Equivalent dynamic human brain NK1-receptor occupancy following single-dose i.v. fosaprepitant vs. oral aprepitant as assessed by PET imaging.
The type 1 neurokinin receptor (NK1R) antagonist aprepitant and its i.v. prodrug fosaprepitant have been approved for prevention of acute and delayed nausea and vomiting associated with chemotherapy. This study evaluated the magnitude and duration of brain NK1R occupancy over a period of 5 days after single-dose i.v. infusion of 150-mg fosaprepitant and single-dose oral administration of 165-mg aprepitant, using serial [(18)F]MK-0999 positron emission tomography (PET) in 16 healthy subjects. Each subject underwent three scans. Brain NK1R occupancy rates after i.v. fosaprepitant at time to peak concentration (T(max); ~30 min), 24, 48, and 120 h after the dose were 100, 100, ≥97, and 41-75%, respectively. After aprepitant, NK1R occupancy rates at these time points (T(max) ~4 h) were ≥99, ≥99, ≥97, and 37-76%, respectively. Aprepitant plasma concentration profiles were comparable for the two dosage forms. The study illustrates the utility of PET imaging in determining central bioequivalence in a limited number of subjects.
Division of Nuclear Medicine, K.U. Leuven and University Hospital Leuven, Leuven, Belgium. koen.vanlaere@uzleuven.be
K
K
Van Laere
J
J
De Hoon
G
G
Bormans
M
M
Koole
I
I
Derdelinckx
I
I
De Lepeleire
R
R
Declercq
S M
SM
Sanabria Bohorquez
T
T
Hamill
P D
PD
Mozley
D
D
Tatosian
W
W
Xie
Y
Y
Liu
F
F
Liu
P
P
Zappacosta
C
C
Mahon
K L
KL
Butterfield
L B
LB
Rosen
M G
MG
Murphy
R J
RJ
Hargreaves
J A
JA
Wagner
C R
CR
Shadle
D000328:Adult; D000932:Antiemetics / Q000008:administration & dosage*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D000077608:Aprepitant; D001921:Brain / Q000000981:diagnostic imaging / Q000187:drug effects*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D009025:Morpholines / Q000008:administration & dosage* / Q000493:pharmacokinetics; D009325:Nausea / Q000139:chemically induced / Q000517:prevention & control*; D064729:Neurokinin-1 Receptor Antagonists; D049268:Positron-Emission Tomography; D011355:Prodrugs; D018040:Receptors, Neurokinin-1 / Q000378:metabolism; D013810:Therapeutic Equivalency; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control*; D055815:Young Adult
D000932:Antiemetics; D000970:Antineoplastic Agents; D009025:Morpholines; D064729:Neurokinin-1 Receptor Antagonists; D011355:Prodrugs; D018040:Receptors, Neurokinin-1; D000077608:Aprepitant; C579707:fosaprepitant