Safety, tolerability, pharmacodynamics, and pharmacokinetics of recombinant Neorudin, a new anticoagulant drug, in patients undergoing coronary angiography
Phase II study published in Clinical Pharmacology in Drug Development (2024)
Abstract
This study evaluated the safety, tolerability, pharmacodynamics, and pharmacokinetics of recombinant neorudin (EPR-hirudin [EH]) in patients with acute coronary syndrome (ACS), providing a basis for further therapeutic research. This open-label, single-center, nonrandomized, nonblinded, and noncontrolled trial categorized 24 patients with nonprogressive ACS who met the screening criteria into 3 groups. They received an intravenous injection of neorudin (0.4 mg/kg), followed by an intravenous drip at doses of 0.15, 0.30, and 0.45 mg/kg/h for 3 days in the low-, medium-, and high-dose groups, respectively. The safety, tolerability, pharmacodynamics, and pharmacokinetics of EH were assessed after treatment, indicating that neorudin was safe and well tolerated in nonprogressive ACS. No serious adverse events or clinical composite end points were observed. The activated partial thromboplastin time and thrombin time increased significantly and dose dependently following EH administration across all groups compared to pretreatment values. Conversely, thrombin activity significantly decreased after drug administration but returned to baseline levels shortly after drug withdrawal. Within the administered dose range, neorudin exposure increased with the dose, and its half-life was approximately 2 hours. Neorudin was found to be safe and tolerable for treating patients with nonprogressive ACS, demonstrating therapeutic efficacy at doses up to 0.45 mg/kg/h over a 3-day period.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Phase II clinical study of recombinant neorudin in coronary angiography patients. Linear pharmacokinetics, dose-dependent aPTT prolongation, favorable safety profile.
Why This Matters for Hirudotherapy
This open-label, single-center, nonrandomized, nonblinded, noncontrolled trial evaluated the safety, tolerability, pharmacodynamics, and pharmacokinetics of recombinant neorudin (EPR-hirudin) in 24 patients with nonprogressive acute coronary syndrome across three dose groups (0.15, 0.30, and 0.45 mg/kg/h following a 0.4 mg/kg bolus) over three days. Neorudin was safe and well tolerated with no serious adverse events or composite endpoints; activated partial thromboplastin time and thrombin time increased dose-dependently while thrombin activity decreased, returning to baseline after withdrawal, with a half-life of approximately two hours. The study is relevant to ASH's domain as it provides early clinical pharmacology data on a recombinant hirudin-based anticoagulant. Caveat: the sample is small (24 patients) with no control group, and therapeutic efficacy beyond pharmacodynamic biomarkers is not established.
Citation
Safety, tolerability, pharmacodynamics, and pharmacokinetics of recombinant Neorudin, a new anticoagulant drug, in patients undergoing coronary angiography.
Liu YB et al. · Clinical pharmacology in drug development, 2024
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