cases the techniques are shown to be highly reproducible and require minimal sample preparation. Excellent linearity is demonstrated for the determination of amorphous material using prepared standards. The present account describes the choice of analytical method, method validation and the results obtained for typical samples of drug substance. It is demonstrated that solid-state NMR should be used as a complementary technique with respect to XRPD for studying crystallinity.
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Cristalización , Preparaciones Farmacéuticas/química , Rastreo Diferencial de Calorimetría , Estabilidad de Medicamentos , Espectroscopía de Resonancia Magnética , Difracción de Rayos XRESUMEN
The terms "agglomerate" and "aggregate" are widely used by powder technologists to describe assemblages of particles that are found in dry powders and powders in liquid suspensions. Each term has a specific meaning but, unfortunately, they are frequently interchanged at will and this has resulted in universal confusion. This confusion is perpetuated by conflicting definitions in national and international standards and this presents problems when describing powder properties or communicating results in reports and research papers. This paper reviews the current status of the definitions, with particular emphasis on their use in the pharmaceutical industry. It is proposed that just one term, agglomerate, should be used to describe an assemblage of particles in a powder and that the term aggregate should be confined to pre-nucleation structures.