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Henriksen K, Broekhuizen K, de Boon WMI, Karsdal MA, Bihlet AR, Christiansen C, Dillingh MR, de Kam M, Kumar R, Burggraaf J, Kamerling IMC. Safety, tolerability and pharmacokinetic characterisation of DACRA KBP-042 in healthy male subjects. Br J Clin Pharmacol 2021; 87:4786-4796. [PMID: 34019711 DOI: 10.1111/bcp.14921] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/28/2021] [Accepted: 05/08/2021] [Indexed: 11/26/2022] Open
Abstract
There is a need for antidiabetic agents successfully targeting insulin sensitivity and treating obesity control at the same time. The aim of this first-in-human study was (a) to evaluate safety and tolerability, (b) to evaluate pharmacokinetics and (c) to assess indications of receptor engagement of single ascending doses of KBP-042, a dual amylin and calcitonin receptor agonist (DACRA) that has shown promising preclinical data, with superior activity in terms of typical amylin-induced responses including reduction of food intake, weight loss and gluco-regulatory capacities. A randomised double-blind placebo-controlled single ascending dose study was performed with six dose levels of KBP-042 (5, 7.5, 10, 20, 20 (evening), 40 ug) in healthy male adults. KBP-042 or placebo was administered as a single dose after an overnight fast, followed by a standardized lunch after 4 hours. KBP-042 was associated with dose-dependent complaints of nausea and vomiting, with a lack of tolerability at doses of 20 μg and above. Doses of 5-40 μg KBP-042 behaved according to a linear pharmacokinetic profile. Indications of target receptor engagement were observed at the level of glucose control and lowering of bone resorption, compared to placebo. The results of this study showed that doses up to 40 μg were safe, although tolerability was not present at the highest doses. The study confirmed target receptor engagement at the studied doses.
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Affiliation(s)
- Kim Henriksen
- Nordic Bioscience, Herlev, Denmark.,KeyBioscience AG, Stans, Switzerland
| | | | | | - Morten A Karsdal
- Nordic Bioscience, Herlev, Denmark.,KeyBioscience AG, Stans, Switzerland
| | | | | | | | | | - Raj Kumar
- KeyBioscience AG, Stans, Switzerland
| | - Jacobus Burggraaf
- Centre for Human Drug Research, Leiden, the Netherland.,Leiden Academic Center for Drug Research, Leiden, the Netherlands.,Leiden University Medical Center, Leiden, the Netherlands
| | - Ingrid M C Kamerling
- Centre for Human Drug Research, Leiden, the Netherland.,Leiden University Medical Center, Leiden, the Netherlands
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van Esdonk MJ, Stevens J, Stuurman FE, de Boon WMI, Dehez M, van der Graaf PH, Burggraaf J. The Pharmacodynamic Effects of a Dopamine-Somatostatin Chimera Agonist on the Cardiovascular System. J Cardiovasc Pharmacol 2020; 74:128-136. [PMID: 31306369 DOI: 10.1097/fjc.0000000000000695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The quantification of the effect of pharmacological treatment on the cardiovascular system is complicated because of the high level of interindividual and circadian variability. Recently, a dopamine-somatostatin chimera, BIM23B065, was under investigation to concurrently target the somatostatin and dopamine D2 receptors for the treatment of neuroendocrine tumors. However, both dopamine and somatostatin interact with different components of the cardiovascular system. This study established the response of the heart rate and the systolic blood pressure after administration of BIM23B065 in healthy male volunteers by analysis of the rate-pressure product (RPP), in a model-informed analysis. The RPP in the supine position of placebo-treated subjects showed a clear circadian component, best described by 2 cosine functions. The pharmacokinetics of BIM23B065 and its metabolite were best described using 2-compartment models with different forms of elimination kinetics. The administration of BIM23B065 gave a statistically significant reduction in the RPP, after which the effect diminished because of the tolerance to the cardiovascular effects after prolonged exposure to BIM23B065. This model provided insight in the circadian rhythm of the RPP in the supine position and the level of interindividual variability in healthy male volunteers. The developed population pharmacokinetic/pharmacodynamic model quantified the interaction between BIM23B065 and the RPP, informing on the clinical pharmacological properties of BIM23B065.
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Affiliation(s)
- Michiel Joost van Esdonk
- Division of Systems Biomedicine and Pharmacology, Leiden Academic Centre for Drug Research, Leiden University, Leiden, the Netherlands.,Centre for Human Drug Research, Leiden, the Netherlands
| | - Jasper Stevens
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | | | | | | | - Piet Hein van der Graaf
- Division of Systems Biomedicine and Pharmacology, Leiden Academic Centre for Drug Research, Leiden University, Leiden, the Netherlands.,Certara QSP, Canterbury, United Kingdom
| | - Jacobus Burggraaf
- Division of Systems Biomedicine and Pharmacology, Leiden Academic Centre for Drug Research, Leiden University, Leiden, the Netherlands.,Centre for Human Drug Research, Leiden, the Netherlands
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van Brummelen EMJ, Ziagkos D, de Boon WMI, Hart EP, Doll RJ, Huttunen T, Kolehmainen P, Groeneveld GJ. Quantification of tremor using consumer product accelerometry is feasible in patients with essential tremor and Parkinson's disease: a comparative study. J Clin Mov Disord 2020; 7:4. [PMID: 32280482 PMCID: PMC7137336 DOI: 10.1186/s40734-020-00086-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 03/10/2020] [Indexed: 11/10/2022]
Abstract
Background To quantify pharmacological effects on tremor in patients with essential tremor (ET) or Parkinson’s Disease (PD), laboratory-grade accelerometers have previously been used. Over the last years, consumer products such as smartphones and smartwatches have been increasingly applied to measure tremor in an easy way. However, it is unknown how the technical performance of these consumer product accelerometers (CPAs) compares to laboratory-grade accelerometers (LGA). This study was performed to compare the technical performance of CPAs with LGA to measure tremor in patients with Parkinson’s Disease (PD) and essential tremor (ET). Methods In ten patients with PD and ten with ET, tremor peak frequency and corresponding amplitude were measured with 7 different CPAs (Apple iPhone 7, Apple iPod Touch 5, Apple watch 2, Huawei Nexus 6P, Huawei watch, mbientlabMetaWear (MW) watch, mbientlab MW clip) and compared to a LGA (Biometrics ACL300) in resting and extended arm position. Results Both in PD and ET patients, the peak frequency of CPAs did not significantly differ from the LGA in terms of limits of agreement. For the amplitude at peak frequency, only the iPhone and MW watch performed comparable to the LGA in ET patients, while in PD patients all methods performed comparable except for the iPod Touch and Huawei Nexus. Amplitude was higher when measured with distally-located CPAs (Clip, iPhone, iPod) compared with proximally-located CPAs (all watches). The variability between subjects was higher than within subjects for frequency (25.1% vs. 13.4%) and amplitude measurement (331% vs. 53.6%). Resting arm position resulted in lower intra-individual variability for frequency and amplitude (13.4 and 53.5%) compared to extended arm position (17.8 and 58.1%). Conclusions Peak frequencies of tremor could be measured with all tested CPAs, with similar performance as LGA. The amplitude measurements appeared to be driven by anatomical location of the device and can therefore not be compared. Our results show that the tested consumer products can be used for tremography, allowing at-home measurements, in particular in studies with a cross-over or intra-individual comparison design using the resting arm position. Trial registration This trial was registered in the Dutch Competent Authority (CCMO) database with number NL60672.058.17 on May 30th 2017.
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Affiliation(s)
| | - Dimitrios Ziagkos
- 1Centre for Human Drug Research, Zernikedreef 8, Leiden, 2333 CL The Netherlands
| | - Wadim M I de Boon
- 1Centre for Human Drug Research, Zernikedreef 8, Leiden, 2333 CL The Netherlands
| | - Ellen P Hart
- 1Centre for Human Drug Research, Zernikedreef 8, Leiden, 2333 CL The Netherlands
| | - Robert J Doll
- 1Centre for Human Drug Research, Zernikedreef 8, Leiden, 2333 CL The Netherlands
| | | | | | - Geert Jan Groeneveld
- 1Centre for Human Drug Research, Zernikedreef 8, Leiden, 2333 CL The Netherlands.,4Department of Anesthesiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
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de Boon WMI, van Esdonk MJ, Stuurman FE, Biermasz NR, Pons L, Paty I, Burggraaf J. A Novel Somatostatin-Dopamine Chimera (BIM23B065) Reduced GH Secretion in a First-in-Human Clinical Trial. J Clin Endocrinol Metab 2019; 104:883-891. [PMID: 30371791 DOI: 10.1210/jc.2018-01364] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 10/23/2018] [Indexed: 02/02/2023]
Abstract
CONTEXT A somatostatin-dopamine chimera (BIM23B065) was under investigation to reduce GH secretion for the treatment of pituitary adenomas. OBJECTIVE To determine pharmacokinetics, safety, and tolerability and to monitor hormonal changes after single and multiple subcutaneous BIM23B065 administrations. DESIGN Randomized, double-blind, placebo-controlled, parallel-group design with five single and three 13-day multiple ascending-dose cohorts. PATIENTS A total of 63 healthy male white volunteers were enrolled (47 active, 16 placebo). MAIN OUTCOME MEASURES Pharmacokinetics, GH, prolactin (PRL), IGF-1, GH after GHRH administration, and general clinical safety criteria. RESULTS The maximum dosage of BIM23B065 administered in this study was 1.5 mg. BIM23B065 reduced the mean GH concentrations after 8 and 13 days of treatment. A decrease in GH release after GHRH administration indicated inhibition of the hypothalamic-pituitary-somatotropic axis. IGF-1 was not altered after single doses but showed a significant change from baseline after multiple dosing. PRL secretion was reduced in all subjects who were treated. Orthostatic hypotension and injection site reactions were commonly observed at high dosages. A 6-day uptitration period was included to successfully lower the cardiovascular effects in the multiple ascending dose part of the study. CONCLUSIONS Proof of pharmacology of BIM23B065 was shown by a reduction in GH, IGF-1, and PRL concentrations in healthy male volunteers, supporting activity of the somatostatin analog and dopamine agonist moieties. The safety and tolerability of the higher dosing regions was limited mainly by orthostatic hypotension.
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Affiliation(s)
| | - Michiel J van Esdonk
- Centre for Human Drug Research, Leiden, Netherlands
- Division of Systems Biomedicine and Pharmacology, Leiden Academic Centre for Drug Research, Leiden University, Leiden, Netherlands
| | - Frederik E Stuurman
- Centre for Human Drug Research, Leiden, Netherlands
- Leiden University Medical Center, Leiden, Netherlands
| | - Nienke R Biermasz
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, 2333 ZA Leiden, Netherlands
| | | | | | - Jacobus Burggraaf
- Centre for Human Drug Research, Leiden, Netherlands
- Division of Systems Biomedicine and Pharmacology, Leiden Academic Centre for Drug Research, Leiden University, Leiden, Netherlands
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Post ICJH, de Boon WMI, Heger M, van Wijk ACWA, Kroon J, van Buul JD, van Gulik TM. Endothelial cell preservation at hypothermic to normothermic conditions using clinical and experimental organ preservation solutions. Exp Cell Res 2013; 319:2501-13. [PMID: 23792081 DOI: 10.1016/j.yexcr.2013.05.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Revised: 04/27/2013] [Accepted: 05/09/2013] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Endothelial barrier function is pivotal for the outcome of organ transplantation. Since hypothermic preservation (gold standard) is associated with cold-induced endothelial damage, endothelial barrier function may benefit from organ preservation at warmer temperatures. We therefore assessed endothelial barrier integrity and viability as function of preservation temperature and perfusion solution, and hypothesized that endothelial cell preservation at subnormothermic conditions using metabolism-supporting solutions constitute optimal preservation conditions. METHODS Human umbilical vein endothelial cells (HUVEC) were preserved at 4-37°C for up to 20 h using Ringer's lactate, histidine-tryptophan-ketoglutarate solution, University of Wisconsin (UW) solution, Polysol, or endothelial cell growth medium (ECGM). Following preservation, the monolayer integrity, metabolic capacity, and ATP content were determined as positive parameters of endothelial cell viability. As negative parameters, apoptosis, necrosis, and cell activation were assayed. A viability index was devised on the basis of these parameters. RESULTS HUVEC viability and barrier integrity was compromised at 4°C regardless of the preservation solution. At temperatures above 20°C, the cells' metabolic demands outweighed the preservation solutions' supporting capacity. Only UW maintained HUVEC viability up to 20°C. Despite high intracellular ATP content, none of the solutions were capable of sufficiently preserving HUVEC above 20°C except for ECGM. CONCLUSION Optimal HUVEC preservation is achieved with UW up to 20°C. Only ECGM maintains HUVEC viability at temperatures above 20°C.
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Affiliation(s)
- Ivo C J H Post
- Department of Surgery (Surgical Laboratory), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Harms FA, de Boon WMI, Balestra GM, Bodmer SIA, Johannes T, Stolker RJ, Mik EG. Oxygen-dependent delayed fluorescence measured in skin after topical application of 5-aminolevulinic acid. J Biophotonics 2011; 4:731-739. [PMID: 21770036 DOI: 10.1002/jbio.201100040] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2011] [Revised: 06/26/2011] [Accepted: 06/27/2011] [Indexed: 05/31/2023]
Abstract
Mitochondrial oxygen tension can be measured in vivo by means of oxygen-dependent quenching of delayed fluorescence of protoporphyrin IX (PpIX). Here we demonstrate that delayed fluorescence is readily observed from skin in rat and man after topical application of the PpIX precursor 5-aminolevulinic acid (ALA). Delayed fluorescence lifetimes respond to changes in inspired oxygen fraction and blood supply. The signals contain lifetime distributions and the fitting of rectangular distributions to the data appears more adequate than mono-exponential fitting. The use of topically applied ALA for delayed fluorescence lifetime measurements might pave the way for clinical use of this technique.
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Affiliation(s)
- Floor A Harms
- Department of Anesthesiology, Laboratory of Experimental Anesthesiology, ErasmusMC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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