Skip to main content

Advertisement

Log in

Population pharmacokinetics and pharmacodynamics of ponesimod, a selective S1P1 receptor modulator

  • Original Paper
  • Published:
Journal of Pharmacokinetics and Pharmacodynamics Aims and scope Submit manuscript

Abstract

Ponesimod (ACT-128800), a reversible, orally active, selective S1P1 receptor modulator, prevents the egress of lymphocytes from the lymph node into the systemic circulation. It is currently in clinical development for the treatment of relapsing multiple sclerosis. Modulation of circulating lymphocytes serves as biomarker of efficacy and safety, such that the quantitative characterization of the pharmacokinetic/pharmacodynamic (PK/PD) relationship guides the clinical development of the compound. The availability of a variety of doses, dosing regimens, and treatment durations permitted estimation of the pharmacokinetics characterized by an absorption lag time followed by a sequential zero/first-order absorption and two compartments with first-order elimination. The PD are modeled as an indirect-effect model with rates of appearance and disappearance of lymphocytes in blood with a circadian rhythm and a drug effect on the rate of appearance. The model suggests a circadian variation of 9 % and a maximum inhibition of 86 % of total lymphocyte count with high doses at steady state. It was instrumental for the selection of doses for subsequent studies that confirmed the effect plateau in total lymphocyte count at approximately 0.5 × 109 counts/L.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9

Similar content being viewed by others

References

  1. Piali L, Froidevaux S, Hess P, Nayler O, Bolli MH, Schlosser E, Kohl C, Steiner B, Clozel M (2011) The selective sphingosine 1-phosphate receptor 1 agonist ponesimod protects against lymphocyte-mediated tissue inflammation. J Pharmacol Exp Ther 337(2):547–556. doi:10.1124/jpet.110.176487

    Article  CAS  PubMed  Google Scholar 

  2. Brossard P, D’Ambrosio D, Cavallaro M, Dingemanse J (2010) Differential effects of ACT-128800, a selective S1P1 receptor agonist, on blood-circulating human T-lymphocyte subpopulations. Poster presented at the 111th Am Soc Clin Pharmacol Ther (ASCPT) meeting, Atlanta, GA, 17–20 March, 2010 Poster PIII-82. Clin Pharmacol Ther 87(S1):S56

    Google Scholar 

  3. Matloubian M, Lo CG, Cinamon G, Lesneski MJ, Xu Y, Brinkmann V, Allende ML, Proia RL, Cyster JG (2004) Lymphocyte egress from thymus and peripheral lymphoid organs is dependent on S1P receptor 1. Nature 427(6972):355–360. doi:10.1038/nature02284

    Article  CAS  PubMed  Google Scholar 

  4. Schwab SR, Pereira JP, Matloubian M, Xu Y, Huang Y, Cyster JG (2005) Lymphocyte sequestration through S1P lyase inhibition and disruption of S1P gradients. Science 309(5741):1735–1739. doi:10.1126/science.1113640

    Article  CAS  PubMed  Google Scholar 

  5. Brossard P, Derendorf H, Xu J, Maatouk H, Halabi A, Dingemanse J (2013) Pharmacokinetics and pharmacodynamics of ponesimod, a selective S1P receptor modulator, in the first-in-human study. Br J Clin Pharmacol 76(6):888–896. doi:10.1111/bcp.12129

    Article  CAS  PubMed  Google Scholar 

  6. Brossard P, Scherz M, Halabi A, Maatouk H, Krause A, Dingemanse J (2014) Multiple-dose tolerability, pharmacokinetics, and pharmacodynamics of ponesimod, an S1P receptor modulator: favorable impact of dose up-titration. J Clin Pharmacol 54(2):179–188. doi:10.1002/jcph.244

    Article  Google Scholar 

  7. Reyes M, Brossard P, Chassard D, Hoch M, Dingemanse J (2014) Effects of ponesimod, a selective S1P1 receptor modulator, on the pharmacokinetics of a hormonal combination contraceptive. Eur J Clin Pharmacol 70(3):287–293. doi:10.1007/s00228-013-1625-2

    Article  CAS  PubMed  Google Scholar 

  8. Brossard P, D’Ambrosio D, Murat I, Dingemanse J (2012) Effects of three different up-titration regimens of ponesimod, a selective S1P1 receptor agonist, on heart rate. Poster presented at the 113th Am Soc Clin Pharmacol Ther (ASCPT) Meeting, National Harbor, MD, 14–17 March, 2012 Poster PII-109. Clin Pharmacol Ther 91(S1):S92–S93

    Google Scholar 

  9. Vaclavkova A, Brossard P, Cavallaro M, D’Ambrosio D, Nacarino Martinez A, Morganti A, Pirron U, Schmidt A-G, Zhang-Fu W (2011) AC-058A200: Multicenter, randomized, double-blind, placebo-controlled, Phase IIa study to evaluate the efficacy, safety, and tolerability of ACT-128800, an S1P1 receptor agonist, administered for 6 weeks to subjects with moderate to severe chronic plaque psoriasis. Pubmed. http://www.clinicaltrials.gov/ct2/show/NCT00852670

  10. Holford NH Absorption models using NM-TRAN. http://holford.fmhs.auckland.ac.nz/docs/absorption-processes.pdf

  11. Holford NH, Ambros RJ, Stoeckel K (1992) Models for describing absorption rate and estimating extent of bioavailability: application to cefetamet pivoxil. J Pharmacokinet Biopharm 20(5):421–442

    Article  CAS  PubMed  Google Scholar 

  12. Braude S, Beck A (2013) Complete blood counts with differential: more accurate reference ranges based on circadian leukocyte trafficking. J Clin Pathol 66(11):909–910. doi:10.1136/jclinpath-2013-201776

    Article  PubMed  Google Scholar 

  13. Kirsch S, Thijssen S, Alarcon Salvador S, Heine GH, van Bentum K, Fliser D, Sester M, Sester U (2012) T-cell numbers and antigen-specific T-cell function follow different circadian rhythms. J Clin Immunol 32(6):1381–1389. doi:10.1007/s10875-012-9730-z

    Article  CAS  PubMed  Google Scholar 

  14. Fisher LE, Ludwig EA, Jusko WJ (1992) Pharmacoimmunodynamics of methylprednisolone: trafficking of helper T lymphocytes. J Pharmacokinet Biopharm 20(4):319–331

    Article  CAS  PubMed  Google Scholar 

  15. Holford NH (2012) An introduction to visual predictive checks. http://holford.fmhs.auckland.ac.nz/docs/vpc-tutorial-and-datatop.pdf

  16. Karlsson MO (2008) A tutorial on visual predictive checks. http://www.page-meeting.org/?abstract=1434

  17. SAS Institute Inc. (2006) Base SAS 9.1.3 procedures guide. SAS Institute Inc., Cary

  18. R Development Core Team (2009) R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna

  19. Beal SL, Sheiner LB (1989–1998) NONMEM users guides. Icon Development Solutions, Ellicott City

  20. Free Software Foundation (2009) GNU Fortran. http://gcc.gnu.org/fortran/

  21. Metrum Institute (2008) NMQual: A software environment for operating NONMEM. https://code.google.com/p/nmqual/

  22. Savic RM, Karlsson MO (2009) Importance of shrinkage in empirical bayes estimates for diagnostics: problems and solutions. AAPS J 11(3):558–569. doi:10.1208/s12248-009-9133-0

    Article  PubMed Central  PubMed  Google Scholar 

  23. Hoch M, D’Ambrosio D, Wilbraham D, Dingemanse J (2013) Up-titration study with ponesimod, a selective S1P1 receptor modulator, to assess its maximum tolerated dose in healthy subjects. Oral contribution OC015 presented at the 11th Conference of the European Association for Clinical Pharmacology and Therapeutics (EACPT), Geneva, Switzerland, August 28–31, 2013. Clin Ther 35(8S):e6–e7

    Article  Google Scholar 

  24. Francis G, Kappos L, O’Connor P, Collins W, Tang D, Mercier F, Cohen J (2013) Temporal profile of lymphocyte counts and relationship with infections with fingolimod therapy. Mult Scler 20(4):471–480. doi:10.1177/1352458513500551

    Article  PubMed  Google Scholar 

  25. Mehling M, Johnson TA, Antel J, Kappos L, Bar-Or A (2011) Clinical immunology of the sphingosine 1-phosphate receptor modulator fingolimod (FTY720) in multiple sclerosis. Neurology 76(8 Suppl 3):S20–S27. doi:10.1212/WNL.0b013e31820db341

    Article  CAS  PubMed  Google Scholar 

  26. Kasper LH, Shoemaker J (2010) Multiple sclerosis immunology: the healthy immune system vs the MS immune system. Neurology 74(Suppl 1):S2–S8. doi:10.1212/WNL.0b013e3181c97c8f

    Article  CAS  PubMed  Google Scholar 

  27. Gergely P, Nuesslein-Hildesheim B, Guerini D, Brinkmann V, Traebert M, Bruns C, Pan S, Gray NS, Hinterding K, Cooke NG, Groenewegen A, Vitaliti A, Sing T, Luttringer O, Yang J, Gardin A, Wang N, Crumb WJ Jr, Saltzman M, Rosenberg M, Wallstrom E (2012) The selective sphingosine 1-phosphate receptor modulator BAF312 redirects lymphocyte distribution and has species-specific effects on heart rate. Br J Pharmacol 167(5):1035–1047. doi:10.1111/j.1476-5381.2012.02061.x

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  28. Mehling M, Brinkmann V, Antel J, Bar-Or A, Goebels N, Vedrine C, Kristofic C, Kuhle J, Lindberg RL, Kappos L (2008) FTY720 therapy exerts differential effects on T cell subsets in multiple sclerosis. Neurology 71(16):1261–1267. doi:10.1212/01.wnl.0000327609.57688.ea

    Article  CAS  PubMed  Google Scholar 

  29. Henault D, Galleguillos L, Moore C, Johnson T, Bar-Or A, Antel J (2013) Basis for fluctuations in lymphocyte counts in fingolimod-treated patients with multiple sclerosis. Neurology 81(20):1768–1772. doi:10.1212/01.wnl.0000435564.92609.2c

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  30. Hoch M, Vaclavkova A, Stoltz R, Brossard P, Dingemanse J (2013) Thorough QT study with ponesimod, a selective S1P1 receptor modulator. Poster PP162 presented at the 11th Conference of the European Association for Clinical Pharmacology and Therapeutics (EACPT), Geneva, Switzerland, August 28–31, 2013. Clin Ther 35(8S):e68–e69

    Article  Google Scholar 

  31. Vaclavkova A, Chimenti S, Arenberger P, Holló P, Sator P-G, Burcklen M, Stefani M, D’Ambrosio D (2014) A multicentre, randomised, double-blind, placebo-controlled phase 2 trial to evaluate the efficacy, safety and tolerability of ponesimod, an oral sphingosine 1-phosphate receptor-1 modulator, in patients with chronic plaque psoriasis. Lancet (to appear)

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Andreas Krause.

Appendix

Appendix

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Krause, A., Brossard, P., D’Ambrosio, D. et al. Population pharmacokinetics and pharmacodynamics of ponesimod, a selective S1P1 receptor modulator. J Pharmacokinet Pharmacodyn 41, 261–278 (2014). https://doi.org/10.1007/s10928-014-9362-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10928-014-9362-4

Keywords

Navigation