Effect of food on the pharmacokinetics of zoliflodacin granules for oral suspension: Phase I open‐label randomized cross‐over study in healthy subjects

Abstract Gonorrhea is a sexually transmitted infection for which antibiotic treatment options have declined due to increasing antibiotic resistance. Zoliflodacin, an investigational oral spiropyrimidinetrione antibiotic with activity against Neisseria gonorrhoeae strains that are multidrug‐resistant...

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Main Authors: Alison Luckey, Emilie Alirol, Sophie Delhomme, John O'Donnell, Esther Bettiol, John Mueller, Seamus O'Brien, Jean‐Yves Gillon
Format: Article
Language:English
Published: Wiley 2023-05-01
Series:Clinical and Translational Science
Online Access:https://doi.org/10.1111/cts.13487
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author Alison Luckey
Emilie Alirol
Sophie Delhomme
John O'Donnell
Esther Bettiol
John Mueller
Seamus O'Brien
Jean‐Yves Gillon
author_facet Alison Luckey
Emilie Alirol
Sophie Delhomme
John O'Donnell
Esther Bettiol
John Mueller
Seamus O'Brien
Jean‐Yves Gillon
author_sort Alison Luckey
collection DOAJ
description Abstract Gonorrhea is a sexually transmitted infection for which antibiotic treatment options have declined due to increasing antibiotic resistance. Zoliflodacin, an investigational oral spiropyrimidinetrione antibiotic with activity against Neisseria gonorrhoeae strains that are multidrug‐resistant, including to third‐generation cephalosporins, is in phase III development for uncomplicated gonorrhea. This phase I, parallel, open‐label, randomized, crossover study in healthy adults evaluated the effect of food on the pharmacokinetics of single 3 or 4 g doses of zoliflodacin administered as granules for oral suspension in the fasted state or after consumption of a standardized high‐fat meal. Forty‐seven out of 48 randomized subjects completed the study. Oral administration of zoliflodacin with food delayed the absorption rate, compared with fasted state, with time to maximum concentration (Tmax) increasing from 3 to 6 h for the 3 g dose, and 2.5 to 4 h for the 4 g dose, but had no impact on the elimination of zoliflodacin. The maximum concentration (Cmax) and area under the plasma concentration‐time curve from time 0 to 24 h (AUC(0–24)) significantly increased with food by 52% and 94% for the 3 g dose, and by 89% and 108% for the 4 g dose. Forty‐two percent of participants reported a total of 34 treatment‐emergent adverse events (TEAEs), which were all considered mild in severity. Headache was the most common TEAE (22/48 subjects, 45.8%) and the only TEAE reported in more than one subject. In conclusion, administration of single 3 and 4 g doses of zoliflodacin as granules for oral suspension, with a high‐fat meal was well‐tolerated and resulted in statistically significant increases in peak and overall systemic exposure to zoliflodacin.
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spelling doaj.art-06e6f3f90fcb4202b94a93a19b09741c2023-05-12T07:05:38ZengWileyClinical and Translational Science1752-80541752-80622023-05-0116577078010.1111/cts.13487Effect of food on the pharmacokinetics of zoliflodacin granules for oral suspension: Phase I open‐label randomized cross‐over study in healthy subjectsAlison Luckey0Emilie Alirol1Sophie Delhomme2John O'Donnell3Esther Bettiol4John Mueller5Seamus O'Brien6Jean‐Yves Gillon7GARDP Geneva SwitzerlandGARDP Geneva SwitzerlandDNDi Geneva SwitzerlandEntasis Therapeutics Waltham Massachusetts USAGARDP Geneva SwitzerlandEntasis Therapeutics Waltham Massachusetts USAGARDP Geneva SwitzerlandDNDi Geneva SwitzerlandAbstract Gonorrhea is a sexually transmitted infection for which antibiotic treatment options have declined due to increasing antibiotic resistance. Zoliflodacin, an investigational oral spiropyrimidinetrione antibiotic with activity against Neisseria gonorrhoeae strains that are multidrug‐resistant, including to third‐generation cephalosporins, is in phase III development for uncomplicated gonorrhea. This phase I, parallel, open‐label, randomized, crossover study in healthy adults evaluated the effect of food on the pharmacokinetics of single 3 or 4 g doses of zoliflodacin administered as granules for oral suspension in the fasted state or after consumption of a standardized high‐fat meal. Forty‐seven out of 48 randomized subjects completed the study. Oral administration of zoliflodacin with food delayed the absorption rate, compared with fasted state, with time to maximum concentration (Tmax) increasing from 3 to 6 h for the 3 g dose, and 2.5 to 4 h for the 4 g dose, but had no impact on the elimination of zoliflodacin. The maximum concentration (Cmax) and area under the plasma concentration‐time curve from time 0 to 24 h (AUC(0–24)) significantly increased with food by 52% and 94% for the 3 g dose, and by 89% and 108% for the 4 g dose. Forty‐two percent of participants reported a total of 34 treatment‐emergent adverse events (TEAEs), which were all considered mild in severity. Headache was the most common TEAE (22/48 subjects, 45.8%) and the only TEAE reported in more than one subject. In conclusion, administration of single 3 and 4 g doses of zoliflodacin as granules for oral suspension, with a high‐fat meal was well‐tolerated and resulted in statistically significant increases in peak and overall systemic exposure to zoliflodacin.https://doi.org/10.1111/cts.13487
spellingShingle Alison Luckey
Emilie Alirol
Sophie Delhomme
John O'Donnell
Esther Bettiol
John Mueller
Seamus O'Brien
Jean‐Yves Gillon
Effect of food on the pharmacokinetics of zoliflodacin granules for oral suspension: Phase I open‐label randomized cross‐over study in healthy subjects
Clinical and Translational Science
title Effect of food on the pharmacokinetics of zoliflodacin granules for oral suspension: Phase I open‐label randomized cross‐over study in healthy subjects
title_full Effect of food on the pharmacokinetics of zoliflodacin granules for oral suspension: Phase I open‐label randomized cross‐over study in healthy subjects
title_fullStr Effect of food on the pharmacokinetics of zoliflodacin granules for oral suspension: Phase I open‐label randomized cross‐over study in healthy subjects
title_full_unstemmed Effect of food on the pharmacokinetics of zoliflodacin granules for oral suspension: Phase I open‐label randomized cross‐over study in healthy subjects
title_short Effect of food on the pharmacokinetics of zoliflodacin granules for oral suspension: Phase I open‐label randomized cross‐over study in healthy subjects
title_sort effect of food on the pharmacokinetics of zoliflodacin granules for oral suspension phase i open label randomized cross over study in healthy subjects
url https://doi.org/10.1111/cts.13487
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