In drug discovery, the extent of brain penetration as measured by free brain/plasma concentration ratio (K) is normally determined from one experiment after constant intravenous infusion, and pharmacokinetics (PK) parameters, including clearance (CL), volume of distribution at steady state (Vss), and effective half-life ( ) are determined from another experiment after a single intravenous bolus injection. The objective of the present study was to develop and verify a method to simultaneously determine K and PK parameters from a single intravenous infusion experiment. In this study, nine compounds (atenolol, loperamide, minoxidil, -[3-(4'-fluorophenyl)-3-(4'-phenylphenoxy)propyl]sarcosine, sulpiride, and four proprietary compounds) were intravenously infused for 4 hours at 1 mg/kg or 24 hours at 1 or 6 mg/kg or bolus injected at 1 mg/kg. Plasma samples were serially collected, and brain and cerebrospinal fluid samples were collected at the end of infusion. The PK parameters were obtained using noncompartmental analysis (NCA) and compartmental analysis. The K values of those compounds increased up to 2.86-fold from 4 to 24 hours. The CL calculated from infusion rate over steady-state concentration from the 24-hour infusion studies was more consistent with the CL from the intravenous bolus studies than that from 4-hour infusion studies (CL avg. fold of difference 1.19-1.44 vs. 2.10). The compartmental analysis using one- and two-compartment models demonstrated better performance than NCA regardless of study design. In addition, volume of distribution at steady state and could be accurately obtained by one-compartment analysis within 2-fold difference. In conclusion, both unbound brain-to-plasma ratio and PK parameters can be successfully estimated from a 24-hour intravenous infusion study design. SIGNIFICANCE STATEMENT: We demonstrated that the extent of brain penetration and pharmacokinetic parameters (such as clearance, V, and effective ) can be determined from a single constant intravenous infusion study in rats.
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http://dx.doi.org/10.1124/dmd.120.000242 | DOI Listing |
Background: Alzheimer's disease (AD) is characterized by progressive atrophy of the cerebral cortex and hippocampus, with concomitant increase in ventricular volume. Lomecel-B is a novel cell-based therapeutic approach to AD that targets neuroinflammation, microvascular dysfunction, and has the potential to stimulate endogenous tissue regeneration. We conducted MRI analysis of brain morphology in the CLEAR-MIND study, a 49-patient proof-of-concept study that tested 3 different dosing regimens of Lomecel-B vs placebo in patients with mild AD dementia.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Vanderbilt University Medical Center, Nashville, TN, USA.
Background: We report the case of a 79-year-old woman with Alzheimer's disease who enrolled in a clinical study of lecanemab. After the third, biweekly infusion she suffered a seizure followed by aphasia and progressive encephalopathy. Magnetic resonance imaging revealed multifocal cerebral edema and an increased burden of cerebral microhemorrhages compared to pre-trial imaging.
View Article and Find Full Text PDFBackground: Lomecel-B is a novel cell-based therapy with potential to demonstrate clinical benefit on Alzheimer's disease (AD) and its progression. Here we present the results of a phase 2a proof-of-concept trial (n = 49) to further define the potential of Lomecel-B in patients with mild AD dementia.
Methods: This double-blind, randomized, placebo-controlled 45-week trial (ClinicalTrials.
Crit Care Resusc
December 2024
Paediatric Intensive Care Unit, Royal Children's Hospital, Melbourne, VIC, Australia.
Objective: Frusemide is a common diuretic administered to critically ill children intravenously, by either continuous infusion (CI) or intermittent bolus (IB). We aim to describe the characteristics of children who receive intravenous frusemide, patterns of use, and incidence of acute kidney injury (AKI), and to investigate factors associated with commencing CI.
Design: Retrospective observational study.
Objective: There is uncertainty about whether early infusion of intravenous amino acids confers clinical benefits in critically ill patients. In this study, we aimed to test the hypothesis that intravenous amino acids could improve 90-day mortality in critically ill patients with normal kidney function.
Design: This is a multicentre, open-label, randomised, parallel-controlled trial.
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