Safety, Tolerability and Pharmacokinetics of Single and Multiple Ascending Doses of Benfotiamine in Healthy Subjects

Abstract

Purpose

Safety, tolerability and pharmacokinetics of single and multiple ascending doses (SADs/MADs) of benfotiamine were assessed after oral administration in two randomized, double-blind, placebo-controlled, phase I trials.

Methods

Healthy subjects were sequentially enrolled into one of five SAD (150–1200 mg) or three MAD (150, 300 or 600 mg) cohorts. In SAD study, each cohort of 12 subjects (n = 10, active; n = 2, placebo) were administrated once-daily doses. In MAD study, each cohort of 16 subjects (n = 12, active; n = 4, placebo) were administrated once-daily on day 1 and twice-daily on day 4–9, followed by a single morning dose on day 10.

Results

In the SAD study, the median time to reach maximum concentration (T_max) arrived 1.0 to 2.0 h for thiamine (TM), 3.5 to 8.0 h for thiamine monophosphate (TMP), and 8.0 to 24.0 h for thiamine diphosphate (TDP) after administration of benfotiamine. The area under concentration-time curve from 0 to last measurable concentration (AUC_0-t) or maximum observed concentration (C_max) of TM, TMP, and TDP was less or more dose proportional over the single dose studied except C_max of TM. Food consumption did not increase the level of TM and TDP at baseline. TM exhibited a relatively long elimination half-life (t_1/2) in all doses studied, resulting in accumulation ratio (Rac) of 1.96 to 2.11 and accumulation ratio based on C_max (Rac, _Cmax) of 1.60 to 1.88 following 7 days of multiple dosing. Comparable accumulation results were also obtained for TDP after multiple dosing. The incidence and severity of adverse events (AEs) were similar between benfotiamine and placebo. The commonly reported drug-related AEs were increased ALT and urinary WBC.

Conclusion

Both SAD and MAD studies of benfotiamine in healthy subjects were safe and well tolerated. TM and TDP exhibited moderate accumulation on repeated administration of benfotiamine.

Keywords:

• Alzheimer’s disease
• benfotiamine
• thiamine
• thiamine diphosphate
• pharmacokinetics

Acknowledgments

This work was supported by grants from National Major Scientific and Technological Special Project for “Significant New Drugs Development” (grant numbers: 2018ZX09734-001, 2014ZX09101-005-005 and 2009ZX09301-011) and Shanghai Science and Technology Development Foundation (grant number: S2016-023).

Data Sharing Statement

The raw data will not be openly shared due to confidentiality concerns.

Disclosure

Wei Cao reports grants from National Major Scientific and Technological Special Project, during the conduct of the study. Wei Cao and Chunjiu Zhong holds shares of Shanghai Rixin Biotech Ltd Company that dedicates to develop new drugs against Alzheimer’s disease. The other authors have declared that they have no conflicts of interest regarding the context of this article.