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Review

Pharmacokinetic-Pharmacodynamic Analysis’ Role in Design of Phase ⅠClinical Trials of Anticoagulant Agents: A Systematic Review

, , , &
Pages 1191-1202 | Received 28 Jun 2020, Accepted 30 Sep 2020, Published online: 27 Oct 2020

References

  • Wendelboe AM, Raskob GE. Global burden of thrombosis: epidemiologic aspects. Circ Res. 2016;118(9):1340–1347.
  • Lippi G, Gosselin R, Favaloro EJ. Current and emerging direct oral anticoagulants: state-of-the-art. Semin Thromb Hemost. 2019;45(5):490–501.
  • Schäfer A, Flierl U, Berliner D, et al. Anticoagulants for stroke prevention in atrial fibrillation in elderly patients. Cardiovasc Drugs Ther. 2020. DOI:https://doi.org/10.1007/s10557-020-06981-3
  • Franchini M, Liumbruno GM, Bonfanti C, et al. The evolution of anticoagulant therapy. Blood Transfus. 2016;14(2):175–184.
  • Lippi G, Favaloro EJ. Laboratory hemostasis: milestones in clinical chemistry and laboratory medicine. Clin Chem Lab Med. 2013;51(1):91–97.
  • Weitz JI, Harenberg J. New developments in anticoagulants: past, present and future. Thromb Haemost. 2017;117(7):1283–1288.
  • Tan CSS, Lee SWH. Warfarin and food, herbal or dietary supplement interactions: a systematic review. Br J Clin Pharmacol. 2020. DOI:https://doi.org/10.1111/bcp.14404
  • Patriarcheas V, Pikoulas A, Kostis M, et al. Heparin-induced thrombocytopenia: pathophysiology, diagnosis and management. Cureus. 2020;12(3):e7385.
  • Dabigatran etexilate (Pradaxa)–a new oral anticoagulant. Med Lett Drugs Ther. 2010;52(1351):89–90.
  • Ahrens I, Bode C. Rivaroxaban for stroke prevention in atrial fibrillation and secondary prevention in patients with a recent acute coronary syndrome. Future Cardiol. 2012;8(4):533–541.
  • Mezue K, Obiagwu C, John J, et al. Novel oral anticoagulants in atrial fibrillation: update on apixaban. Curr Cardiol Rev. 2017;13(1):41–46.
  • Barrios V, Escobar C. Implications of edoxaban in the prevention and treatment of thromboembolic complications in clinical practice. Future Cardiol. 2016;12(4):419–433.
  • Palladino M, Merli G, Thomson L. Evaluation of the oral direct factor Xa inhibitor - betrixaban. Expert Opin Investig Drugs. 2013;22(11):1465–1472.
  • Greinacher A, Thiele T, Selleng K. Reversal of anticoagulants: an overview of current developments. Thromb Haemost. 2015;113(5):931–942.
  • Hellenbart EL, Faulkenberg KD, Finks SW. Evaluation of bleeding in patients receiving direct oral anticoagulants. Vasc Health Risk Manag. 2017;13:325–342.
  • Jaffer IH, Stafford AR, Fredenburgh JC, et al. Dabigatran is less effective than warfarin at attenuating mechanical heart valve-induced thrombin generation. J Am Heart Assoc. 2015;4(8):e002322.
  • Steffel J, Verhamme P, Potpara TS, et al. The 2018 European heart rhythm association practical guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: executive summary. Europace. 2018;20(8):1231–1242.
  • Group IEW. ICH harmonised tripartite guideline general considerations for clinical trials E8. In: International conference on harmonisation of technical requirements for registration of pharmaceuticals for human use. (Ed.^(Eds); 1997.
  • Gaussem P, Dubar M, le Bonniec B, et al. Dose-effect relationship for several coagulation markers during administration of the direct thrombin inhibitor S 18326 in healthy subjects. Br J Clin Pharmacol. 2002;53(2):147–154.
  • Stern R, Chanoine F, Criswell K. Are coagulation times biomarkers? Data from a phase I study of the oral thrombin inhibitor LB-30057 (CI-1028). J Clin Pharmacol. 2003;43(2):118–121.
  • Johansson S, Wahlander K, Larson G, et al. Pharmacokinetics and anticoagulant effect of the direct thrombin inhibitor melagatran following subcutaneous administration to healthy young men. Blood Coagul Fibrinolysis. 2003;14(7):677–684.
  • Eriksson UG, Bredberg U, Gislen K, et al. Pharmacokinetics and pharmacodynamics of ximelagatran, a novel oral direct thrombin inhibitor, in young healthy male subjects. Eur J Clin Pharmacol. 2003;59(1):35–43.
  • Stangier J, Rathgen K, Stahle H, et al. The pharmacokinetics, pharmacodynamics and tolerability of dabigatran etexilate, a new oral direct thrombin inhibitor, in healthy male subjects. Br J Clin Pharmacol. 2007;64(3):292–303.
  • Johansson S, Cullberg M, Eriksson UG, et al. Single-dose pharmacokinetics, pharmacodynamics and safety of AZD0837, a novel oral direct thrombin inhibitor, in young healthy male subjects. Int J Clin Pharmacol Ther. 2011;49(4):258–267.
  • Kim J, Lee SH, Boyce M, et al. Pharmacokinetics, pharmacodynamics and food effect of LB30870, a novel direct thrombin inhibitor, after single oral doses in healthy men. Xenobiotica. 2015;45(8):663–671.
  • Oral AZD8165 after single oral ascending doses in healthy male subjects (NCT01150812). [ Cited 2020 Feb 20]. Available from: https://www.clinicaltrials.gov/ct2/show/NCT01150812?term=NCT01150812&draw=2&rank=1
  • A Study to Evaluate Safety, Tolerability, Pharmacokinetics, Immunogenicity, and Pharmacodynamics of JNJ-64179375 in Healthy Male Subjects NCT02949206. [ Cited 2020 Feb 20]. Available from: https://www.clinicaltrials.gov/ct2/show/NCT02949206?term=NCT02949206&draw=2&rank=1
  • Murayama N, Tanaka M, Kunitada S, et al. Tolerability, pharmacokinetics, and pharmacodynamics of DX-9065a, a new synthetic potent anticoagulant and specific factor Xa inhibitor, in healthy male volunteers. Clin Pharmacol Ther. 1999;66(3):258–264.
  • Paccaly A, Ozoux ML, Chu V, et al. Pharmacodynamic markers in the early clinical assessment of otamixaban, a direct factor Xa inhibitor. Thromb Haemost. 2005;94(6):1156–1163.
  • Kubitza D, Becka M, Wensing G, et al. Safety, pharmacodynamics, and pharmacokinetics of BAY 59-7939–an oral, direct factor Xa inhibitor–after multiple dosing in healthy male subjects. Eur J Clin Pharmacol. 2005;61(12):873–880.
  • Frost C, Wang J, Nepal S, et al. Apixaban, an oral, direct factor Xa inhibitor: single dose safety, pharmacokinetics, pharmacodynamics and food effect in healthy subjects. Br J Clin Pharmacol. 2013;75(2):476–487.
  • Schmitt C, Pannier A, McIntyre C, et al. Crossover dose escalation study to assess safety, pharmacokinetics, and pharmacodynamics of single doses of R1663, an oral factor Xa inhibitor, in healthy male volunteers. J Clin Pharmacol. 2012;52(4):499–510.
  • Ogata K, Mendell-Harary J, Tachibana M, et al. Clinical safety, tolerability, pharmacokinetics, and pharmacodynamics of the novel factor Xa inhibitor edoxaban in healthy volunteers. J Clin Pharmacol. 2010;50(7):743–753.
  • Kadokura T, Kashiwa M, Groenendaal D, et al. Clinical pharmacokinetics, pharmacodynamics, safety and tolerability of darexaban, an oral direct factor Xa inhibitor, in healthy Caucasian and Japanese subjects. Biopharm Drug Dispos. 2013;34(8):431–441.
  • Ogata K, Shimizu T, Masumoto H, et al. Clinical safety, tolerability, pharmacokinetics and pharmacodynamics of the novel factor Xa inhibitor DY-807f in healthy volunteers. Thromb Res. 2015;135(4):594–601.
  • Choi HY, Choi S, Kim YH, et al. Population pharmacokinetic and pharmacodynamic modeling analysis of GCC-4401C, a novel direct factor xa inhibitor, in healthy volunteers. CPT. 2016;5(10):532–543.
  • Xuan D, McBride S, Wastall P, et al. Safety, pharmacokinetics, and pharmacodynamics of PD 0348292, an oral, direct factor Xa inhibitor, after single and multiple dosings in healthy subjects. Clin Pharmacol Drug Dev. 2016;5(1):13–26.
  • Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of Single Rising Oral Doses of BI 11634 Solution in Healthy Male Volunteers (NCT02214914). [ Cited 2020 Feb 20]. Available from: https://www.clinicaltrials.gov/ct2/show/NCT02214914?term=NCT02214914&draw=2&rank=1
  • Phase I Study of Direct Coagulation Factor Xa Inhibitor SYHA136 Tablets in Chinese Healthy Volunteers (NCT04036656). [ Cited 2020 Feb 20]. Available from: https://www.clinicaltrials.gov/ct2/show/NCT04036656?term=NCT04036656&draw=2&rank=1
  • Fujimoto T, Imaeda Y, Konishi N, et al. Discovery of a tetrahydropyrimidin-2(1H)-one derivative (TAK-442) as a potent, selective, and orally active factor Xa inhibitor. J Med Chem. 2010;53(9):3517–3531.
  • Agnelli G, Haas S, Ginsberg JS, et al. A phase II study of the oral factor Xa inhibitor LY517717 for the prevention of venous thromboembolism after hip or knee replacement. J Thromb Haemost. 2007;5(4):746–753.
  • Turpie AG, Bauer KA, Davidson BL, et al. A randomized evaluation of betrixaban, an oral factor Xa inhibitor, for prevention of thromboembolic events after total knee replacement (EXPERT). Thromb Haemost. 2009;101(1):68–76.
  • Albrecht D, Ellis D, Canafax DM, et al. Pharmacokinetics and pharmacodynamics of tecarfarin, a novel vitamin K antagonist oral anticoagulant. Thromb Haemost. 2017;117(4):706–717.
  • Dimitropoulos G, Rahim SMZ, Moss AS, et al. New anticoagulants for venous thromboembolism and atrial fibrillation: what the future holds. Expert Opin Investig Drugs. 2018;27(1):71–86.
  • Verhamme P, Pakola S, Jensen TJ, et al. Tolerability and pharmacokinetics of TB-402 in healthy male volunteers. Clin Ther. 2010;32(6):1205–1220.
  • Chow FS, Benincosa LJ, Sheth SB, et al. Pharmacokinetic and pharmacodynamic modeling of humanized anti-factor IX antibody (SB 249417) in humans. Clin Pharmacol Ther. 2002;71(4):235–245.
  • Dyke CK, Steinhubl SR, Kleiman NS, et al. First-in-human experience of an antidote-controlled anticoagulant using RNA aptamer technology: a phase 1a pharmacodynamic evaluation of a drug-antidote pair for the controlled regulation of factor IXa activity. Circulation. 2006;114(23):2490–2497.
  • Eriksson BI, Dahl OE, Lassen MR, et al. Partial factor IXa inhibition with TTP889 for prevention of venous thromboembolism: an exploratory study. J Thromb Haemost. 2008;6(3):457–463.
  • Perera V, Luettgen JM, Wang Z, et al. First-in-human study to assess the safety, pharmacokinetics and pharmacodynamics of BMS-962212, a direct, reversible, small molecule factor XIa inhibitor in non-Japanese and Japanese healthy subjects. Br J Clin Pharmacol. 2018;84(5):876–887.
  • Koch AW, Schiering N, Melkko S, et al. MAA868, a novel FXI antibody with a unique binding mode, shows durable effects on markers of anticoagulation in humans. Blood. 2019;133(13):1507–1516.
  • Thomas D, Thelen K, Kraff S, et al. BAY 1213790, a fully human IgG1 antibody targeting coagulation factor XIa: first evaluation of safety, pharmacodynamics, and pharmacokinetics. Res Pract Thromb Haemost. 2019;3(2):242–253.
  • Lorentz CU, Verbout NG, Wallisch M, et al. Contact activation inhibitor and factor XI antibody, AB023, produces safe, dose-dependent anticoagulation in a phase 1 first-in-human trial. Arterioscler Thromb Vasc Biol. 2019;39(4):799–809.
  • Safety and tolerability study of BMS-986177 in healthy subjects (NCT02608970). [ Cited 2020 Feb 20]. Available from: https://www.clinicaltrials.gov/ct2/show/NCT02608970?term=NCT02608970&draw=2&rank=1
  • Study to Evaluate Safety, PK and PD of Single and Multiple Ascending Doses of EP-7041 in Healthy Subjects (NCT02914353). [ Cited 2020 Feb 20]. Available from: https://www.clinicaltrials.gov/ct2/show/NCT02914353?term=NCT02914353&draw=2&rank=1
  • A Study to Assess the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of Single and Multiple Doses of IONIS FXI-LRx in up to 84 Healthy Volunteers (NCT03582462). [ Cited 2020 Feb 20]. Available from: https://www.clinicaltrials.gov/ct2/show/NCT03582462?term=NCT03582462&draw=2&rank=1
  • The PK/PD Study of SHR2285 Tablets in Healthy Subjects (NCT03769831). [ Cited 2020 Feb 20]. Available from: https://www.clinicaltrials.gov/ct2/show/NCT03769831?term=NCT03769831&draw=2&rank=1
  • A Two-Part Study to Assess the Safety, Tolerability, PK and PD of ONO-7684 in Healthy Adult Volunteers (NCT03919890). [ Cited 2020 Feb 20]. Available from: https://www.clinicaltrials.gov/ct2/show/NCT03919890?term=NCT03919890&draw=2&rank=1
  • Büller HR, Bethune C, Bhanot S, et al. Factor XI antisense oligonucleotide for prevention of venous thrombosis. N Engl J Med. 2015;372(3):232–240.
  • Cao H, Biondo M, Lioe H, et al. Antibody-mediated inhibition of FXIIa blocks downstream bradykinin generation. J Allergy Clin Immunol. 2018;142(4):1355–1358.
  • Pharmacodynamics, Safety and Pharmacokinetics After Oral Administration of BIBR 1048 MS in Healthy Volunteers (NCT02170116). [ Cited 2020 Feb 20]. Available from: https://www.clinicaltrials.gov/ct2/show/NCT02170116?term=NCT02170116&draw=2&rank=1
  • A Phase I Study of Monoclonal Antibody TB-402 in Healthy Male Volunteers (NCT00612196). [ Cited 2020 Feb 20]. Available from: https://www.clinicaltrials.gov/ct2/show/NCT00612196?term=NCT00612196&draw=2&rank=1
  • A Study to Assess Safety, Tolerability, and Pharmacokinetics of Orally Administered GCC4401C in Healthy Volunteers (NCT01651234). [ Cited 2020 Feb 20]. Available from: https://www.clinicaltrials.gov/ct2/show/NCT01651234?term=NCT01651234&draw=2&rank=1
  • A Study to Access Safety, Tolerability, Pharmacokinetics(PK) and Pharmacodynamics(PD) of Orally Administered GCC-4401C in Healthy Volunteers. [ Cited 2020 Feb 20]. Available from: https://clinicaltrials.gov/ct2/show/NCT01954238?term=NCT01954238&draw=2&rank=1
  • A Study to Evaluate the Safety and Tolerability of YM150 in Healthy Caucasian and Japanese Male and Female Subjects, and to Assess the Effect That Gender May Have on Its Actions in the Body (NCT01655056). [ Cited 2020 Feb 20]. Available from: https://www.clinicaltrials.gov/ct2/show/NCT01655056?term=NCT01655056&draw=2&rank=1
  • A Short and Long Intravenous Infusion Study to Evaluate the Safety, Pharmacokinetics, and Pharmacodynamics of BMS-962212 in Healthy Subjects (NCT03197779). [ Cited 2020 Feb 20]. Available from: https://www.clinicaltrials.gov/ct2/show/NCT03197779?term=NCT03197779&draw=2&rank=1
  • Safety and Tolerability Study of Xisomab 3G3 in Healthy Adult Subjects (NCT03097341). [ Cited 2020 Feb 20]. Available from: https://www.clinicaltrials.gov/ct2/show/NCT03097341?term=NCT03097341&draw=2&rank=1
  • Sibille M, Patat A, Caplain H, et al. A safety grading scale to support dose escalation and define stopping rules for healthy subject first-entry-into-man studies: some points to consider from the French Club Phase I working group. Br J Clin Pharmacol. 2010;70(5):736–748.
  • Emanuel EJ, Bedarida G, Macci K, et al. Quantifying the risks of non-oncology phase I research in healthy volunteers: meta-analysis of phase I studies. BMJ. 2015;350:h3271.
  • Johnson RA, Rid A, Emanuel E, et al. Risks of phase I research with healthy participants: a systematic review. Clin Trials. 2016;13(2):149–160.
  • Gueret P, Krezel C, Fuseau E, et al. EP42675, a synthetic parenteral dual-action anticoagulant: pharmacokinetics, pharmacodynamics, and absence of interactions with antiplatelet drugs. J Thromb Haemost. 2014;12(1):24–33.
  • Kubitza D, Becka M, Voith B, et al. Safety, pharmacodynamics, and pharmacokinetics of single doses of BAY 59-7939, an oral, direct factor Xa inhibitor. Clin Pharmacol Ther. 2005;78(4):412–421.
  • Gueret P, Combe S, Krezel C, et al. First in man study of EP217609, a new long-acting, neutralisable parenteral antithrombotic with a dual mechanism of action. Eur J Clin Pharmacol. 2016;72(9):1041–1050.
  • Graefe-Mody EU, Schuhly U, Rathgen K, et al. Pharmacokinetics and pharmacodynamics of BIBT 986, a novel small molecule dual inhibitor of thrombin and factor Xa. J Thromb Haemost. 2006;4(7):1502–1509.
  • Lin L, Zhao L, Gao N, et al. From multi-target anticoagulants to DOACs, and intrinsic coagulation factor inhibitors. Blood Rev. 2020;39:100615.
  • Yandrapalli S, Andries G, Gupta S, et al. Investigational drugs for the treatment of acute myocardial infarction: focus on antiplatelet and anticoagulant agents. Expert Opin Investig Drugs. 2019;28(3):223–234.
  • Rai V, Balters MW, Agrawal DK. Factors IX, XI, and XII: potential therapeutic targets for anticoagulant therapy in atherothrombosis. Rev Cardiovasc Med. 2019;20(4):245–253.
  • Goldstein S, Bates ER, Bhatt DL, et al. Phase 2 study of TAK-442, an oral factor Xa inhibitor, in patients following acute coronary syndrome. Thromb Haemost. 2014;111(6):1141–1152.
  • Doggrell SA. Is there evidence to support the use of direct Factor Xa inhibitors in coronary artery disease? Rev Recent Clin Trials. 2011;6(2):147–157.
  • Astellas Pharma Inc. Discontinues development of darexaban (YM150),an oral direct factor xa inhibitor. [ Cited 2020 Mar 4]. Available from: https://www.astellas.com/en/news/13301
  • DeLoughery EP, Olson SR, Puy C, et al. The safety and efficacy of novel agents targeting factors XI and XII in early phase human trials. Semin Thromb Hemost. 2019;45(5):502–508.
  • Székely O, Borgi M, Lip GYH. Factor XI inhibition fulfilling the optimal expectations for ideal anticoagulation. Expert Opin Emerg Drugs. 2019;24(1):55–61.
  • Chan NC, Weitz JI. Antithrombotic Agents. Circ Res. 2019;124(3):426–436.
  • Wada S, Toyoda K, Sato S, et al. Anti-Xa activity and event risk in patients with direct factor Xa inhibitors initiated early after stroke. Circ J. 2018;82(11):2872–2879.
  • Sakaguchi T, Osanai H, Murase Y, et al. Monitoring of anti-Xa activity and factors related to bleeding events: a study in Japanese patients with nonvalvular atrial fibrillation receiving rivaroxaban. J Cardiol. 2017;70(3):244–249.
  • Purrucker JC, Rizos T, Haas K, et al. Coagulation testing in intracerebral hemorrhage related to non-vitamin K antagonist oral anticoagulants. Neurocrit Care. 2017;27(2):208–213.
  • Kodato K, Ishida K, Shibanuma N, et al. Prothrombin time-international normalized ratio is a useful marker for edoxaban efficacy in preventing venous thromboembolism after total knee arthroplasty. Eur J Orthop Surg Traumatol. 2018;28(1):103–108.
  • Chan N, Sager PT, Lawrence J, et al. Is there a role for pharmacokinetic/pharmacodynamic-guided dosing for novel oral anticoagulants? Am Heart J. 2018;199:59–67.
  • Samuelson BT, Cuker A, Siegal DM, et al. Laboratory assessment of the anticoagulant activity of direct oral anticoagulants: a systematic review. Chest. 2017;151(1):127–138.
  • Gosselin RC, Adcock DM, Bates SM, et al. International council for standardization in haematology (ICSH) recommendations for laboratory measurement of direct oral anticoagulants. Thromb Haemost. 2018;118(3):437–450.
  • Van Blerk M, Bailleul E, Chatelain B, et al. Influence of apixaban on commonly used coagulation assays: results from the Belgian national external quality assessment scheme. Int J Lab Hematol. 2017;39(4):402–408.
  • Cuker A, Husseinzadeh H. Laboratory measurement of the anticoagulant activity of edoxaban: a systematic review. J Thromb Thrombolysis. 2015;39(3):288–294.
  • Yin OQP, Antman EM, Braunwald E, et al. Linking endogenous factor Xa activity, a biologically relevant pharmacodynamic marker, to edoxaban plasma concentrations and clinical outcomes in the ENGAGE AF-TIMI 48 trial. Circulation. 2018;138(18):1963–1973.
  • van Pelt LJ, Lukens MV, Testa S, et al. The DaXa-inhibition assay: a concept for a readily available, universal aXa assay that measures the direct inhibitory effect of all anti-Xa drugs. Thromb Res. 2018;168:63–66.
  • Frost C, Song Y, Barrett YC, et al. A randomized direct comparison of the pharmacokinetics and pharmacodynamics of apixaban and rivaroxaban. Clin Pharmacol. 2014;6:179–187.
  • Kreutz R, Persson PB, Kubitza D, et al. Dissociation between the pharmacokinetics and pharmacodynamics of once-daily rivaroxaban and twice-daily apixaban: a randomized crossover study. J Thromb Haemost. 2017;15(10):2017–2028.
  • Shepshelovich D, Goldvaser H, Wang L, et al. Comparison of reporting phase I trial results in ClinicalTrials.gov and matched publications. Invest New Drugs. 2017;35(6):827–833.
  • Shepshelovich D, Goldvaser H, Wang L, et al. Comparison of published and unpublished phase I clinical cancer trials: an analysis of the CliniclTrials.gov database. Invest New Drugs. 2018;36(5):933–938.

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