Abstract

ASP8232 is a novel inhibitor of vascular adhesion protein-1 that was under evaluation for reducing residual albuminuria in patients with diabetic kidney disease. To characterize the pharmacokinetics (PK) of ASP8232 and its effect on vascular adhesion protein 1 (VAP-1) plasma activity and VAP-1 concentrations (pharmacodynamics, PD) in an integrated and quantitative manner, a target mediated drug disposition model was developed based on pooled data from four completed clinical trials with ASP8232 in healthy volunteers, and in patients with diabetic kidney disease and diabetic macular edema, respectively. In this model, the binding of ASP8232 to its soluble and membrane-bound target in the central and peripheral compartments were included. The model was able to adequately describe the non-linear PK and PD of ASP8232. The observed difference in PK between healthy volunteers and renally impaired patients could be explained by an effect of baseline estimated glomerular filtration rate on ASP8232 clearance and relative bioavailability. The relationship between ASP8232 concentration and VAP-1 inhibition was successfully established and can be applied to simulate drug exposure and degree of VAP-1 inhibition for any given dose of ASP8232 across the spectrum of renal function.

Highlights

  • Vascular adhesion protein-1 (VAP-1) is a 180 kDa transmembrane homodimeric glycoprotein [1, 2]

  • Binding of ASP8232 to sVAP-1 in the central compartment (sVAP-1c) and to Membrane bound VAP-1 (mVAP-1) in all compartments was parameterized with KD

  • vascular adhesion protein 1 (VAP-1) plasma activity was a function of unbound soluble VAP-1 (sVAP-1) plasma concentration according to a power model with estimated slope parameter (SL) and power coefficient (POW)

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Summary

Introduction

Vascular adhesion protein-1 (VAP-1) is a 180 kDa transmembrane homodimeric glycoprotein [1, 2]. VAP-1 has both enzymatic and non-enzymatic activities, and plays an important role in leukocyte trafficking and adhesion [3,4,5]. ASP8232 is a small molecule VAP-1 inhibitor that was evaluated for the treatment of diabetic kidney disease (DKD) as an add-on to first-line antihypertensive therapy in a Phase 2 study (ALBUM study). In this trial, ASP8232 was found effective in reducing albuminuria following a 12-week treatment with daily oral doses of 40 mg ASP8232 in DKD patients receiving standard of care, i.e. angiotensin converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) therapy [11].

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