Antiresorptive effect of a cathepsin K inhibitor ONO-5334 and its relationship to BMD increase in a phase II trial for postmenopausal osteoporosis

Abstract Background ONO-5334 is a cathepsin K inhibitor that induced bone mineral density (BMD) gain in a phase II study in postmenopausal osteoporosis patients. Even though the antiresorptive effect could only be monitored in the morning during the study, simulation can allow the antiresorptive eff...

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Main Authors: Makoto Tanaka, Yoshitaka Hashimoto, Chihiro Hasegawa, Steve Deacon, Richard Eastell
Format: Article
Language:English
Published: BMC 2017-06-01
Series:BMC Musculoskeletal Disorders
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12891-017-1625-y
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author Makoto Tanaka
Yoshitaka Hashimoto
Chihiro Hasegawa
Steve Deacon
Richard Eastell
author_facet Makoto Tanaka
Yoshitaka Hashimoto
Chihiro Hasegawa
Steve Deacon
Richard Eastell
author_sort Makoto Tanaka
collection DOAJ
description Abstract Background ONO-5334 is a cathepsin K inhibitor that induced bone mineral density (BMD) gain in a phase II study in postmenopausal osteoporosis patients. Even though the antiresorptive effect could only be monitored in the morning during the study, simulation can allow the antiresorptive effect to be assessed over 24 h, with assessment of the relationship to BMD gain. Methods Inhibition of the serum C-telopeptide of type I collagen (sCTX) level at doses of ONO-5334 of 100 mg once daily (QD), 300 mg QD, and 50 mg twice daily (BID) was simulated using plasma ONO-5334 pharmacokinetic (PK) data for repeated dose administration in a phase I study and corresponding sCTX inhibition from the PK-pharmacodynamic (PK/PD) relationship. sCTX was selected because it has a high signal-to-noise ratio compared to other telopeptides. A negative sigmoidal shape for the PK/PD relationship between plasma ONO-5334 and sCTX levels was obtained in our previous study. Results The simulated sCTX inhibition reached >99% of the maximal inhibitory effect (Emax) at 0.5 h in all treatment groups, and decreased to <80% Emax at 8 and 12 h at 50 mg BID and 100 mg QD, respectively. However, sCTX inhibition at 300 mg QD was maintained at ≥82% Emax over 24 h. The mean sCTX inhibition rates for 24 h at 100 mg QD, 300 mg QD and 50 mg BID were 63, 95 and 80% Emax, respectively. There was a positive linear relationship by treatment group between mean sCTX inhibition over 24 h and observed BMD gain in the phase II study. Conclusion The dose response for BMD with ONO-5334 at 100 and 300 mg QD and higher BMD gain at 50 mg BID vs. 100 mg QD can be explained by sCTX inhibition over 24 h. The simulation gave the antiresorptive effect of ONO-5334 over 24 h and allowed prediction of BMD gain due to ONO-5334. Trial registration The registration number in The European Union Clinical Trials Register is 2007–002417-39 . The date of registration was August 31, 2007.
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spelling doaj.art-c573300c5eeb4f41a34f190c3a32f7db2022-12-22T01:25:20ZengBMCBMC Musculoskeletal Disorders1471-24742017-06-011811910.1186/s12891-017-1625-yAntiresorptive effect of a cathepsin K inhibitor ONO-5334 and its relationship to BMD increase in a phase II trial for postmenopausal osteoporosisMakoto Tanaka0Yoshitaka Hashimoto1Chihiro Hasegawa2Steve Deacon3Richard Eastell4Research Promotion, Ono Pharmaceutical Co., LtdTranslational Medicine Center, Ono Pharmaceutical Co., LtdTranslational Medicine Center, Ono Pharmaceutical Co., LtdClinical Development, Ono Pharma UK LtdAcademic Unit of Bone Metabolism, University of SheffieldAbstract Background ONO-5334 is a cathepsin K inhibitor that induced bone mineral density (BMD) gain in a phase II study in postmenopausal osteoporosis patients. Even though the antiresorptive effect could only be monitored in the morning during the study, simulation can allow the antiresorptive effect to be assessed over 24 h, with assessment of the relationship to BMD gain. Methods Inhibition of the serum C-telopeptide of type I collagen (sCTX) level at doses of ONO-5334 of 100 mg once daily (QD), 300 mg QD, and 50 mg twice daily (BID) was simulated using plasma ONO-5334 pharmacokinetic (PK) data for repeated dose administration in a phase I study and corresponding sCTX inhibition from the PK-pharmacodynamic (PK/PD) relationship. sCTX was selected because it has a high signal-to-noise ratio compared to other telopeptides. A negative sigmoidal shape for the PK/PD relationship between plasma ONO-5334 and sCTX levels was obtained in our previous study. Results The simulated sCTX inhibition reached >99% of the maximal inhibitory effect (Emax) at 0.5 h in all treatment groups, and decreased to <80% Emax at 8 and 12 h at 50 mg BID and 100 mg QD, respectively. However, sCTX inhibition at 300 mg QD was maintained at ≥82% Emax over 24 h. The mean sCTX inhibition rates for 24 h at 100 mg QD, 300 mg QD and 50 mg BID were 63, 95 and 80% Emax, respectively. There was a positive linear relationship by treatment group between mean sCTX inhibition over 24 h and observed BMD gain in the phase II study. Conclusion The dose response for BMD with ONO-5334 at 100 and 300 mg QD and higher BMD gain at 50 mg BID vs. 100 mg QD can be explained by sCTX inhibition over 24 h. The simulation gave the antiresorptive effect of ONO-5334 over 24 h and allowed prediction of BMD gain due to ONO-5334. Trial registration The registration number in The European Union Clinical Trials Register is 2007–002417-39 . The date of registration was August 31, 2007.http://link.springer.com/article/10.1186/s12891-017-1625-yCathepsin KONO-5334Bone resorptionPK/PD relationshipOCEAN study
spellingShingle Makoto Tanaka
Yoshitaka Hashimoto
Chihiro Hasegawa
Steve Deacon
Richard Eastell
Antiresorptive effect of a cathepsin K inhibitor ONO-5334 and its relationship to BMD increase in a phase II trial for postmenopausal osteoporosis
BMC Musculoskeletal Disorders
Cathepsin K
ONO-5334
Bone resorption
PK/PD relationship
OCEAN study
title Antiresorptive effect of a cathepsin K inhibitor ONO-5334 and its relationship to BMD increase in a phase II trial for postmenopausal osteoporosis
title_full Antiresorptive effect of a cathepsin K inhibitor ONO-5334 and its relationship to BMD increase in a phase II trial for postmenopausal osteoporosis
title_fullStr Antiresorptive effect of a cathepsin K inhibitor ONO-5334 and its relationship to BMD increase in a phase II trial for postmenopausal osteoporosis
title_full_unstemmed Antiresorptive effect of a cathepsin K inhibitor ONO-5334 and its relationship to BMD increase in a phase II trial for postmenopausal osteoporosis
title_short Antiresorptive effect of a cathepsin K inhibitor ONO-5334 and its relationship to BMD increase in a phase II trial for postmenopausal osteoporosis
title_sort antiresorptive effect of a cathepsin k inhibitor ono 5334 and its relationship to bmd increase in a phase ii trial for postmenopausal osteoporosis
topic Cathepsin K
ONO-5334
Bone resorption
PK/PD relationship
OCEAN study
url http://link.springer.com/article/10.1186/s12891-017-1625-y
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