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Biomarker-Assisted Dose Selection for Safety and Efficacy in Early Development of PNU-100480 for Tuberculosis
- Source :
- Antimicrobial Agents and Chemotherapy. 55:567-574
- Publication Year :
- 2011
- Publisher :
- American Society for Microbiology, 2011.
-
Abstract
- Tuberculosis is a serious global health threat for which new treatments are urgently needed. This study examined the safety, tolerability, pharmacokinetics, and pharmacodynamics of multiple ascending doses of the oxazolidinone PNU-100480 in healthy volunteers, using biomarkers for safety and efficacy. Subjects were randomly assigned to PNU-100480 or placebo (4:1) at schedules of 100, 300, or 600 mg twice daily or 1,200 mg daily for 14 days or a schedule of 600 mg twice daily for 28 days to which pyrazinamide was added on days 27 and 28. A sixth cohort was given linezolid at 300 mg daily for 4 days. Signs, symptoms, and routine safety tests were monitored. Bactericidal activity against Mycobacterium tuberculosis was measured in ex vivo whole-blood culture. Plasma drug and metabolite concentrations were compared to the levels required for inhibition of M. tuberculosis growth and 50% inhibition of mitochondrial protein synthesis. All doses were safe and well tolerated. There were no hematologic or other safety signals during 28 days of dosing at 600 mg twice daily. Plasma concentrations of PNU-100480 and metabolites at this dose remained below those required for 50% inhibition of mitochondrial protein synthesis. Cumulative whole-blood bactericidal activity of PNU-100480 at this dose (−0.316 ± 0.04 log) was superior to the activities of all other doses tested ( P < 0.001) and was significantly augmented by pyrazinamide (−0.420 ± 0.06 log) ( P = 0.002). In conclusion, PNU-100480 was safe and well tolerated at all tested doses. Further studies in patients with tuberculosis are warranted. Biomarkers can accelerate early development of new tuberculosis treatments.
- Subjects :
- Adult
Tuberculosis
Adolescent
Antitubercular Agents
SQ109
Microbial Sensitivity Tests
Clinical Therapeutics
Pharmacology
Drug Administration Schedule
Mycobacterium tuberculosis
Young Adult
chemistry.chemical_compound
Pharmacokinetics
Acetamides
Animals
Humans
Medicine
Serum Bactericidal Test
Pharmacology (medical)
Dosing
Oxazolidinones
Dose-Response Relationship, Drug
biology
business.industry
Linezolid
Middle Aged
Pyrazinamide
medicine.disease
biology.organism_classification
Rats
Treatment Outcome
Infectious Diseases
Tolerability
chemistry
Area Under Curve
Pharmacodynamics
business
medicine.drug
Subjects
Details
- ISSN :
- 10986596 and 00664804
- Volume :
- 55
- Database :
- OpenAIRE
- Journal :
- Antimicrobial Agents and Chemotherapy
- Accession number :
- edsair.doi.dedup.....0ec8dc04ec5818d7ae460fb5167ba48d