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Pharmacokinetics of Daprodustat and Metabolites in Individuals with Normal and Impaired Hepatic Function
Author(s) -
Mahar Kelly M.,
Shaddinger Bonnie C.,
Ramanjineyulu Bandi,
Andrews Susan,
Caltabiano Stephen,
Lindsay Alistair C.,
Cobitz Alexander R.
Publication year - 2022
Publication title -
clinical pharmacology in drug development
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.711
H-Index - 22
eISSN - 2160-7648
pISSN - 2160-763X
DOI - 10.1002/cpdd.1090
Subject(s) - medicine , pharmacokinetics , tolerability , gastroenterology , adverse effect , metabolite , pharmacodynamics , area under the curve
Daprodustat is a hypoxia‐inducible factor‐prolyl hydroxylase inhibitor in development for treatment of anemia of chronic kidney disease. We evaluated the role of hepatic impairment on daprodustat pharmacokinetics, pharmacodynamics, and tolerability. Participants with mild (Child‐Pugh Class A, score 5‒6) and moderate (Child‐Pugh Class B, score 7‒9) hepatic impairment and matched healthy controls were administered single 6‐mg doses of daprodustat. Exposure parameters were determined for daprodustat and its six metabolites. Comparisons resulted in 1.5‐ and 2.0‐fold higher daprodustat C max and area under the curve (AUC) exposures in participants with mild and moderate hepatic impairment, respectively, versus controls; C max in mild hepatic impairment was comparable to controls. Similarly, aligned with parent drug, unbound daprodustat C max and AUC exposures increased 1.6‐ to 2.3‐fold in hepatic‐impaired participants versus controls, and metabolite exposures were 1.2‐ to 2.0‐fold higher in participants with hepatic impairment. Erythropoeitin (EPO) baseline‐corrected AUC exposures were between 0.3‐fold lower and 2.2‐fold higher in matched controls versus hepatic‐impaired participants. No serious or study drug‐related adverse events were reported. Daprodustat exposure was increased in participants with moderate and mild hepatic impairment compared with matched controls; however, no meaningful differences in EPO were observed and no new safety concerns were identified (ClinicalTrials.gov: NCT03223337).