Effects of the thiol methyltransferase inhibitor DCMB on the pharmacokinetics and metabolism of vicagrel in rats.

ABSTRACT

P2Y12 receptor inhibitors are commonly used in clinical antiplatelet therapy, typically alongside other medications. Vicagrel, a promising P2Y12 receptor inhibitor, has submitted a new drug marketing application to the U.S. FDA. Its primary metabolites and some metabolic pathways are identical to those of clopidogrel. The aim of this study was to investigate the effects of the thiol methyltransferase inhibitor ({plus minus})-2,3-dichloro-α-methylbenzylamine (DCMB) on the metabolism and pharmacokinetics of vicagrel. In vitro incubation with human and rat liver microsomes revealed that DCMB significantly inhibited the methylation of vicagrel's thiol metabolite M15-1. Rats were orally administered 6 mg/kg [14C]vicagrel (100 µCi/kg) 1 h after peritoneal injection with or without DCMB (80 mg/kg). Compared to the control group, the plasma of DCMB-pretreated rats exhibited C max decrease and T max delay for all vicagrel-related substances, the methylation product of the thiol metabolite (M9-2) and the derivatization product of the active thiol metabolite (MP-M15-2). However, no significant changes in AUC or t 1/2 were observed. DCMB had negligible effect on the total radiological recovery of vicagrel within 72 h, although the rate of vicagrel excretion slowed down within 48 h. DCMB had a negligible impact on the metabolic pathway of vicagrel. Overall, the present study found that DCMB did not significantly affect the total exposure, metabolic pathways, metabolite profiles, or total excretion rates of vicagrel-related metabolites in rats, but led to C max decrease, T max delay, and slower excretion rate within 48 h. Significance Statement This study used LC-MS/MS combined with radiolabeling technology to investigate the effects of the TMT inhibitor DCMB on the absorption, metabolism and excretion of vicagrel in rats. This work helps to better understand the in vivo metabolism of active thiol metabolites of P2Y12 inhibitors such as clopidogrel and vicagrel, etc.