Pharmacokinetics and Pharmacodynamics of Rusfertide, a Hepcidin Mimetic, Following Subcutaneous Administration of a Lyophilized Powder Formulation in Healthy Volunteers

Abstract Background and Objective Hepcidin, an endogenous peptide hormone, binds to ferroportin and is the master regulator of iron trafficking. Rusfertide, a synthetic peptide, is a potent hepcidin mimetic. Clinical studies suggest rusfertide may be effective in the treatment of polycythemia vera....

Full description

Saved in:
Bibliographic Details
Main Authors: Nishit B. Modi, Sarita Khanna, Sneha Rudraraju, Frank Valone
Format: Article
Language:English
Published: Adis, Springer Healthcare 2024-11-01
Series:Drugs in R&D
Online Access:https://doi.org/10.1007/s40268-024-00497-z
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850253909878112256
author Nishit B. Modi
Sarita Khanna
Sneha Rudraraju
Frank Valone
author_facet Nishit B. Modi
Sarita Khanna
Sneha Rudraraju
Frank Valone
author_sort Nishit B. Modi
collection DOAJ
description Abstract Background and Objective Hepcidin, an endogenous peptide hormone, binds to ferroportin and is the master regulator of iron trafficking. Rusfertide, a synthetic peptide, is a potent hepcidin mimetic. Clinical studies suggest rusfertide may be effective in the treatment of polycythemia vera. This study investigated the dose-ranging pharmacokinetics, pharmacodynamics, and safety of a lyophilized formulation of rusfertide. Methods A randomized open-label crossover study was conducted in two groups of healthy adult subjects to evaluate the safety, tolerability, pharmacokinetics, and pharmacodynamics of subcutaneous rusfertide doses that ranged from 10 to 60 mg of a lyophilized formulation and 20 mg of an aqueous prefilled syringe formulation that were used in clinical trials. Results Rusfertide showed a rapid initial absorption. Median time to peak plasma concentrations for the lyophilized formulation was 24 h for doses of 10–30 mg and 2–4 h for doses of 45 and 60 mg. Mean terminal half-life ranged from 19.6 to 57.1 h. Rusfertide peak concentration and area under the concentration–time curve increased with an increasing dose, but in a less than dose-proportional manner. Metabolites M4 and M9 were identified as major metabolites. At the rusfertide 20-mg dose, the lyophilized formulation had an area under the concentration–time curve from time zero to infinity approximately 1.5-fold higher than the aqueous formulation. The elimination half-life was comparable for the two formulations. Dose-related decreases in serum iron and transferrin-iron saturation were seen following rusfertide treatment. The majority of treatment-emergent adverse events were mild; treatment-related treatment-emergent adverse events seen in ≥10% of subjects were injection-site erythema and injection-site pruritus. Conclusions Rusfertide was well tolerated; the pharmacokinetic and pharmacodynamic results indicate that lyophilized rusfertide is suitable for once-weekly or twice-weekly administration.
format Article
id doaj-art-9fe984d68e7c4b589d6ab2d3f7689ceb
institution OA Journals
issn 1174-5886
1179-6901
language English
publishDate 2024-11-01
publisher Adis, Springer Healthcare
record_format Article
series Drugs in R&D
spelling doaj-art-9fe984d68e7c4b589d6ab2d3f7689ceb2025-08-20T01:57:15ZengAdis, Springer HealthcareDrugs in R&D1174-58861179-69012024-11-0124453955210.1007/s40268-024-00497-zPharmacokinetics and Pharmacodynamics of Rusfertide, a Hepcidin Mimetic, Following Subcutaneous Administration of a Lyophilized Powder Formulation in Healthy VolunteersNishit B. Modi0Sarita Khanna1Sneha Rudraraju2Frank Valone3Protagonist Therapeutics, Inc.Protagonist Therapeutics, Inc.Protagonist Therapeutics, Inc.Protagonist Therapeutics, Inc.Abstract Background and Objective Hepcidin, an endogenous peptide hormone, binds to ferroportin and is the master regulator of iron trafficking. Rusfertide, a synthetic peptide, is a potent hepcidin mimetic. Clinical studies suggest rusfertide may be effective in the treatment of polycythemia vera. This study investigated the dose-ranging pharmacokinetics, pharmacodynamics, and safety of a lyophilized formulation of rusfertide. Methods A randomized open-label crossover study was conducted in two groups of healthy adult subjects to evaluate the safety, tolerability, pharmacokinetics, and pharmacodynamics of subcutaneous rusfertide doses that ranged from 10 to 60 mg of a lyophilized formulation and 20 mg of an aqueous prefilled syringe formulation that were used in clinical trials. Results Rusfertide showed a rapid initial absorption. Median time to peak plasma concentrations for the lyophilized formulation was 24 h for doses of 10–30 mg and 2–4 h for doses of 45 and 60 mg. Mean terminal half-life ranged from 19.6 to 57.1 h. Rusfertide peak concentration and area under the concentration–time curve increased with an increasing dose, but in a less than dose-proportional manner. Metabolites M4 and M9 were identified as major metabolites. At the rusfertide 20-mg dose, the lyophilized formulation had an area under the concentration–time curve from time zero to infinity approximately 1.5-fold higher than the aqueous formulation. The elimination half-life was comparable for the two formulations. Dose-related decreases in serum iron and transferrin-iron saturation were seen following rusfertide treatment. The majority of treatment-emergent adverse events were mild; treatment-related treatment-emergent adverse events seen in ≥10% of subjects were injection-site erythema and injection-site pruritus. Conclusions Rusfertide was well tolerated; the pharmacokinetic and pharmacodynamic results indicate that lyophilized rusfertide is suitable for once-weekly or twice-weekly administration.https://doi.org/10.1007/s40268-024-00497-z
spellingShingle Nishit B. Modi
Sarita Khanna
Sneha Rudraraju
Frank Valone
Pharmacokinetics and Pharmacodynamics of Rusfertide, a Hepcidin Mimetic, Following Subcutaneous Administration of a Lyophilized Powder Formulation in Healthy Volunteers
Drugs in R&D
title Pharmacokinetics and Pharmacodynamics of Rusfertide, a Hepcidin Mimetic, Following Subcutaneous Administration of a Lyophilized Powder Formulation in Healthy Volunteers
title_full Pharmacokinetics and Pharmacodynamics of Rusfertide, a Hepcidin Mimetic, Following Subcutaneous Administration of a Lyophilized Powder Formulation in Healthy Volunteers
title_fullStr Pharmacokinetics and Pharmacodynamics of Rusfertide, a Hepcidin Mimetic, Following Subcutaneous Administration of a Lyophilized Powder Formulation in Healthy Volunteers
title_full_unstemmed Pharmacokinetics and Pharmacodynamics of Rusfertide, a Hepcidin Mimetic, Following Subcutaneous Administration of a Lyophilized Powder Formulation in Healthy Volunteers
title_short Pharmacokinetics and Pharmacodynamics of Rusfertide, a Hepcidin Mimetic, Following Subcutaneous Administration of a Lyophilized Powder Formulation in Healthy Volunteers
title_sort pharmacokinetics and pharmacodynamics of rusfertide a hepcidin mimetic following subcutaneous administration of a lyophilized powder formulation in healthy volunteers
url https://doi.org/10.1007/s40268-024-00497-z
work_keys_str_mv AT nishitbmodi pharmacokineticsandpharmacodynamicsofrusfertideahepcidinmimeticfollowingsubcutaneousadministrationofalyophilizedpowderformulationinhealthyvolunteers
AT saritakhanna pharmacokineticsandpharmacodynamicsofrusfertideahepcidinmimeticfollowingsubcutaneousadministrationofalyophilizedpowderformulationinhealthyvolunteers
AT sneharudraraju pharmacokineticsandpharmacodynamicsofrusfertideahepcidinmimeticfollowingsubcutaneousadministrationofalyophilizedpowderformulationinhealthyvolunteers
AT frankvalone pharmacokineticsandpharmacodynamicsofrusfertideahepcidinmimeticfollowingsubcutaneousadministrationofalyophilizedpowderformulationinhealthyvolunteers