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02-05-2024 | Fabry Disease | Original Research Article

Pharmacokinetics, Pharmacodynamics, Safety, and Tolerability of Oral AL01211 in Healthy Chinese Volunteers

Authors: Lei Dong, Jianxing Xiang, Michael Babcock, Yuanzhi Cheng, Yan Wang, Yuqiao Shen, Li Li, Liping Tan, Marvin Garovoy, Wei Hu, Jianhong Zheng

Published in: Clinical Drug Investigation

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Abstract

Background and Objective

Aberrant accumulation of glycosphingolipids (GSLs) in the lysosome leads to GSL storage diseases. Glucosylceramide synthase inhibitors (GCSi) have the potential to treat several GSL storage diseases by reducing the synthesis of the disease-causing GSLs. AL01211 is a potent oral GCSi under investigation for Type 1 Gaucher disease and Fabry disease. Here, we evaluate the pharmacokinetics, pharmacodynamics, safety, and tolerability of AL01211 in healthy Chinese volunteers.

Methods

AL01211 was tested in a Phase 1, single-center, randomized, double-blind, placebo-controlled study with single-dose (15 and 60 mg) and multiple-dose (30 mg) arms.

Results

Results of AL01211 demonstrated dose-dependent pharmacokinetics, rapid absorption (median time to maximum plasma concentration [tmax] 2.5–4 hours), relatively slow clearance rate (mean apparent total clearance from plasma [CL/F] 88.3–200 L/h) and the mean terminal half-life above 30 hours. Repeated once-daily oral administration of AL01211 for 14 days had an approximately 2-fold accumulation, reaching steady-state levels between 7 and 10 days, and led to a 73% reduction in plasma glucosylceramide (GL1) on Day 14. AL01211 was safe and well tolerated, with no identified serious adverse events.

Conclusion

AL01211 showed a favorable pharmacokinetic, pharmacodynamics, safety, and tolerability profile in healthy Chinese volunteers. These data support the further clinical development of AL01211 as a therapy for GSL storage diseases.

Clinical Trial Registry

Clinical Trial Registry no. CTR20221202 (http://​www.​chinadrugtrials.​org.​cn) registered on 6 June 2022 and ChiCTR2200061431 (http://​www.​chictr.​org.​cn) registered on 24 June 2022.
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Literature
1.
go back to reference Breiden B, Sandhoff K. Lysosomal glycosphingolipid storage diseases. Annu Rev Biochem. 2019;20(88):461–85.CrossRef Breiden B, Sandhoff K. Lysosomal glycosphingolipid storage diseases. Annu Rev Biochem. 2019;20(88):461–85.CrossRef
2.
4.
go back to reference Hughes DA, Pastores GM. Gaucher disease. In: Adam MP, Feldman J, Mirzaa GM, Pagon RA, Wallace SE, Bean LJH, et al. (eds) GeneReviews((R)), Seattle 1993. Hughes DA, Pastores GM. Gaucher disease. In: Adam MP, Feldman J, Mirzaa GM, Pagon RA, Wallace SE, Bean LJH, et al. (eds) GeneReviews((R)), Seattle 1993.
7.
go back to reference Solomon M, Muro S. Lysosomal enzyme replacement therapies: historical development, clinical outcomes, and future perspectives. Adv Drug Deliv Rev. 2017;1(118):109–34.CrossRef Solomon M, Muro S. Lysosomal enzyme replacement therapies: historical development, clinical outcomes, and future perspectives. Adv Drug Deliv Rev. 2017;1(118):109–34.CrossRef
8.
go back to reference Azevedo O, Gago MF, Miltenberger-Miltenyi G, Sousa N, Cunha D. Fabry disease therapy: state-of-the-art and current challenges. Int J Mol Sci. 2020;22(1):206.CrossRefPubMedPubMedCentral Azevedo O, Gago MF, Miltenberger-Miltenyi G, Sousa N, Cunha D. Fabry disease therapy: state-of-the-art and current challenges. Int J Mol Sci. 2020;22(1):206.CrossRefPubMedPubMedCentral
10.
12.
go back to reference Hughes DA, Nicholls K, Shankar SP, Sunder-Plassmann G, Koeller D, Nedd K, et al. Oral pharmacological chaperone migalastat compared with enzyme replacement therapy in Fabry disease: 18-month results from the randomised phase III ATTRACT study. J Med Genet. 2017;54(4):288–96.CrossRefPubMed Hughes DA, Nicholls K, Shankar SP, Sunder-Plassmann G, Koeller D, Nedd K, et al. Oral pharmacological chaperone migalastat compared with enzyme replacement therapy in Fabry disease: 18-month results from the randomised phase III ATTRACT study. J Med Genet. 2017;54(4):288–96.CrossRefPubMed
13.
14.
go back to reference Cox TM, Drelichman G, Cravo R, Balwani M, Burrow TA, Martins AM, et al. Eliglustat maintains long-term clinical stability in patients with Gaucher disease type 1 stabilized on enzyme therapy. Blood. 2017;129(17):2375–83.CrossRefPubMedPubMedCentral Cox TM, Drelichman G, Cravo R, Balwani M, Burrow TA, Martins AM, et al. Eliglustat maintains long-term clinical stability in patients with Gaucher disease type 1 stabilized on enzyme therapy. Blood. 2017;129(17):2375–83.CrossRefPubMedPubMedCentral
15.
go back to reference Nabizadeh A, Amani B, Kadivar M, Toroski M, Asl AA, Bayazidi Y, et al. The clinical efficacy of imiglucerase versus eliglustat in patients with Gaucher’s disease type 1: a systematic review. J Res Pharm Pract. 2018;7(4):171–7.CrossRefPubMedPubMedCentral Nabizadeh A, Amani B, Kadivar M, Toroski M, Asl AA, Bayazidi Y, et al. The clinical efficacy of imiglucerase versus eliglustat in patients with Gaucher’s disease type 1: a systematic review. J Res Pharm Pract. 2018;7(4):171–7.CrossRefPubMedPubMedCentral
16.
go back to reference Peterschmitt MJ, Crawford NPS, Gaemers SJM, Ji AJ, Sharma J, Pham TT. Pharmacokinetics, pharmacodynamics, safety, and tolerability of oral venglustat in healthy volunteers. Clin Pharmacol Drug Dev. 2021;10(1):86–98.CrossRefPubMed Peterschmitt MJ, Crawford NPS, Gaemers SJM, Ji AJ, Sharma J, Pham TT. Pharmacokinetics, pharmacodynamics, safety, and tolerability of oral venglustat in healthy volunteers. Clin Pharmacol Drug Dev. 2021;10(1):86–98.CrossRefPubMed
17.
go back to reference Deegan PB, Goker-Alpan O, Geberhiwot T, Hopkin RJ, Lukina E, Tylki-Szymanska A, et al. Venglustat, an orally administered glucosylceramide synthase inhibitor: assessment over 3 years in adult males with classic Fabry disease in an open-label phase 2 study and its extension study. Mol Genet Metab. 2023;138(2): 106963.CrossRefPubMed Deegan PB, Goker-Alpan O, Geberhiwot T, Hopkin RJ, Lukina E, Tylki-Szymanska A, et al. Venglustat, an orally administered glucosylceramide synthase inhibitor: assessment over 3 years in adult males with classic Fabry disease in an open-label phase 2 study and its extension study. Mol Genet Metab. 2023;138(2): 106963.CrossRefPubMed
18.
go back to reference Schiffmann R, Cox TM, Dedieu JF, Gaemers SJM, Hennermann JB, Ida H, et al. Venglustat combined with imiglucerase for neurological disease in adults with Gaucher disease type 3: the LEAP trial. Brain. 2023;146(2):461–74.CrossRefPubMed Schiffmann R, Cox TM, Dedieu JF, Gaemers SJM, Hennermann JB, Ida H, et al. Venglustat combined with imiglucerase for neurological disease in adults with Gaucher disease type 3: the LEAP trial. Brain. 2023;146(2):461–74.CrossRefPubMed
19.
go back to reference Giladi N, Alcalay RN, Cutter G, Gasser T, Gurevich T, Hoglinger GU, et al. Safety and efficacy of venglustat in GBA1-associated Parkinson’s disease: an international, multicentre, double-blind, randomised, placebo-controlled, phase 2 trial. Lancet Neurol. 2023;22(8):661–71.CrossRefPubMed Giladi N, Alcalay RN, Cutter G, Gasser T, Gurevich T, Hoglinger GU, et al. Safety and efficacy of venglustat in GBA1-associated Parkinson’s disease: an international, multicentre, double-blind, randomised, placebo-controlled, phase 2 trial. Lancet Neurol. 2023;22(8):661–71.CrossRefPubMed
20.
go back to reference Gansevoort RT, Hariri A, Minini P, Ahn C, Chapman AB, Horie S, et al. Venglustat, a novel glucosylceramide synthase inhibitor, in patients at risk of rapidly progressing ADPKD: primary results of a double-blind, placebo-controlled, phase 2/3 randomized clinical trial. Am J Kidney Dis. 2023;81(5):517-27.e1.CrossRefPubMed Gansevoort RT, Hariri A, Minini P, Ahn C, Chapman AB, Horie S, et al. Venglustat, a novel glucosylceramide synthase inhibitor, in patients at risk of rapidly progressing ADPKD: primary results of a double-blind, placebo-controlled, phase 2/3 randomized clinical trial. Am J Kidney Dis. 2023;81(5):517-27.e1.CrossRefPubMed
21.
go back to reference Guerard N, Oder D, Nordbeck P, Zwingelstein C, Morand O, Welford RWD, et al. Lucerastat, an iminosugar for substrate reduction therapy: tolerability, pharmacodynamics, and pharmacokinetics in patients with Fabry disease on enzyme replacement. Clin Pharmacol Ther. 2018;103(4):703–11.CrossRefPubMed Guerard N, Oder D, Nordbeck P, Zwingelstein C, Morand O, Welford RWD, et al. Lucerastat, an iminosugar for substrate reduction therapy: tolerability, pharmacodynamics, and pharmacokinetics in patients with Fabry disease on enzyme replacement. Clin Pharmacol Ther. 2018;103(4):703–11.CrossRefPubMed
22.
go back to reference Guerard N, Zwingelstein C, Dingemanse J. Lucerastat, an iminosugar for substrate reduction therapy: pharmacokinetics, tolerability, and safety in subjects with mild, moderate, and severe renal function impairment. J Clin Pharmacol. 2017;57(11):1425–31.CrossRefPubMed Guerard N, Zwingelstein C, Dingemanse J. Lucerastat, an iminosugar for substrate reduction therapy: pharmacokinetics, tolerability, and safety in subjects with mild, moderate, and severe renal function impairment. J Clin Pharmacol. 2017;57(11):1425–31.CrossRefPubMed
23.
go back to reference Babcock M, Zheng J, Li L, Garovoy M, Shen Y. Development of AL01211, a novel glucosylceramide synthase inhibitor, to treat Fabry disease. In: 7th International Update on Fabry Disease. 29–31 May 2022; Würzburg, Germany. Babcock M, Zheng J, Li L, Garovoy M, Shen Y. Development of AL01211, a novel glucosylceramide synthase inhibitor, to treat Fabry disease. In: 7th International Update on Fabry Disease. 29–31 May 2022; Würzburg, Germany.
24.
25.
go back to reference Peterschmitt MJ, Burke A, Blankstein L, Smith SE, Puga AC, Kramer WG, et al. Safety, tolerability, and pharmacokinetics of eliglustat tartrate (Genz-112638) after single doses, multiple doses, and food in healthy volunteers. J Clin Pharmacol. 2011;51(5):695–705.CrossRefPubMed Peterschmitt MJ, Burke A, Blankstein L, Smith SE, Puga AC, Kramer WG, et al. Safety, tolerability, and pharmacokinetics of eliglustat tartrate (Genz-112638) after single doses, multiple doses, and food in healthy volunteers. J Clin Pharmacol. 2011;51(5):695–705.CrossRefPubMed
26.
go back to reference Cox TM. Eliglustat tartrate, an orally active glucocerebroside synthase inhibitor for the potential treatment of Gaucher disease and other lysosomal storage diseases. Curr Opin Investig Drugs. 2010;11(10):1169–81.PubMed Cox TM. Eliglustat tartrate, an orally active glucocerebroside synthase inhibitor for the potential treatment of Gaucher disease and other lysosomal storage diseases. Curr Opin Investig Drugs. 2010;11(10):1169–81.PubMed
27.
go back to reference Babcock M. Development of AL01211, an oral, non-brain penetrant glucosylceramide synthase inhibitor (GCSi), to treat Fabry disease. Poster LB-08 presented at the WORLD Symposium. February 23, 2023; Orlando, Fl. Babcock M. Development of AL01211, an oral, non-brain penetrant glucosylceramide synthase inhibitor (GCSi), to treat Fabry disease. Poster LB-08 presented at the WORLD Symposium. February 23, 2023; Orlando, Fl.
28.
go back to reference Wanner C, Kimonis V, Politei J, Warnock DG, Uceyler N, Frey A, et al. Understanding and modifying Fabry disease: rationale and design of a pivotal Phase 3 study and results from a patient-reported outcome validation study. Mol Genet Metab Rep. 2022;31: 100862.PubMedPubMedCentral Wanner C, Kimonis V, Politei J, Warnock DG, Uceyler N, Frey A, et al. Understanding and modifying Fabry disease: rationale and design of a pivotal Phase 3 study and results from a patient-reported outcome validation study. Mol Genet Metab Rep. 2022;31: 100862.PubMedPubMedCentral
29.
go back to reference Hasunuma T, Tohkin M, Kaniwa N, Jang IJ, Yimin C, Kaneko M, et al. Absence of ethnic differences in the pharmacokinetics of moxifloxacin, simvastatin, and meloxicam among three East Asian populations and Caucasians. Br J Clin Pharmacol. 2016;81(6):1078–90.CrossRefPubMedPubMedCentral Hasunuma T, Tohkin M, Kaniwa N, Jang IJ, Yimin C, Kaneko M, et al. Absence of ethnic differences in the pharmacokinetics of moxifloxacin, simvastatin, and meloxicam among three East Asian populations and Caucasians. Br J Clin Pharmacol. 2016;81(6):1078–90.CrossRefPubMedPubMedCentral
30.
go back to reference Belmatoug N, Burlina A, Giraldo P, Hendriksz CJ, Kuter DJ, Mengel E, et al. Gastrointestinal disturbances and their management in miglustat-treated patients. J Inherit Metab Dis. 2011;34(5):991–1001.CrossRefPubMed Belmatoug N, Burlina A, Giraldo P, Hendriksz CJ, Kuter DJ, Mengel E, et al. Gastrointestinal disturbances and their management in miglustat-treated patients. J Inherit Metab Dis. 2011;34(5):991–1001.CrossRefPubMed
Metadata
Title
Pharmacokinetics, Pharmacodynamics, Safety, and Tolerability of Oral AL01211 in Healthy Chinese Volunteers
Authors
Lei Dong
Jianxing Xiang
Michael Babcock
Yuanzhi Cheng
Yan Wang
Yuqiao Shen
Li Li
Liping Tan
Marvin Garovoy
Wei Hu
Jianhong Zheng
Publication date
02-05-2024
Publisher
Springer International Publishing
Published in
Clinical Drug Investigation
Print ISSN: 1173-2563
Electronic ISSN: 1179-1918
DOI
https://doi.org/10.1007/s40261-024-01362-2