title: Entry-into-human study with the novel immunosuppressant SDZ RAD in stable renal transplant recipients.
abstract: OBJECTIVE
  To evaluate the tolerability of single oral SDZ RAD doses in stable renal transplant recipients and the pharmacokinetics of ascending SDZ RAD doses when coadministered with steady-state cyclosporin A microemulsion (Neoral).
  
  
  METHODS
  This randomized, double-blind, placebo-controlled, sequential study involved 54 patients in six treatment groups; a different SDZ RAD dose (0.25, 0. 75, 2.5, 7.5, 15, 25 mg) was assessed in each group. Patients received a single oral dose of SDZ RAD (n=6) or placebo (n=3) with their usual Neoral dose. SDZ RAD and cyclosporin A pharmacokinetic parameters were determined.
  
  
  RESULTS
  All SDZ RAD doses were well tolerated, with no discontinuations due to adverse events, serious adverse events, or deaths. Similar proportions of patients receiving SDZ RAD and placebo had at least one adverse event (44% and 50%, respectively). Mean changes in laboratory variables (baseline to endpoint) showed no clinically meaningful differences between SDZ RAD and placebo groups. SDZ RAD was absorbed rapidly and showed dose-proportional pharmacokinetics (dose: 2.5-25 mg), based on systemic exposure. Multiple postabsorptive phases in the pharmacokinetic profile indicate tissue distribution. The elimination half-life ranged from 24 to 35 h across the five highest dose groups. Pharmacokinetics were similar in men and women. Co-administration of escalating single oral SDZ RAD doses did not affect steady-state cyclosporin A pharmacokinetics.
  
  
  CONCLUSIONS
  SDZ RAD was well tolerated; safety profiles of SDZ RAD and placebo were similar. SDZ RAD pharmacokinetics were dose-proportional across the range 2.5-25 mg in conjunction with cyclosporin A-based therapy, according to systemic exposure. Cyclosporin A pharmacokinetics were not affected by coadministration of single oral doses of 0.25-25 mg SDZ RAD.
authors.affiliation: Nephrology Section, University Hospital Charité, Berlin, Germany.
authors.forename: H H
authors.initials: HH
authors.lastname: Neumayer
authors.forename: K
authors.initials: K
authors.lastname: Paradis
authors.forename: A
authors.initials: A
authors.lastname: Korn
authors.forename: C
authors.initials: C
authors.lastname: Jean
authors.forename: L
authors.initials: L
authors.lastname: Fritsche
authors.forename: K
authors.initials: K
authors.lastname: Budde
authors.forename: M
authors.initials: M
authors.lastname: Winkler
authors.forename: V
authors.initials: V
authors.lastname: Kliem
authors.forename: R
authors.initials: R
authors.lastname: Pichlmayr
authors.forename: I A
authors.initials: IA
authors.lastname: Hauser
authors.forename: K
authors.initials: K
authors.lastname: Burkhardt
authors.forename: A E
authors.initials: AE
authors.lastname: Lison
authors.forename: I
authors.initials: I
authors.lastname: Barndt
authors.forename: S
authors.initials: S
authors.lastname: Appel-Dingemanse
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D016572:Cyclosporine / Q000008:administration & dosage / Q000493:pharmacokinetics; D004311:Double-Blind Method; D004655:Emulsions; D000068338:Everolimus; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000493:pharmacokinetics*; D016030:Kidney Transplantation / Q000276:immunology*; D007958:Leukocyte Count / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D010976:Platelet Count / Q000187:drug effects; D020123:Sirolimus / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000493:pharmacokinetics
chemical_list: D004655:Emulsions; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D000068338:Everolimus; D020123:Sirolimus