Multiple daytime administration of the selective orexin-2 receptor antagonist JNJ-42847922 induces somnolence in healthy subjects without residual central effects

J Psychopharmacol. 2018 Dec;32(12):1330-1340. doi: 10.1177/0269881118791521. Epub 2018 Sep 5.

Abstract

Background: Pharmacokinetics, pharmacodynamics and general safety and tolerability of JNJ-42847922, a selective orexin-2 receptor antagonist, were assessed in healthy subjects.

Methods: Five consecutive cohorts of healthy subjects were enrolled and received doses of 5-60 mg orally once daily over 10 days of JNJ-42847922 ( n=6) or placebo ( n=2). Concentrations of drug in plasma and urine were measured over 24 h after dosing on Days 1, 5 and 10. Observed- and self-reported somnolence was used to evaluate the principal pharmacodynamic effect of JNJ-42847922. A test battery to assess vigilance state, sedation and alertness was assessed at 4, 6 and 8 h after dosing. Safety assessments included recording of adverse events, vital signs, electrocardiograms, clinical laboratory assessments and suicidality per Columbia Suicide Severity Rating Scale.

Results: JNJ-42847922 was rapidly absorbed after the morning dose administration. The median tmax ranged from 0.5-1.5 h and mean t1/2 values from 2-3 h. At JNJ-42847922 dose levels ⩾20 mg, mean Cmax and mean area under the curve, values increased less than dose proportionally. At doses ⩾20 mg, JNJ-42847922 consistently induced somnolence on all study days. At four hours post-dose administration, dose levels >5 mg JNJ-42847922 were identified as sedating by the Addiction Research Center Inventory-49. Except for a mild decrease in attention (Bond and Lader Visual Analogue Scale Factor 1) at dose levels >10 mg at four hours post-dose, no clinically relevant changes in other central measures have been observed. JNJ-42847922 was well tolerated.

Keywords: Alertness; JNJ-42847922; orexin-2; pharmacodynamics; pharmacokinetics.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adolescent
  • Adult
  • Area Under Curve
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Female
  • Half-Life
  • Humans
  • Male
  • Middle Aged
  • Orexin Receptor Antagonists / administration & dosage*
  • Orexin Receptor Antagonists / pharmacokinetics
  • Orexin Receptor Antagonists / pharmacology
  • Orexin Receptors / drug effects*
  • Orexin Receptors / metabolism
  • Pyrimidines / administration & dosage*
  • Pyrimidines / pharmacokinetics
  • Pyrimidines / pharmacology
  • Pyrroles / administration & dosage*
  • Pyrroles / pharmacokinetics
  • Pyrroles / pharmacology
  • Sleepiness*
  • Time Factors
  • Triazoles / administration & dosage*
  • Triazoles / pharmacokinetics
  • Triazoles / pharmacology
  • Young Adult

Substances

  • Orexin Receptor Antagonists
  • Orexin Receptors
  • Pyrimidines
  • Pyrroles
  • Triazoles
  • seltorexant