Metabolism and Mass Balance of the Novel Nonsteroidal Androgen Receptor Inhibitor Darolutamide in Humans
作者:Päivi Taavitsainen、Olaf Prien、Marja Kähkönen、Michael Niehues、Timo Korjamo、Karsten Denner、Pirjo Nykänen、Annamari Vuorela、Natalia A. Jungmann、Clemens-Jeremias von Bühler、Mikko Koskinen、Christian Zurth、Hille Gieschen
DOI:10.1124/dmd.120.000309
日期:2021.6
The biotransformation and excretion of darolutamide were investigated in a phase I study. Six healthy male volunteers received a single dose of 300 mg 14C-darolutamide as an oral solution in the fasted state. Plasma, urine, and feces samples were analyzed for mass balance evaluation by liquid scintillation counting (LSC). Metabolite profiling and identification were determined using liquid chromatography mass-spectrometry with off-line radioactivity detection using LSC. Complete mass balance was achieved, with mean radioactivity recovery of 95.9% within 168 hours (63.4% in urine, 32.4% in feces). The administered 1:1 ratio of ( S , R )- and ( S , S )-darolutamide changed to approximately 1:5, respectively, in plasma. Darolutamide and the oxidation product, keto-darolutamide, were the only components quantifiable by LSC in plasma, accounting for 87.4% of total radioactivity, with a 2.1-fold higher plasma exposure for keto-darolutamide. Aside from darolutamide, the most prominent metabolites in urine were O -glucoronide (M-7a/b) and N -glucuronide (M-15a/b), as well as pyrazole sulfates (M-29, M-24) and glucuronides (M-21, M-22) resulting from oxidative cleavage of the parent. The darolutamide diastereomers were mainly detected in feces. In vitro assays showed that darolutamide metabolism involves a complex interplay between oxidation and reduction, as well as glucuronidation. Interconversion of the diastereomers involves oxidation to keto-darolutamide, primarily mediated by CYP3A4, followed by reduction predominantly catalyzed by cytosolic reductase(s), with aldo-keto reductase 1C3 playing the major role. The latter reaction showed stereoselectivity with preferential formation of ( S , S )-darolutamide. SIGNIFICANCE STATEMENT The metabolism and excretion of darolutamide in humans revealed that oxidation (CYP3A4) and glucuronidation (UGT1A9, UGT1A1) were the main metabolic routes of elimination. Direct excretion also contributed to overall clearance. The two pharmacologically equipotent diastereomers of darolutamide interconvert primarily via oxidation to the active metabolite keto-darolutamide, followed by reduction predominantly by cytosolic reductase(s). The latter reaction showed stereoselectivity with preferential formation of ( S,S )-darolutamide. Data indicate a low drug-drug interaction potential of darolutamide with inducers or inhibitors of metabolizing enzymes.
在一项Ⅰ期研究中,调查了达洛鲁胺的生物转化和排泄。六名健康男性志愿者在禁食状态下接受了一次性300毫克的14C-达洛鲁胺口服溶液。通过液体闪烁计数(LSC)分析血浆、尿液和粪便样本以评估质量平衡。使用液相色谱质谱联用(LC-MS)结合离线放射性检测(LSC)确定了代谢物的分析和鉴定。实现了完整的质量平衡,在168小时内平均放射性回收率为95.9%(尿液中63.4%,粪便中32.4%)。在血浆中,给药的(S,R)-和(S,S)-达洛鲁胺的1:1比率变化为大约1:5。达洛鲁胺和氧化产物酮-达洛鲁胺是血浆中唯一可被LSC定量的成分,占总体放射性的87.4%,而酮-达洛鲁胺的血浆暴露水平是达洛鲁胺的2.1倍。除了达洛鲁胺,尿液中最显著的代谢物是O-葡萄糖苷(M-7a/b)、N-葡萄糖苷(M-15a/b)、以及由母体氧化裂解产生的噻唑酯(M-29,M-24)和葡萄糖苷(M-21,M-22)。达洛鲁胺的互变异构体主要在粪便中被检测到。体外实验显示,达洛鲁胺代谢涉及氧化与还原的复杂相互作用,以及葡萄糖苷化。互变异构体的转化涉及氧化生成酮-达洛鲁胺,主要由CYP3A4介导,随后主要通过细胞质还原酶进行还原,其中醛酮还原酶1C3发挥主要作用。后者反应表现出立体选择性,偏向生成(S,S)-达洛鲁胺。
重要性声明:达洛鲁胺在人体内的代谢和排泄揭示氧化(CYP3A4)和葡萄糖苷化(UGT1A9,UGT1A1)是主要的代谢消除途径。直接排泄也对总体清除率有所贡献。两个药理效能相当的达洛鲁胺异构体主要通过氧化转化为活性代谢物酮-达洛鲁胺,随后主要通过细胞质还原酶还原。后者反应表现出立体选择性,偏向生成(S,S)-达洛鲁胺。数据显示达洛鲁胺与代谢酶诱导剂或抑制剂之间的药物相互作用潜力较低。