SAGE-217, A Novel GABAA Receptor Positive Allosteric Modulator: Clinical Pharmacology and Tolerability in Randomized Phase I Dose-Finding Studies

Clin Pharmacokinet. 2020 Jan;59(1):111-120. doi: 10.1007/s40262-019-00801-0.

Abstract

Background: SAGE-217, a novel γ-aminobutyric acid A (GABAA) receptor positive allosteric modulator, was evaluated in phase I, double-blind, placebo-controlled, single ascending dose (SAD) and multiple ascending dose (MAD) studies to assess the safety and pharmacokinetics (PK) of SAGE-217 following administration as an oral solution.

Methods: In the SAD study, subjects were randomized 6:2 to a single dose of SAGE-217 or placebo. Doses ranged from 0.25 to 66 mg across nine cohorts. In the MAD study, subjects were randomized 9:3 and received SAGE-217 (15, 30, or 35 mg) or placebo once daily for 7 days. In both studies, PK, maximum tolerated dose (MTD; against predetermined criteria), safety, and tolerability were assessed.

Results: A total of 108 healthy volunteers enrolled in the studies-72 subjects in the SAD study and 36 subjects in the MAD study. SAGE-217 was orally bioavailable, with a terminal-phase half-life of 16-23 h and a tmax of approximately 1 h. The MTDs for the oral solution of SAGE-217 in the SAD and MAD studies were determined to be 55 and 30 mg daily, respectively. In both studies, SAGE-217 was generally well tolerated, and no serious adverse events (SAEs) were reported. Most AEs were mild, dose-dependent, transient, occurred around the tmax, and related to drug pharmacology.

Conclusions: SAGE-217 was generally well tolerated, and its PK profile was well characterized. Based on this profile, SAGE-217 has been advanced into multiple phase II clinical programs and pivotal studies of major depressive disorder and postpartum depression.

Publication types

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

MeSH terms

  • Administration, Oral
  • Adult
  • Allosteric Regulation
  • Depression, Postpartum / epidemiology
  • Depression, Postpartum / physiopathology
  • Depression, Postpartum / psychology
  • Depressive Disorder, Major / drug therapy*
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Drug Administration Schedule
  • Female
  • GABA-A Receptor Agonists / administration & dosage
  • GABA-A Receptor Agonists / pharmacokinetics*
  • GABA-A Receptor Agonists / therapeutic use
  • Healthy Volunteers
  • Humans
  • Male
  • Middle Aged
  • Pharmacology, Clinical / methods*
  • Placebos / administration & dosage
  • Pregnanes / administration & dosage
  • Pregnanes / pharmacokinetics*
  • Pregnanes / therapeutic use
  • Pyrazoles / administration & dosage
  • Pyrazoles / pharmacokinetics*
  • Pyrazoles / therapeutic use
  • Safety

Substances

  • GABA-A Receptor Agonists
  • Placebos
  • Pregnanes
  • Pyrazoles
  • zuranolone