title: Blinded prospective evaluation of computer-based mechanistic schizophrenia disease model for predicting drug response.
abstract: The tremendous advances in understanding the neurobiological circuits involved in schizophrenia have not translated into more effective treatments. An alternative strategy is to use a recently published 'Quantitative Systems Pharmacology' computer-based mechanistic disease model of cortical/subcortical and striatal circuits based upon preclinical physiology, human pathology and pharmacology. The physiology of 27 relevant dopamine, serotonin, acetylcholine, norepinephrine, gamma-aminobutyric acid (GABA) and glutamate-mediated targets is calibrated using retrospective clinical data on 24 different antipsychotics. The model was challenged to predict quantitatively the clinical outcome in a blinded fashion of two experimental antipsychotic drugs; JNJ37822681, a highly selective low-affinity dopamine D(2) antagonist and ocaperidone, a very high affinity dopamine D(2) antagonist, using only pharmacology and human positron emission tomography (PET) imaging data. The model correctly predicted the lower performance of JNJ37822681 on the positive and negative syndrome scale (PANSS) total score and the higher extra-pyramidal symptom (EPS) liability compared to olanzapine and the relative performance of ocaperidone against olanzapine, but did not predict the absolute PANSS total score outcome and EPS liability for ocaperidone, possibly due to placebo responses and EPS assessment methods. Because of its virtual nature, this modeling approach can support central nervous system research and development by accounting for unique human drug properties, such as human metabolites, exposure, genotypes and off-target effects and can be a helpful tool for drug discovery and development.
authors.affiliation: In Silico Biosciences, Berwyn, Pennsylvania, United States of America. Hugo-Geerts@In-Silico-Biosciences.com
authors.forename: Hugo
authors.initials: H
authors.lastname: Geerts
authors.forename: Athan
authors.initials: A
authors.lastname: Spiros
authors.forename: Patrick
authors.initials: P
authors.lastname: Roberts
authors.forename: Roy
authors.initials: R
authors.lastname: Twyman
authors.forename: Larry
authors.initials: L
authors.lastname: Alphs
authors.forename: Anthony A
authors.initials: AA
authors.lastname: Grace
mesh_terms: D014150:Antipsychotic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D003198:Computer Simulation; D006801:Humans; D008959:Models, Neurological; D017072:Neostriatum / Q000187:drug effects; D010880:Piperidines / Q000494:pharmacology / Q000627:therapeutic use; D011446:Prospective Studies; D011724:Pyridazines / Q000494:pharmacology / Q000627:therapeutic use; D011744:Pyrimidinones / Q000494:pharmacology / Q000627:therapeutic use; D012559:Schizophrenia / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; C576398:N-(1-(3,4-difluorobenzyl)piperidin-4-yl)-6-(trifluoromethyl)pyridazin-3-amine; D010880:Piperidines; D011724:Pyridazines; D011744:Pyrimidinones; C072259:ocaperidone