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ABSTRACT: Background
An urgent need remains for antiviral therapies to treat patients hospitalized with COVID-19. PF-07304814-the prodrug (lufotrelvir) and its active moiety (PF-00835231)-is a potent inhibitor of the SARS-CoV-2 3CL protease.Method
Eligible participants were 18 to 79 years old and hospitalized with confirmed COVID-19. This first-in-human phase 1b study was designed with 2 groups: single ascending dose (SAD) and multiple ascending dose (MAD). Participants could receive local standard-of-care therapy. In SAD, participants were randomized to receive a 24-hour infusion of lufotrelvir/placebo. In MAD, participants were randomized to receive a 120-hour infusion of lufotrelvir/placebo. The primary endpoint was to assess the safety and tolerability of lufotrelvir. The secondary endpoint was to evaluate the pharmacokinetics of lufotrelvir and PF-00835231.Results
In SAD, participants were randomized to receive 250 mg lufotrelvir (n = 2), 500 mg lufotrelvir (n = 2), or placebo (n = 4) by continuous 24-hour infusion. In MAD, participants were randomized to receive 250 mg lufotrelvir (n = 7), 500 mg lufotrelvir (n = 6), or placebo (n = 4) by continuous 120-hour infusion. No adverse events or serious adverse events were considered related to lufotrelvir. At doses of 250 and 500 mg, concentrations for the prodrug lufotrelvir and active moiety PF-00835231 increased in a dose-related manner. Unbound concentrations of the lufotrelvir active metabolite reached steady state approximately 2- and 4-fold that of in vitro EC90 following 250- and 500-mg doses, respectively.Conclusions
These safety and pharmacokinetic findings support the continued evaluation of lufotrelvir in clinical studies. Clinical Trials Registration. ClinicalTrials.gov NCT04535167.
SUBMITTER: Robinson P
PROVIDER: S-EPMC10407246 | biostudies-literature | 2023 Aug
REPOSITORIES: biostudies-literature
Robinson Philip P Toussi Sima S SS Aggarwal Sudeepta S Bergman Arthur A Zhu Tong T Hackman Frances F Sathish Jean G JG Updyke Lawrence L Loudon Peter P Krishna Ganesh G Clevenbergh Philippe P Hernandez-Mora Miguel Gorgolas MG Cisneros Herreros Jose Miguel JM Albertson Timothy E TE Dougan Michael M Thacker Amber A Baniecki Mary Lynn ML Soares Holly H Whitlock Mark M Nucci Gianluca G Menon Sandeep S Anderson Annaliesa S AS Binks Michael M
Open forum infectious diseases 20230710 8
<h4>Background</h4>An urgent need remains for antiviral therapies to treat patients hospitalized with COVID-19. PF-07304814-the prodrug (lufotrelvir) and its active moiety (PF-00835231)-is a potent inhibitor of the SARS-CoV-2 3CL protease.<h4>Method</h4>Eligible participants were 18 to 79 years old and hospitalized with confirmed COVID-19. This first-in-human phase 1b study was designed with 2 groups: single ascending dose (SAD) and multiple ascending dose (MAD). Participants could receive local ...[more]