Pharmacokinetic/pharmacodynamic modeling of renin biomarkers in subjects treated with the renin inhibitor aliskiren

Clin Pharmacol Ther. 2008 Jul;84(1):136-43. doi: 10.1038/sj.clpt.6100495. Epub 2008 Feb 20.

Abstract

A semimechanistic pharmacokinetic/pharmacodynamic (PK/PD) model was developed to evaluate the effects of aliskiren on the renin-angiotensin system (RAS) in humans. Mean data were extracted from a three-way crossover, placebo-controlled study. Outcome measures included the time-course of plasma renin activity (PRA) and plasma concentrations of aliskiren, active renin (AR), angiotensin I (ANG I), and angiotensin II (ANG II). The disposition of aliskiren may be best described as a two-compartment model with nonlinear elimination and distribution. The four biomarkers of RAS inhibition were co-modeled, and the AR showed a dose-dependent increase after the administration of aliskiren. This effect was described in terms of an indirect stimulatory response model in conjunction with an empirical submodel of functional adaptation. The estimated concentration of aliskiren necessary for producing 50% inhibition of PRA is 0.66 ng/ml, which is similar to in vitro estimates (0.33 ng/ml) after correction for plasma protein binding. The final and reduced models test the current hypothesis that RAS is inhibited by direct renin antagonism, and also provide suitable platforms for future clinical study design and analysis.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amides / blood
  • Amides / pharmacokinetics*
  • Amides / pharmacology*
  • Biomarkers / blood
  • Controlled Clinical Trials as Topic / methods
  • Cross-Over Studies
  • Dose-Response Relationship, Drug
  • Fumarates / blood
  • Fumarates / pharmacokinetics*
  • Fumarates / pharmacology*
  • Humans
  • Male
  • Models, Biological*
  • Renin / antagonists & inhibitors*
  • Renin / blood
  • Renin / metabolism*
  • Renin-Angiotensin System / drug effects
  • Renin-Angiotensin System / physiology

Substances

  • Amides
  • Biomarkers
  • Fumarates
  • aliskiren
  • Renin