Population pharmacokinetic modeling and simulation to guide dose selection for RBP-7000, a new sustained-release formulation of risperidone

J Clin Pharmacol. 2015 Jan;55(1):93-103. doi: 10.1002/jcph.366. Epub 2014 Jul 23.

Abstract

RBP-7000 is a long-acting formulation of risperidone designed for once-monthly subcutaneous injection for the treatment of schizophrenia. The objective was to estimate clinically effective doses of RBP-7000 based on model simulations and on the comparison with other long-acting injectable antipsychotics. A population pharmacokinetic model of RBP-7000 was developed in 90 clinically stable schizophrenic patients having received single/repeated doses of 60, 90, or 120 mg. Model simulations were conducted to compare active moiety plasma exposure after repeated RBP-7000 administrations to the published data of long-acting risperidone injection (Risperdal® Consta®) at 25 and 50 mg, and of paliperidone palmitate (Invega® Sustenna®) at 50 and 100 mg equivalent paliperidone. Predictions of dopamine D2 receptor occupancy were derived from the simulated active moiety concentrations. Simulations showed similar active moiety plasma exposure at steady-state for 90 mg of RBP-7000 and 25 mg of long-acting risperidone. In comparison to risperidone, RBP-7000 reached effective concentrations immediately after the first administration. RBP-7000 at the doses of 60 and 90 mg provided similar active moiety plasma concentrations at steady-state compared to 50 and 100 mg equivalent paliperidone, respectively. These findings provide guidance for dose selection in Phase III clinical trials and suggest potential benefits for RBP-7000 over competitors.

Keywords: RBP-7000; dopamine D2 receptor occupancy; dose switching simulation; long-acting risperidone; paliperidone palmitate.

Publication types

  • Clinical Trial, Phase I
  • Clinical Trial, Phase II
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antipsychotic Agents / administration & dosage
  • Antipsychotic Agents / blood
  • Antipsychotic Agents / pharmacokinetics*
  • Delayed-Action Preparations / administration & dosage
  • Delayed-Action Preparations / pharmacokinetics
  • Female
  • Humans
  • Isoxazoles / administration & dosage
  • Isoxazoles / blood
  • Isoxazoles / pharmacokinetics
  • Male
  • Middle Aged
  • Models, Biological*
  • Paliperidone Palmitate
  • Palmitates / administration & dosage
  • Palmitates / blood
  • Palmitates / pharmacokinetics
  • Pyrimidines / blood
  • Risperidone / administration & dosage
  • Risperidone / blood
  • Risperidone / pharmacokinetics

Substances

  • Antipsychotic Agents
  • Delayed-Action Preparations
  • Isoxazoles
  • Palmitates
  • Pyrimidines
  • Risperidone
  • Paliperidone Palmitate