Dotinurad: a clinical pharmacokinetic study of a novel, selective urate reabsorption inhibitor in subjects with hepatic impairment

Clin Exp Nephrol. 2020 Mar;24(Suppl 1):25-35. doi: 10.1007/s10157-019-01816-4. Epub 2019 Nov 23.

Abstract

Background: Dotinurad is a novel, selective urate reabsorption inhibitor, which reduces serum uric acid levels by inhibiting the urate transporter 1 (URAT1). We compared the pharmacokinetics (PK), pharmacodynamics (PD), and safety of dotinurad in subjects with hepatic impairment and normal hepatic function.

Methods: This was a multicenter, open-label, single dose study. A total of 24 subjects were divided into four groups: the normal hepatic function group and the mild, moderate, and severe hepatic impairment groups. The primary endpoints were changes in plasma dotinurad levels and PK parameters.

Results: The geometric mean ratio of the maximum plasma concentration (Cmax) [two-sided 90% confidence interval (CI)] of dotinurad in in the mild, moderate, and severe hepatic impairment groups relative to that in the normal hepatic function group was 0.840 (0.674-1.047), 0.798 (0.653-0.976), and 0.747 (0.570-0.979), respectively, showing a lower Cmax in the moderate and severe hepatic impairment groups. Following adjustment for body weight, only the moderate hepatic impairment group had a lower Cmax than the normal hepatic function group. No meaningful differences in other PK parameters were observed between the groups. Regarding the PD of dotinurad, the changes in serum uric acid levels after dosing were similar in all groups. As for safety, no noteworthy concerns were raised in relation to any group.

Conclusion: The study revealed no clinically meaningful influence of hepatic impairment on the PK, PD, or safety of dotinurad. These findings indicate possibility that dotinurad can be used without dose adjustment in patients with hepatic impairment.

Keywords: Dotinurad; Hepatic impairment; Pharmacodynamics; Pharmacokinetics; Selective urate reabsorption inhibitor (SURI); URAT1 inhibitor.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Benzothiazoles / adverse effects
  • Benzothiazoles / pharmacokinetics*
  • Benzothiazoles / pharmacology
  • Female
  • Humans
  • Japan
  • Liver Diseases / physiopathology*
  • Male
  • Middle Aged
  • Uric Acid / blood*
  • Uricosuric Agents / pharmacokinetics*

Substances

  • Benzothiazoles
  • Uricosuric Agents
  • Uric Acid
  • dotinurad