title: Assessment of the effects of renal impairment on the pharmacokinetics of the soluble guanylate cyclase activator cinaciguat after a single intravenous dose.
abstract: This open-label, parallel-group, single-dose study assessed the safety and pharmacokinetics of cinaciguat, a novel soluble guanylate cyclase activator in clinical development for the treatment of acute decompensated heart failure, in individuals with mild, moderate, or severe renal impairment compared with individuals with normal renal function. Cinaciguat was administered as a 100 µg/h continuous infusion over 4 hours. Plasma concentrations were determined by high-performance liquid chromatography coupled with mass spectrometry. Renal function had only minor effects on the pharmacokinetics of cinaciguat. The apparent volume of distribution at steady state was slightly increased in individuals with renal impairment. The total body clearance from plasma showed a slight tendency to increase with progression of renal impairment, which can be explained by an increased hematocrit in individuals with renal impairment. No relevant influence was found on the terminal half-life. The fraction of cinaciguat unbound in plasma was very low (<1%) in all groups. Pharmacokinetic variability tended to be somewhat increased in individuals with renal impairment. Adverse events were mostly mild, and their incidence was similar in all groups. In conclusion, cinaciguat, a promising drug candidate for the treatment of acute decompensated heart failure, will not require dose adjustment based on renal function.
authors.affiliation: Bayer HealthCare Pharmaceuticals Inc, Montville, NJ, USA.
authors.forename: John T
authors.initials: JT
authors.lastname: Lettieri
authors.forename: Christian
authors.initials: C
authors.lastname: Scheerans
authors.forename: Martin
authors.initials: M
authors.lastname: Blunck
authors.forename: Arthur L
authors.initials: AL
authors.lastname: Mazzu
authors.forename: Reiner
authors.initials: R
authors.lastname: Frey
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Mück
authors.forename: Pavur R
authors.initials: PR
authors.lastname: Sundaresan
mesh_terms: D000328:Adult; D000368:Aged; D001565:Benzoates / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics*; D002851:Chromatography, High Pressure Liquid / Q000379:methods; D005260:Female; D006162:Guanylate Cyclase / Q000378:metabolism*; D006207:Half-Life; D006333:Heart Failure / Q000188:drug therapy* / Q000378:metabolism; D006801:Humans; D008297:Male; D013058:Mass Spectrometry / Q000379:methods; D008875:Middle Aged; D018160:Receptors, Cytoplasmic and Nuclear / Q000378:metabolism*; D051437:Renal Insufficiency / Q000378:metabolism / Q000503:physiopathology*; D000071756:Soluble Guanylyl Cyclase
chemical_list: D001565:Benzoates; D018160:Receptors, Cytoplasmic and Nuclear; C480588:BAY 58-2667; D006162:Guanylate Cyclase; D000071756:Soluble Guanylyl Cyclase