title: Odanacatib, a selective cathepsin K inhibitor to treat osteoporosis: safety, tolerability, pharmacokinetics and pharmacodynamics--results from single oral dose studies in healthy volunteers.
abstract: OBJECTIVE
  To evaluate the safety, tolerability, pharmacokinetics and pharmacodynamics of odanacatib (ODN), a cathepsin K inhibitor, in humans.
  
  
  METHODS
  Two double-blind, randomized, placebo-controlled, single oral dose studies were performed with ODN (2-600 mg) in 44 healthy volunteers (36 men and eight postmenopausal women).
  
  
  RESULTS
  Adverse experiences (AEs) with single doses of ODN were transient and mild to moderate, with the exception of one severe AE of gastroenteritis. Headache was the most frequent AE. After absorption of ODN (initial peak concentrations 4-6 h postdose), plasma concentrations exhibited a monophasic decline, with an apparent terminal half-life of ∼40-80 h. The area under the curve0-24 hours (AUC(0-24 h)), concentration at 24 hours (C(24 h)) and maximum concentration (C(max,overal)) increased in a less than dose-proportional manner from 2 to 600 mg. Administration of ODN with a high-fat meal led to ∼100% increases in AUC(0-24 h), C(max,day1), C(max,overall) and C(24 h) relative to the fasted state, while administration with a low-fat meal led to a ∼30% increase in those parameters. Reduction of biomarkers of bone resorption, the C- and N-telopeptides of cross-links of type I collagen, (CTx and NTx, respectively), was noted at 24 h for doses ≥5 mg and at 168 h postdose for ≥10 mg. In postmenopausal women administered 50 mg ODN, reductions in serum CTx of -66% and urine NTx/creatinine (uNTx/Cr) of -51% relative to placebo were observed at 24 h. At 168 h, reductions in serum CTx (-70%) and uNTx/Cr (-78%) were observed relative to baseline. Pharmacokinetic/pharmacodynamic modeling characterized the ODN concentration/uNTx/Cr relation, with a modeled EC50 value of 43.8 nM and ∼80% maximal reduction.
  
  
  CONCLUSIONS
  Odanacatib was well tolerated and has a pharmacokinetic and pharmacodynamic profile suitable for once weekly dosing.
authors.affiliation: Merck Sharp & Dohme Corp., Whitehouse Station, NJ, USA. aubrey.stoch@merck.com
authors.forename: S Aubrey
authors.initials: SA
authors.lastname: Stoch
authors.forename: Stefan
authors.initials: S
authors.lastname: Zajic
authors.forename: Julie A
authors.initials: JA
authors.lastname: Stone
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Miller
authors.forename: Lucas
authors.initials: L
authors.lastname: van Bortel
authors.forename: Kenneth C
authors.initials: KC
authors.lastname: Lasseter
authors.forename: Barnali
authors.initials: B
authors.lastname: Pramanik
authors.forename: Caroline
authors.initials: C
authors.lastname: Cilissen
authors.forename: Qi
authors.initials: Q
authors.lastname: Liu
authors.forename: Lida
authors.initials: L
authors.lastname: Liu
authors.forename: Boyd B
authors.initials: BB
authors.lastname: Scott
authors.forename: Deborah
authors.initials: D
authors.lastname: Panebianco
authors.forename: Yu
authors.initials: Y
authors.lastname: Ding
authors.forename: Keith
authors.initials: K
authors.lastname: Gottesdiener
authors.forename: John A
authors.initials: JA
authors.lastname: Wagner
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001713:Biphenyl Compounds / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology*; D001862:Bone Resorption / Q000378:metabolism; D056657:Cathepsin K / Q000037:antagonists & inhibitors*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004791:Enzyme Inhibitors / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology*; D005260:Female; D006207:Half-Life; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000188:drug therapy* / Q000378:metabolism; D055815:Young Adult
chemical_list: D001713:Biphenyl Compounds; D004791:Enzyme Inhibitors; D056657:Cathepsin K; C527128:odanacatib