A model-based approach to characterize the population pharmacokinetics and the relationship between the pharmacokinetic and safety profiles of RBP-7000, a new, long-acting, sustained-released formulation of risperidone

J Clin Pharmacol. 2013 Oct;53(10):1010-9. doi: 10.1002/jcph.141. Epub 2013 Jul 19.

Abstract

RBP-7000 is a sustained-release (once-monthly injection for subcutaneous administration) formulation of risperidone using the ATRIGEL® Delivery System, developed for treatment of schizophrenia to address compliance issues associated with oral administration. The objective of this analysis was to report the results of a population pharmacokinetic analysis and to describe the relationship between risperidone and 9-hydroxyrisperidone levels with dopamine (DA) D2-receptor occupancy, prolactin levels, and adverse events using data collected in 45 clinically stable schizophrenic patients receiving RBP-7000 in single ascending doses (risperidone) of 60, 90, and 120 mg. The population PK model accounted for an initial peak, a delayed and slow delivery, the disposition of risperidone, and the conversion of risperidone to 9-hydroxyrisperidone. BMI was a covariate affecting absorption of risperidone and ultimately formation of 9-hydroxyrisperidone. A logistic analysis indicated a correlation between the increase in Active Moiety (risperidone + 9-OH-risperidone) exposure (Cmax ) and the probability of observing GI disorders. An Emax population PK/prolactin model best described the relationship between the circulating Active Moiety and the serum prolactin levels. Gender was a significant covariate associated with Emax . These data provided a comprehensive characterization of the relationship between circulating Active Moiety and the efficacy/safety profile of RBP-7000 in clinically stable schizophrenic patients.

Keywords: D2 receptor occupancy; long-acting risperidone; prolactin levels.

Publication types

  • Clinical Trial, Phase I
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Antipsychotic Agents / administration & dosage
  • Antipsychotic Agents / adverse effects
  • Antipsychotic Agents / chemistry
  • Antipsychotic Agents / pharmacokinetics*
  • Cytochrome P-450 CYP2D6 / genetics
  • Delayed-Action Preparations / administration & dosage
  • Delayed-Action Preparations / adverse effects
  • Delayed-Action Preparations / chemistry
  • Delayed-Action Preparations / pharmacokinetics
  • Female
  • Humans
  • Injections, Subcutaneous
  • Isoxazoles / blood
  • Male
  • Middle Aged
  • Models, Biological*
  • Paliperidone Palmitate
  • Polyglactin 910 / chemistry
  • Prolactin / blood
  • Pyrimidines / blood
  • Receptors, Dopamine D2 / metabolism
  • Risperidone / administration & dosage
  • Risperidone / adverse effects
  • Risperidone / chemistry
  • Risperidone / pharmacokinetics*
  • Schizophrenia / drug therapy
  • Schizophrenia / genetics
  • Schizophrenia / metabolism*
  • Young Adult

Substances

  • Antipsychotic Agents
  • DRD2 protein, human
  • Delayed-Action Preparations
  • Isoxazoles
  • Pyrimidines
  • Receptors, Dopamine D2
  • Polyglactin 910
  • Prolactin
  • Cytochrome P-450 CYP2D6
  • Risperidone
  • Paliperidone Palmitate