Phase I Safety and Pharmacokinetic Studies of Brequinar Sodium after Single Ascending Oral Doses in Stable Renal, Hepatic, and Cardiac Allograft Recipients

• Published in: Journal of clinical pharmacology 1997-12, Vol.37 (12), p.1121-1128
• Main Authors: Joshi, Amita S., King, Shang-Ying P., Zajac, Barbara A., Makowka, Leonard, Sher, Linda S., Kahan, Barry D., Menkis, Alan H., Stiller, Calvin R., Schaefle, Brigitte, Kornhauser, David M.
• Format: Article
• Language: English
• Subjects: Administration, Oral; Adult; Aged; Biological and medical sciences; Biphenyl Compounds - blood; Biphenyl Compounds - pharmacokinetics; Cyclosporine - blood; Cyclosporine - pharmacokinetics; Female; Heart Transplantation - physiology; Humans; Immunomodulators; Immunosuppressive Agents - blood; Immunosuppressive Agents - pharmacokinetics; Kidney Transplantation - physiology; Liver Transplantation - physiology; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments
• ISSN: 0091-2700; 1552-4604
• DOI: 10.1002/j.1552-4604.1997.tb04296.x

Brequinar sodium (BQR), a substituted 4‐quinoline carboxylic acid, was in clinical development in combination with cyclosporine (CsA) as a potentially effective therapy for the treatment and prophylaxis of rejection in organ transplant patients. This phase I study was performed in stable renal, hepatic, and cardiac transplant patients receiving CsA and prednisone maintenance therapy for immunosuppression. The pharmacokinetic objectives of this study were to characterize the pharmacokinetics of (a) single oral 0.5‐ to 4‐mg/kg doses of BQR when given in combination with CsA and prednisone to stable renal, hepatic, and cardiac transplant patients and (b) steady‐state oral doses of CsA, with and without single oral doses of BQR. In all three patient populations, the pharmacokinetics of BQR were characterized by a lower oral clearance (12–19 mL/min) than that seen in previous studies in patients with cancer (∼30 mL/min at similar doses) and a long terminal half life (13–18 hrs). This slower oral clearance for BQR could be due either to a drug interaction between BQR and CsA or to altered clearance or metabolic processes in patients with transplants. Steady‐state CsA trough levels and the oral clearance of CsA were not affected by BQR coadministration. Among the three transplant populations, the cardiac transplant patients had lower oral clearance values of BQR and of CsA. The cause of this lower clearance is not known. Safety results indicate that BQR was well tolerated by this patient population.