Population pharmacokinetics of fingolimod phosphate in healthy participants

J Clin Pharmacol. 2012 Jul;52(7):1054-68. doi: 10.1177/0091270011409229. Epub 2011 Nov 22.

Abstract

Fingolimod (FTY720) is a sphingosine 1-phosphate receptor (S1PR) modulator currently being evaluated for the treatment of multiple sclerosis. Fingolimod undergoes phosphorylation in vivo to yield fingolimod phosphate (fingolimod-P), which modulates S1PRs expressed on lymphocytes and cells in the central nervous system. The authors developed a population model, using pooled data from 7 phase 1 studies, to enable characterization of fingolimod-P pharmacokinetics following oral administration of fingolimod and to evaluate the impact of key demographic variables on exposure. The fingolimod-P concentration-time course after either single or multiple doses of fingolimod was described by a 2-compartment model with first-order apparent formation and elimination, lag time in the apparent formation, and dose-dependent relative bioavailability and apparent central volume of distribution. Body weight and ethnicity were identified as demographic covariates correlated with the disposition of fingolimod-P. Model predictions indicated no need for dose adjustment of fingolimod based on body weight; the effect of ethnicity on the disposition of fingolimod requires further investigation. The accurate prediction of the pharmacokinetic profile of fingolimod-P determined empirically in 2 large phase 3 trials provides external validation of the model.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Administration, Oral
  • Adult
  • Biological Availability
  • Clinical Trials, Phase I as Topic
  • Clinical Trials, Phase III as Topic
  • Dose-Response Relationship, Drug
  • Female
  • Fingolimod Hydrochloride
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / pharmacokinetics*
  • Male
  • Middle Aged
  • Models, Biological*
  • Phosphorylation
  • Propylene Glycols / administration & dosage
  • Propylene Glycols / pharmacokinetics*
  • Receptors, Lysosphingolipid / drug effects
  • Receptors, Lysosphingolipid / metabolism
  • Sphingosine / administration & dosage
  • Sphingosine / analogs & derivatives*
  • Sphingosine / pharmacokinetics
  • Time Factors
  • Tissue Distribution
  • Young Adult

Substances

  • Immunosuppressive Agents
  • Propylene Glycols
  • Receptors, Lysosphingolipid
  • Fingolimod Hydrochloride
  • Sphingosine