21 results on '"Rosa Luo"'
Search Results
2. CRN04894: an oral, nonpeptide adrenocorticotropic hormone (ACTH) receptor antagonist decreases basal and stimulated cortisol secretion in healthy volunteers
- Author
-
Peter Trainer, Christine Ferrara-Cook, Alejandro Ayala, Rosa Luo, Stephanie Miller, Yang Wang, Martha Hernandez-Illas, Struthers R. Scott, Stephen Betz, and Alan Krasner
- Published
- 2022
- Full Text
- View/download PDF
3. ACROBAT Edge: Safety and efficacy of switching injected SRLs to oral paltusotine in patients with acromegaly
- Author
-
Monica R Gadelha, Murray B Gordon, Mirjana Doknic, Emese Mezősi, Miklós Tóth, Harpal Randeva, Tonya Marmon, Theresa Jochelson, Rosa Luo, Michael Monahan, Ajay Madan, Christine Ferrara-Cook, R Scott Struthers, and Alan Krasner
- Subjects
Endocrinology ,Endocrinology, Diabetes and Metabolism ,Biochemistry (medical) ,Clinical Biochemistry ,Biochemistry - Abstract
Context Paltusotine is a once-daily, oral, nonpeptide small-molecule somatostatin receptor type 2 (SST2) agonist in clinical development for treatment of acromegaly. Objective This work aimed to evaluate change in insulin-like growth factor I (IGF-I) levels in patients switched from octreotide long-acting release or lanreotide depot monotherapy to paltusotine. Methods A phase 2, open-label, prospective, multicenter, multinational, nonrandomized, single-arm exploratory study was conducted in which dosage uptitrations were performed in a double-blinded manner. At 26 global sites, patients with acromegaly switched to paltusotine from injected somatostatin receptor ligand (SRL)-based therapy. Patients received 13-week treatment with once-daily oral paltusotine (10-40 mg/d). The primary end point was change from baseline to week 13 in IGF-I for patients who switched from long-acting octreotide or lanreotide depot monotherapy to paltusotine (group 1). All patients underwent a 4-week paltusotine washout at end of treatment period (wk 13-17). IGF-I, growth hormone (GH), patient-reported outcome, and safety data were collected. Results Forty-seven patients enrolled. In group 1 (n = 25), IGF-I and GH showed no significant change between SRL baseline and end of paltusotine treatment at week 13 (median change in IGF-I = −0.03×upper limit of normal [ULN]; P = .6285; GH = −0.05 ng/mL; P = .6285). IGF-I and GH rose significantly in the 4 weeks after withdrawing paltusotine (median change in IGF-I = 0.55×ULN; P < .0001 [median increase 39%]; GH = 0.72 ng/mL; P < .0001 [109.1% increase]). No patients discontinued because of adverse events (AE); no treatment-related serious AEs were reported. Conclusion These results suggest once-daily oral paltusotine was effective in maintaining IGF-I values in patients with acromegaly who switched from injected SRLs. Paltusotine was well tolerated with a safety profile consistent with other SRLs.
- Published
- 2022
4. Discovery of 4-(3-aminopyrrolidinyl)-3-aryl-5-(benzimidazol-2-yl)-pyridines as potent and selective SST5 agonists for the treatment of congenital hyperinsulinism
- Author
-
Jian Zhao, Shimiao Wang, Sun Hee Kim, Sangdon Han, Elizabeth Rico-Bautista, Emmanuel Sturchler, Julie Nguyen, Hannah Tan, Christine Staley, Ana Karin Kusnetzow, Stephen F. Betz, Michael Johns, Lance Goulet, Rosa Luo, Melissa Fowler, Jon Athanacio, Stacy Markison, R. Scott Struthers, and Yunfei Zhu
- Subjects
Male ,Pyridines ,Organic Chemistry ,Clinical Biochemistry ,Pharmaceutical Science ,Biochemistry ,Rats ,Rats, Sprague-Dawley ,Dogs ,Drug Discovery ,Molecular Medicine ,Animals ,Humans ,Congenital Hyperinsulinism ,Receptors, Somatostatin ,Somatostatin ,Molecular Biology - Abstract
SST5 receptor activation potently inhibits insulin secretion from pancreatic β-cells, and an orally available nonpeptide selective SST5 agonist may be used to effectively manage the blood glucose levels of congenital HI patients to avoid severe hypoglycemia. Our medicinal chemistry efforts have led to the discovery of 4-(3-aminopyrrolidinyl)-3-aryl-5-(benzimidazol-2-yl)-pyridine analogs as potent SST5 agonists. This class of molecules exhibits excellent human SST5 potency and selectivity against SST1, SST2, SST3 and SST4 receptors. Leading compound 3-{4-[(3S)-3-aminopyrrolidin-1-yl]-5-(4-methyl-1H-1,3-benzodiazol-2-yl)pyridin-3-yl-5-fluorobenzonitrile (28, CRN02481) showed limited off-target activity and good pharmacokinetic profiles in both male Sprague Dawley rats and Beagle dogs to advance into further preclinical evaluations.
- Published
- 2022
5. PSUN304 CRN04777 an Oral, Nonpeptide SST5-selective Somatostatin Agonist Dose Dependently Suppresses Basal and Stimulated Insulin Secretion
- Author
-
Christine Ferrara-Cook, Rosa Luo, Eduardo De La Torre, Yang Wang, Stephen Betz, Ajay Madan, Scott Struthers, Ulrike Hövelmann, Tim Heise, and Alan Krasner
- Subjects
Endocrinology, Diabetes and Metabolism - Abstract
Congenital hyperinsulinism (HI) is the most common cause of persistent hypoglycemia in neonates, infants, and children, and is caused by genetic mutations in the insulin secretion pathway in pancreatic beta-cells. Current medical and surgical treatments are often highly burdensome, only partially effective, and associated with significant morbidity. CRN04777 is a potent orally bioavailable SST5 agonist (EC50=0.41 nM) that is >1300 fold selective over other SST receptor subtypes. CRN04777 has been shown to suppress both glucose- and sulfonylurea (SU)-induced insulin secretion in rats. The latter is a model for the most common known monogenic form of human congenital HI. We report initial results from a randomized, double-blinded, placebo-controlled single ascending dose study evaluating the safety, pharmacokinetics and pharmacodynamics of CRN04777 in 74 healthy volunteers. Endogenous insulin secretion was stimulated using intravenous glucose tolerance tests (IVGTT) or SU challenges in separate cohorts of volunteers. In the IVGTT cohorts, single doses of CRN04777 (0.5-120 mg) were administered after an overnight fast and 1 hour prior to an IV bolus of 300 mg/kg glucose, followed by serial measurements of blood glucose and insulin over 180 minutes. The SU-challenge cohorts received single doses of CRN04777 (30 and 60 mg) one hour after SU administration (5 mg of glibenclamide/glyburide), followed by measurement of the IV glucose infusion rate (GIR) over 8 hours under automated euglycemic clamp conditions (ClampArt®). CRN04777 was orally absorbed (Tmax 1-3 hours) and demonstrated a dose dependent increase in systemic exposures with an apparent terminal elimination t1/2 of approximately 40 hours. Basal insulin secretion was reduced dose-dependently, with a 73% reduction following 120 mg of CRN04777. Likewise, glucose stimulated insulin secretion during the IVGTT (plasma insulin AUC) was reduced dose-dependently by approximately 50% with a parallel doubling of plasma glucose AUC following 120 mg of CRN04777. CRN04777 resulted in dose-dependent reversal of SU-induced insulin secretion, with 79% and 90% reductions in insulin AUC5-180min, respectively, at 30 and 60 mg doses. At the 60 mg dose of CRN04777, no exogenous glucose infusion was needed to prevent SU-induced hypoglycemia. CRN04777 was well tolerated across the dose range evaluated. All adverse events (AEs) were considered mild or moderate and there were no serious AEs. The data from this single-dose, proof-of-concept study show that the selective SST5 agonist CRN04777 is well tolerated after oral administration in healthy volunteers, is suitable for once daily dosing and suppresses insulin secretion under basal and stimulated conditions, including in a pharmacologic model of congenital HI. Multiple ascending dose evaluations in healthy volunteers are underway to support future studies in congenital HI patients. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.
- Published
- 2022
- Full Text
- View/download PDF
6. Paltusotine, a novel oral once-daily nonpeptide SST2 receptor agonist, suppresses GH and IGF-1 in healthy volunteers
- Author
-
Ajay Madan, Stacy Markison, Stephen F. Betz, Alan Krasner, Rosa Luo, Theresa Jochelson, Jason Lickliter, and R. Scott Struthers
- Subjects
Male ,Endocrinology ,Double-Blind Method ,Human Growth Hormone ,Endocrinology, Diabetes and Metabolism ,Growth Hormone ,Acromegaly ,Humans ,Insulin-Like Growth Factor I ,Healthy Volunteers - Abstract
Purpose Evaluate the pharmacodynamics, pharmacokinetics, and safety of paltusotine, an orally bioavailable, nonpeptide, somatostatin receptor subtype 2 (SST2) agonist being developed for the treatment of acromegaly and neuroendocrine tumors. Methods A randomized, double-blind, placebo-controlled, single center, single and multiple ascending dose phase 1 study was conducted in healthy male volunteers who received (i) single-dose of oral paltusotine 1.25, 2.5, 5, 10, and 20 mg (solution); and 40 and 60 mg (capsules) or (ii) multiple-dose oral paltusotine capsules once daily 5 mg (× 7 days), 10, 20, and 30 mg (× 10 days). Main outcome measures were pharmacodynamics (changes in growth hormone-releasing hormone [GHRH] stimulated growth hormone [GH] and insulin-like growth factor 1 [IGF-1]), pharmacokinetics, safety, and tolerability. Results Single-dose cohorts: n = 41 active, n = 14 placebo. Multiple-dose cohorts: n = 24 active, n = 12 placebo. Paltusotine was well tolerated, orally bioavailable, associated with increased plasma concentrations to doses up to 40 mg, and was eliminated with a half-life of approximately 30 h. Single-dose paltusotine 1.25 to 20 mg suppressed GHRH-stimulated GH secretion by 44% to 93% compared to 15% with placebo. Multiple-dose paltusotine 5 to 30 mg administered once daily for 10 days suppressed IGF-1 by 19% to 37% compared to an increase of 2.4% with placebo. Conclusions Paltusotine suppresses GH and IGF-1 in a dose-dependent fashion, with a safety profile similar to currently approved SST2 receptor ligands. Paltusotine is a promising once-daily oral nonpeptide SST2 agonist candidate for managing acromegaly and neuroendocrine tumors. Trial registration NCT03276858, registered September 8, 2017, retrospectively registered.
- Published
- 2021
7. ACROBAT Advance: progress report on a study of long-term safety and efficacy of paltusotine for the treatment of acromegaly
- Author
-
Struthers R. Scott, Murray B. Gordon, Alan Krasner, Rosa Luo, Miklós Tóth, Emese Mezosi, Alessandra Casagrande, Cesar Boguszewski, Mirjana Doknic, Harpal S. Randeva, Gadelha Monica R, Melissa Nichols, Theresa Jochelson, Christine Ferrara-Cook, and Ajay Madan
- Subjects
medicine.medical_specialty ,business.industry ,Acromegaly ,Medicine ,Long term safety ,business ,Intensive care medicine ,medicine.disease - Published
- 2021
- Full Text
- View/download PDF
8. Efficacy of Vesicular Monoamine Transporter 2 Inhibition and Synergy with Antipsychotics in Animal Models of Schizophrenia
- Author
-
Samuel R. J. Hoare, Andrea E. Kudwa, Rosa Luo, and Dimitri E. Grigoriadis
- Subjects
Pharmacology ,Dopamine ,Vesicular Monoamine Transport Proteins ,Models, Animal ,Schizophrenia ,Molecular Medicine ,Animals ,Weight Gain ,Antipsychotic Agents - Abstract
Antipsychotic medications function by blocking postsynaptic dopaminergic signaling in the central nervous system. Dopamine transmission can also be modulated presynaptically by inhibitors of vesicular monoamine transporter 2 (VMAT2), which inhibit loading of dopamine into presynaptic vesicles. Here we investigated the combination of these mechanisms in animal models of schizophrenia and weight gain (a primary side effect of antipsychotics). When dosed alone, the highly selective VMAT2 inhibitor RRR-dihydrotetrabenazine (RRR-DHTBZ, also known as [+]
- Published
- 2021
9. OR12-2 Inhibition of Basal and ACTH-stimulated Cortisol Secretion in Humans Using an Oral Nonpeptide ACTH Antagonist (CRN04894)
- Author
-
Stephen Betz, Christine Ferrara-Cook, Martha Hernandez-Illas, Rosa Luo, Ajay Madan, Stephanie Miller, Scott Struthers, Peter Trainer, Yang Wang, and Alan Krasner
- Subjects
Endocrinology, Diabetes and Metabolism - Abstract
CRN04894 is a potent orally bioavailable MC2R (adrenal cortex specific ACTH receptor) antagonist (Kb=0.34 nM) that is >1000-fold selective for MC2R over other melanocortin receptor subtypes. In rats receiving continuous administration of ACTH via subcutaneously implanted osmotic pumps, oral administration of CRN04894 over 7 days has previously been shown to result in dose-dependent suppression of basal and ACTH stimulated corticosterone levels. This compound is in clinical development for the treatment of diseases of ACTH excess including congenital adrenal hyperplasia (CAH) and Cushing's Disease. We report initial results from a randomized double-blinded, placebo-controlled single ascending dose study evaluating the safety, pharmacokinetics and pharmacodynamics of CRN04894 in 39 healthy volunteers. After an overnight fast, single doses of CRN04894 were administered at approximately 8 am, 2 hours prior to an IV bolus of ACTH 1-24 (cosyntropin). Serial cortisol over 600 minutes and pharmacokinetics over 168 hours post CRN04894 dose were measured. Two different challenge doses of ACTH 1-24 were studied: 250 μg (supra-pharmacological) and 1 μg (comparable to ACTH concentrations encountered in CAH and Cushing's Disease). CRN04894 was rapidly orally absorbed (median tmax 0.5-1.5 hour), and demonstrated a dose dependent increase in systemic exposure, with an apparent terminal elimination t1/2 of approximately 20 hours. Unstimulated (basal) cortisol measured 2 hours after CRN04894 administration fell in a dose-dependent manner, resulting in reduction near the theoretical maximum with the 80 mg dose cohort (-56.1% [SEM 4.0%, n=12] vs +17.4% in placebo [SEM=18.1%, n=9]). Dose-dependent cortisol suppression following a supra-pharmacological ACTH-stimulated (250 μg) was also observed, with a 41% reduction in the area under the curve (AUC60-600min) post-stimulation at the 80 mg dose. Furthermore, a single dose of 80 mg of CRN04894 reduced the cortisol response (AUC15-120 min) to a disease relevant 1 μg ACTH challenge by 48%, maintaining cortisol concentrations within the normal range seen prior to dosing in a basal unstimulated state. Single doses of CRN04894 were well tolerated with no need for glucocorticoid supplementation. All adverse events (AEs) were considered mild or moderate and there were no serious AEs. The data from this single-dose, proof-of-concept study show that MC2R antagonist CRN04894 was well tolerated after oral delivery in healthy volunteers and demonstrated dose-dependent increases in exposure with lowering of basal and ACTH-stimulated cortisol secretion, including in the presence of disease relevant excess ACTH exposure. Multiple ascending dose evaluations are underway in anticipation of studies in patients with diseases of ACTH excess. Presentation: Sunday, June 12, 2022 11:15 a.m. - 11:30 a.m.
- Published
- 2022
- Full Text
- View/download PDF
10. Safety and IGF-1 levels with once daily oral sst2 agonist paltusotine (CRN00808) in acromegaly patients previously treated with peptide long-acting somatostatin receptor ligands: Initial data from the open label ACROBAT Edge phase 2 study
- Author
-
Struthers R. Scott, Murray B. Gordon, Alan Krasner, Harpal S. Randeva, Michael Monahan, Tonya Marmon, Ajay Madan, Emese Mezosi, Rosa Luo, Chris Ferrara-Cook, Kim Fowler, Miklós Tóth, and Mirjana Doknic
- Subjects
Agonist ,chemistry.chemical_classification ,medicine.medical_specialty ,medicine.drug_class ,Chemistry ,Somatostatin receptor ,Phases of clinical research ,Peptide ,medicine.disease ,Long acting ,Endocrinology ,Internal medicine ,Acromegaly ,medicine ,Open label ,Previously treated - Published
- 2020
- Full Text
- View/download PDF
11. Effects of nonpeptide orally bioavailable ACTH antagonists on adrenal gland size and function in rats
- Author
-
R. Scott Struthers, Stephen F. Betz, Taylor Kredel, Shirley Cruz, Melissa Fowler, Michael Johns, Jon Athanacio, Agnes Antwan, Stacy Markison, Ajay Madan, Greg J. Reinhart, Oleg Tsivkovski, Ana Karin Kusnetzow, and Rosa Luo
- Subjects
medicine.medical_specialty ,Endocrinology ,medicine.anatomical_structure ,Chemistry ,Adrenal gland ,Internal medicine ,medicine ,Function (biology) ,Bioavailability - Published
- 2020
- Full Text
- View/download PDF
12. Absolute oral bioavailability and absorption, metabolism, excretion of [14C]-Labeled paltusotine (CRN00808), an orally bioavailable, nonpeptide, selective, somatostatin receptor 2 (sst2) biased agonist for the treatment of acromegaly
- Author
-
Rosa Luo, Marle Sjoerd van, Struthers R. Scott, Ajay Madan, Alan Krasner, and Chris Ferrara-Cook
- Subjects
Excretion ,Agonist ,medicine.drug_class ,Chemistry ,Acromegaly ,medicine ,Somatostatin receptor 2 ,Absorption (skin) ,Metabolism ,Pharmacology ,medicine.disease ,Bioavailability - Published
- 2020
- Full Text
- View/download PDF
13. OR23-05 Human Absorption, Metabolism, Excretion, and Absolute Oral Bioavailability of 14C-CRN00808, an Orally Bioavailable, Nonpeptide, Selective, Somatostatin Receptor 2 (sST2) Biased Agonist for the Treatment of Acromegaly
- Author
-
Rosa Luo, Alan Krasner, Stephen Ferrara Cook, Ajay Madan, Scott Struthers, and Sjoerd van Marle
- Subjects
Agonist ,medicine.drug_class ,Chemistry ,Endocrinology, Diabetes and Metabolism ,Metabolism ,Absorption (skin) ,Pharmacology ,medicine.disease ,Bioavailability ,Excretion ,Neuroendocrinology and Pituitary ,Acromegaly ,medicine ,Somatostatin receptor 2 ,Pituitary Tumors: Trials and Studies ,AcademicSubjects/MED00250 - Abstract
Injected depot formulations of somatostatin peptide analogs are routinely used to treat acromegaly and neuroendocrine tumors (NETs). CRN00808, a small molecule nonpeptide selective somatostatin receptor 2 (sst2) agonist, is being evaluated for efficacy and safety in patients with acromegaly. The current Phase 1 study was conducted in two Parts: In Part A, the absorption, metabolism, excretion, and mass balance of a single oral dose of 20 mg [14C]-CRN00808 (3.0 MBq) oral solution was characterized in six healthy male subjects. Plasma, blood, urine, and feces were collected for up to 432 hours, and were analyzed for total radioactivity and CRN00808 concentrations (plasma only). Metabolite profiling was conducted on the plasma, urine, and feces samples. In Part B, the absolute bioavailability of CRN00808 was determined by administering a single oral dose of 20 mg CRN00808 compared with a single micro-tracer intravenous (IV) bolus injection of 50 µg [14C]-CRN00808 (0.0185 MBq) in five healthy male subjects. The IV dose was administered approximately 90 minutes after the oral dose. Plasma samples were collected for up to 144 hours and were analyzed for total radioactivity and CRN00808 concentrations (plasma only). Key data from Part A and Part B will be presented. Available data from Part A of the study show that >90% of radioactivity was recovered within 7 days of dosing. The primary route of excretion was the feces (>90%) with minimal excretion in the urine (
- Published
- 2020
- Full Text
- View/download PDF
14. MON-089 Discovery and Identification of Late Stage Selective Nonpeptide Somatostatin Subtype 5 (sst5) Agonists for the Treatment of Hyperinsulinemic Hypoglycemia
- Author
-
Rosa Luo, Ana Karin Kusnetzow, Stacy Markison, Stephen F. Betz, Agnes Antwan, Michael Johns, Oleg Tsivkovski, Rosalia de Necochea-Campion, Yun Fei Zhu, Scott Struthers, Melissa Fowler, Shmiao Wang, Jon Athanacio, Ajay Madan, Elizabeth Rico, Emmanuel Sturchler, Taylor Kredel, and Jian Zhao
- Subjects
medicine.medical_specialty ,business.industry ,Endocrinology, Diabetes and Metabolism ,Late stage ,medicine.disease_cause ,Endocrinology ,Somatostatin ,Pediatric Endocrinology ,Internal medicine ,medicine ,Identification (biology) ,Pediatric Obesity, Thyroid, and Cancer ,business ,Hyperinsulinemic hypoglycemia ,AcademicSubjects/MED00250 - Abstract
Congenital hyperinsulinism (CHI) results from mutations within the insulin secretion pathway and is characterized by excessive and/or inappropriate insulin secretion by pancreatic islet β-cells. CHI is the most common cause of persistent hypoglycemia in newborns and infants and is estimated to affect 1:2500 to 1:50,000 live births. Prompt recognition and treatment are vital to prevent coma, long-term neurological complications, and even death. If medical control of CHI is unsuccessful, a near-total pancreatectomy may be required, but hypoglycemia often persists. The neuropeptide somatostatin is an important modulator of pancreatic hormonal signaling and activity at different somatostatin receptor (sst) subtypes dictates the suppression of insulin and/or glucagon. The injectable peptide drugs octreotide and lanreotide are potent sst2 agonists used to treat CHI, but in addition to suppressing insulin, the sst2 activity of these peptides may also inhibit glucagon secretion, potentially reducing effectiveness and compromising a key defense against hypoglycemia. Glucagon secretion from α-cells is inhibited through activation of sst2 receptors, while insulin secretion from β-cells is inhibited through activation of sst2 and sst5. We therefore hypothesize that agonists selectively targeting sst5 and lacking sst2 activity will offer an improved efficacy/safety profile for patients with hyperinsulinemic hypoglycemia. Using iterative medicinal chemistry and pharmacology, Crinetics has discovered several classes of highly potent, orally bioavailable, small molecule sst-subtype selective agonists with drug-like pharmaceutical properties. Our discovery efforts aimed at finding a compound to treat CHI have yielded potent and selective nonpeptide sst5 agonists with sub-nanomolar EC50s in cell-based assays of receptor activation. Insulin secretion from isolated human and rat islets was suppressed upon exposure to sst5 agonists. Potent and selective sst5 agonists were then evaluated in a number acute and repeat dose in vivo models (e.g., oGTT, fed/fasted conditions, sulfonylurea-induced hypoglycemia) to assess physiological effects and to gain mechanistic insights. As predicted by the in vitro pharmacology, selective nonpeptide sst5 agonists suppressed insulin secretion and raised blood glucose levels in each model, while having minimal effects on glucagon secretion. Leading sst5 agonists were also evaluated for drug like characteristics, including stability in liver microsomes, lack of inhibition of cytochromes P450 and the hERG ion channel, and were shown to exhibit good exposure upon oral dosing in both rats and dogs. The culmination of these studies has led to a subset of candidate molecules that are being evaluated in genotoxicity, safety pharmacology, and general toxicity studies to determine the molecule most suitable for evaluation in human clinical trials.
- Published
- 2020
- Full Text
- View/download PDF
15. SAT-364 Nonpeptide Orally-Bioavailable ACTH Antagonists: Suppression of ACTH-Induced Corticosterone Secretion and Adrenal Hypertrophy in Rats
- Author
-
Ana Karin Kusnetzow, Scott Struthers, Michael Johns, Julie Nguyen, Elizabeth Rico-Bautista, Taylor Kredel, Rosa Luo, Yun Fei Zhu, Stacy Markison, Melissa Fowler, Stephen F. Betz, Greg J. Reinhart, Sun Hee Kim, Christine Staley, Sangdon Han, Hannah Tan, Jon Athanacio, and Ajay Madan
- Subjects
medicine.medical_specialty ,chemistry.chemical_compound ,Endocrinology ,chemistry ,Corticosterone ,Adrenal hypertrophy ,Endocrinology, Diabetes and Metabolism ,Internal medicine ,medicine ,Secretion ,Adrenal ,Adrenal Basic and Translational ,Bioavailability - Abstract
Cushing’s disease is most commonly the result of a microadenoma derived from pituitary corticotrophic cells that secretes excess adrenocorticotropic hormone (ACTH). ACTH is an important modulator of steroidal hormone synthesis and secretion from the adrenal gland and its selective activity at the melanocortin type 2 receptor (MC2) dictates the synthesis and secretion of cortisol (corticosterone in rats). The resulting hypercortisolemia in Cushing’s patients presents in a myriad of symptoms that include growth of fat pads, excessive sweating, dilation of capillaries, thinning of the skin, muscle weakness, hirsutism, depression/anxiety, hypertension, osteoporosis, insulin resistance, hyperglycemia, and heart disease, among others that result in high morbidity. We hypothesize that blocking ACTH action directly via a selective MC2 receptor antagonist may provide an important new therapeutic mechanism to help better manage Cushing’s disease in patients. To test this hypothesis, we launched an iterative medicinal chemistry program to identify potent and selective nonpeptide MC2 receptor antagonists with pharmaceutical and safety characteristics suitable for evaluation in human clinical trials. Unlike most other G protein coupled receptors, MC2 requires the presence of an accessory protein (MRAP) for cell surface expression and recognition of ACTH and our effort led to small molecule nonpeptides with antagonist activity in CHO-K cells stably expressing the MC2-MRAP complex. Iterative optimization led rapidly to the discovery of multiple chemical classes of highly potent, nonpeptide MC2 selective antagonist leads, which were then further optimized for drug-like characteristics. We have identified multiple compounds that exhibit high potency for human and rat MC2 receptors (hMC2 Kb
- Published
- 2019
- Full Text
- View/download PDF
16. Pharmacokinetics and Safety of an Improved Oral Formulation of Paltusotine, a Selective, Non-Peptide Somatostatin Receptor 2 (SST2) Agonist for the Treatment of Acromegaly
- Author
-
Cosina Mui, Rosa Luo, Sepehr Shakib, Ajay Madan, Gerald Burke, Alan Krasner, and Christine Ferrara-Cook
- Subjects
Agonist ,Pharmacokinetics ,business.industry ,medicine.drug_class ,Endocrinology, Diabetes and Metabolism ,Acromegaly ,medicine ,Somatostatin receptor 2 ,Pharmacology ,medicine.disease ,business ,Non peptide - Abstract
Depot injection formulations of peptide somatostatin receptor ligands (SRLs) are routinely used to treat acromegaly and neuroendocrine tumors (NETs). Paltusotine (CRN00808), an orally administered small molecule nonpeptide selective somatostatin receptor 2 (SST2) agonist has been shown to maintain GH and IGF-1 levels in acromegaly patients previously on depot SRLs (ACROBAT Edge NCT03789656). In this study, a capsule formulation was used, which did not exhibit dose proportional pharmacokinetics (PK) at doses >40 mg, required a 2-hour post-dose fast in overnight fasted patients, and had the potential for reduced bioavailability when taken with proton-pump inhibitors (PPI). A spray-dried dispersion (SDD) tablet formulation was developed with improved solubility in the physiological pH range and its performance was evaluated in healthy volunteers. Male and female healthy volunteers who met inclusion/exclusion criteria were enrolled in a single-center Phase 1 study (ANZCTR registration ACTRN12619001562167). A Cohort of 12 subjects was administered a single dose of paltusotine in a four-period cross-over design. Periods 1 and 2 assessed the effect of lansoprazole (a PPI) on PK of 20 mg dose of paltusotine SDD tablets. In Period 3, 20 mg dose of paltusotine SDD tablets was co-administered with a high fat, high-calorie meal. In Period 4, a 60 mg dose of paltusotine SDD tablets was administered to assess dose proportionality. In a separate cohort of subjects (n=12; also, a 4-period cross-over design), the relative bioavailability of capsules and SDD tablets was assessed, and the effect of food administration 0.5, 1, and 2 hour post-dose was evaluated. Subsequently, in another cohort of 12 subjects (a 3-period cross-over design), dose proportionality of the SDD tablets was evaluated at 40 mg and 80 mg dose with a 1-hour post-dose fast. A 4 hours post-dose fast was also assessed for the 80 mg dose. Pharmacokinetics and safety of paltusotine were evaluated. Paltusotine was generally well tolerated in this study. SDD tablets exhibited dose proportional increase in total systemic exposure (AUC) up to a dose of 80 mg. Healthy volunteers pretreated with the PPI, lansoprazole (15 mg bid for 3 days), and co-administered with paltusotine SDD tablets exhibited a small decrease (approximately 25%) in systemic exposure to paltusotine compared with the same subjects that had washed out from the PPI-pretreatment. SDD tablets exhibited significant reduction in systemic exposure when co-administered with a high-fat, high-calorie meal. However, the SDD formulation was less sensitive to timing of post-dose food administration compared to the capsule formulation. These data suggest that the SDD tablet formulation of paltusotine improves flexibility in dose administration, can be co-administered with PPIs and other agents that increase stomach pH, and reduces the post-dose fasting requirement.
- Published
- 2021
- Full Text
- View/download PDF
17. Single-Dose Study of a Corticotropin-Releasing Factor Receptor-1 Antagonist in Women With 21-Hydroxylase Deficiency
- Author
-
Adina F. Turcu, Tim Muth, Richard J. Auchus, Carole A. Ramm, Robert Farber, Dimitri E. Grigoriadis, Rosa Luo, David Madrigal, Christopher F. O'Brien, and Joanna L. Spencer-Segal
- Subjects
Adult ,0301 basic medicine ,medicine.medical_specialty ,Time Factors ,medicine.drug_class ,Endocrinology, Diabetes and Metabolism ,Clinical Biochemistry ,030209 endocrinology & metabolism ,Adrenocorticotropic hormone ,Pharmacology ,Receptors, Corticotropin-Releasing Hormone ,Biochemistry ,Young Adult ,03 medical and health sciences ,Corticotropin-releasing hormone ,0302 clinical medicine ,Endocrinology ,Adrenocorticotropic Hormone ,Internal medicine ,medicine ,Humans ,Androstenedione ,Hydrocortisone ,Oxadiazoles ,Adrenal Hyperplasia, Congenital ,Dose-Response Relationship, Drug ,business.industry ,17-alpha-Hydroxyprogesterone ,Biochemistry (medical) ,Corticotropin-Releasing Factor Receptor 1 ,Antagonist ,Original Articles ,Middle Aged ,Receptor antagonist ,030104 developmental biology ,Tolerability ,Female ,business ,Azabicyclo Compounds ,medicine.drug - Abstract
Context: Treatment of 21-hydroxylase deficiency (21OHD) is difficult to optimize. Normalization of excessive ACTH and adrenal steroid production commonly requires supraphysiologic doses of glucocorticoids. Objectives: We evaluated the safety and tolerability of the selective corticotropin releasing factor type 1 (CRF1) receptor antagonist NBI-77860 in women with classic 21OHD and tested the hypothesis that CRF1 receptor blockade decreases early-morning ACTH and 17α-hydroxyprogesterone (17OHP) in these patients. Participants: The study enrolled eight classic 21OHD females, ages 18–58 years, seen at a single tertiary referral university setting. Design: This was a phase Ib, single-blind, placebo-controlled, fixed-sequence, single-dose trial. During three treatment periods separated by 3-week washout intervals, patients sequentially received placebo, NBI-77860 300 mg, and NBI-77860 600 mg at 10 pm; glucocorticoid therapy was withheld for 20 hours. We evaluated ACTH, 17OHP, androstenedione, and testosterone as well as NBI-77860 pharmacokinetics over 24 hours. Results: Dose-dependent reductions of ACTH and/or 17OHP were observed in six of eight subjects. Relative to placebo, NBI-77860 led to an ACTH and 17OHP reduction by a mean of 43% and 0.7% for the 300 mg dose, respectively, and by 41% and 27% for the 600 mg dose, respectively. Both NBI-77860 doses were well tolerated. Conclusion: The meaningful reductions in ACTH and 17OHP following NBI-77860 dosing in 21OHD patients demonstrate target engagement and proof of principle in this disorder. These promising data provide a rationale for additional investigations of CRF1 receptor antagonists added to physiologic doses of hydrocortisone and fludrocortisone acetate for the treatment of classic 21OHD.
- Published
- 2016
- Full Text
- View/download PDF
18. Single Dose and Repeat Once-Daily Dose Safety, Tolerability and Pharmacokinetics of Valbenazine in Healthy Male Subjects
- Author
-
Rosa, Luo, Haig, Bozigian, Roland, Jimenez, Gordon, Loewen, and Christopher F, O'Brien
- Subjects
Adult ,Male ,Adrenergic Uptake Inhibitors ,Double-Blind Method ,Drug-Related Side Effects and Adverse Reactions ,Vesicular Monoamine Transport Proteins ,Tetrabenazine ,Humans ,Tardive Dyskinesia ,Valine ,Healthy Volunteers ,Original Presentations - Abstract
Valbenazine (VBZ) is a vesicular monoamine transporter 2 (VMAT2) inhibitor approved for the treatment of tardive dyskinesia. The safety, tolerability and pharmacokinetics of VBZ following single and repeat once-daily (QD) dosing were evaluated in 2 randomized, single-center, double-blind studies in healthy male subjects. In the first study, 2 cohorts of 8 subjects were administered single doses (SD) of placebo (PBO; N = 2/period) or VBZ (N = 6/period; 1, 2, 5, or 12.5 mg for Cohort 1 and 12.5, 25, 50, or 75 mg for Cohort 2) using a sequential escalation scheme. The second study consisted of 2 phases. In the initial phase, subjects were administered SD PBO (N = 2/period) or VBZ (N = 6/period; 75, 100, 125 or 150 mg) with sequential escalation. In the second phase, subjects received PBO, or 50 or 100 mg VBZ (N = 4:8:8) QD for 8 days (Cohort 1) or PBO or 50 mg VBZ (N = 6:6) QD for 8 days (Cohort 2). For both studies, plasma concentrations of VBZ and its active metabolite, NBI-98782, were determined. Safety was assessed throughout the studies. PK parameters were determined using noncompartmental methods. In both studies, VBZ was rapidly absorbed with peak concentrations typically observed within 1.5 hours. Peak NBI-98782 concentrations were typically observed at 4.0 to 9.0 hours. Terminal elimination half-life for both VBZ and NBI-98782 was ~20 hours. Across the 1 to 150 mg SD range evaluated across the studies, VBZ and NBI-98782 Cmax and AUC increased dose-proportionally from 50 to 150 mg and more than dose-proportionally from 1 to 50 mg. QD VBZ and NBI-98782 Cmax and AUC parameters were also dose-proportional between the 50 and 100 mg doses. Steady-state for both analytes appeared to be achieved by Day 8. The accumulation index was ~1.5 for VBZ and ~2.5 for NBI-98782. Peak to trough fluctuation was approximately 250% for VBZ and 70% for NBI-98782. Across both studies, NBI-98782 exposure was approximately 20%–30% that of VBZ based on molar ratios. In the first study, the maximum-tolerated dose was not achieved; headache (2 events) was the only treatment-emergent adverse event (TEAE) reported by more than one subject. In the second study, fatigue (4 events) was the only TEAE reported by more than one subject following SD VBZ. Following QD VBZ, the TEAEs of fatigue, insomnia, disturbance in attention, and nervousness were dose-dependent; the latter three TEAEs were considered dose-limiting. Subject withdrawals due to TEAEs were 1 each for PBO and 50 mg VBZ QD, and 3 for 100 mg VBZ QD. Clinically relevant effects on laboratory parameters, vital signs or ECGs were limited to increased CPK (SD: 1 each for 5 mg VBZ and PBO), ALT (QD: 1 each for 50 and 100 mg VBZ and PBO), and triglycerides (QD: 1 each for 50 mg VBZ and PBO). VBZ has an acceptable safety profile and predictable pharmacokinetics that result in stable concentrations of active compounds with low peak-to-trough fluctuation following once-daily dosing.
- Published
- 2017
19. Pharmacokinetics of Valbenazine and Its Active Metabolite by Age Group
- Author
-
Roland Jimenez, Rosa Luo, Christopher F. O'Brien, Gordon Loewen, and Haig Bozigian
- Subjects
03 medical and health sciences ,Psychiatry and Mental health ,0302 clinical medicine ,030214 geriatrics ,Pharmacokinetics ,Group (periodic table) ,business.industry ,Medicine ,Valbenazine ,Geriatrics and Gerontology ,Pharmacology ,business ,Active metabolite - Published
- 2018
- Full Text
- View/download PDF
20. A novel on-line solid-phase extraction approach integrated with a monolithic column and tandem mass spectrometry for direct plasma analysis of multiple drugs and metabolites
- Author
-
Rosa Luo, Ning Song, Xu Zang, Ta Kung Chen, and Haig Bozigian
- Subjects
Bioanalysis ,Analyte ,Monolithic HPLC column ,Chromatography ,Chemistry ,Organic Chemistry ,Extraction (chemistry) ,Analytical chemistry ,Tandem mass spectrometry ,Sensitivity and Specificity ,High-performance liquid chromatography ,Mass Spectrometry ,Analytical Chemistry ,Pharmaceutical Preparations ,Sample preparation ,Solid phase extraction ,Chromatography, High Pressure Liquid ,Spectroscopy ,Chromatography, Liquid - Abstract
An on-line solid-phase extraction liquid chromatography/tandem mass spectrometry (SPE LC/MS/ MS) assay using a newly developed SPE column and a monolithic column was developed and validated for direct analysis of plasma samples containing multiple analytes. This assay was developed in an effort to increase bioanalysis throughput and reduce the complexity of on-line SPE LC/MS/ MS systems. A simple column-switching configuration that requires only one six-port valve and one HPLC pumping system was employed for on-line plasma sample preparation and subsequent gradient chromatographic separation. The resulting analytical method couples the desired sensitivity with ease of use. The method was found to perform satisfactorily for direct plasma analysis with respect to assay linearity, specificity, sensitivity, precision, accuracy, carryover, and short-term stability of an eight-analyte mixture in plasma. A gradient LC condition was applied to separate the eight analytes that cannot be distinctly differentiated by MS/MS. With a run time for every injection of 2.8 min, a minimum of 300 direct plasma injections were made on one on-line SPE column without noticeable changes in system performance. Due to the ruggedness and simplicity of this system, generic methods can be easily developed and applied to analyze a wide variety of compounds in a high-throughput manner without laborious off-line sample preparation.
- Published
- 2005
- Full Text
- View/download PDF
21. Validation and application of a liquid chromatography-tandem mass spectrometric method for the simultaneous determination of testosterone and dihydrotestosterone in rat prostatic tissue using a 96-well format
- Author
-
Michael S. Brown, Noah Post, Coon Timothy Richard, Trudy A. Kohout, Rosa Luo, Zhihong O’Brien, and Ajay Madan
- Subjects
Male ,endocrine system ,Calibration curve ,medicine.drug_class ,Clinical Biochemistry ,In Vitro Techniques ,urologic and male genital diseases ,Biochemistry ,High-performance liquid chromatography ,Analytical Chemistry ,Rats, Sprague-Dawley ,chemistry.chemical_compound ,Microtiter plate ,Liquid chromatography–mass spectrometry ,Tandem Mass Spectrometry ,medicine ,Animals ,Testosterone ,Derivatization ,Detection limit ,Chromatography ,Prostate ,Reproducibility of Results ,Dihydrotestosterone ,Cell Biology ,General Medicine ,Androgen ,Rats ,chemistry ,hormones, hormone substitutes, and hormone antagonists ,medicine.drug ,Chromatography, Liquid - Abstract
A liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed to extract and quantify the androgen concentration in the rat prostate. This method introduced a novel 96-well plate format for the extraction and derivatization of testosterone (T) and dihydrotestosterone (DHT) from rat prostatic tissue that greatly simplified the sample preparation procedure. Due to the difficulty to obtain reproducible specimens with non-detectable level of androgen, a matrix-free standard solution was used for method validation. Both T and DHT calibration curves were linear over the calibration range (12.5-2500 pg) with correlation coefficient values greater than 0.9900. The intra-day and inter-day accuracy, reported as %bias, and precision, reported as %CV, of T and DHT were within +/-10%. The lower limit of detection (LLOD) and lower limits of quantification (LLOQ) for both T and DHT were determined to be 5 and 12.5 pg. The validation results demonstrated the selectivity, sensitivity, accuracy, precision, linearity and ruggedness of the method, as well as the suitability of the method for simultaneous detection of T and DHT in rat prostatic tissues. The validated method was successfully applied to determine the physiological T and DHT level in rat prostatic tissues. Similarly to the serum concentration profile pattern, T and DHT intraprostatic levels peaked 2 h after lights-on and decreased after lights-off with DHT level approximately 4-fold greater than T.
- Published
- 2009
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.