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The Antiparasitic Moxidectin: Safety, Tolerability, and Pharmacokinetics in Humans

From Experimental Medicine (Dr. Cotreau, Ms. Warren, Dr. Ryan, Dr. Schwertschlag), Biostatistics and Clinical Information Systems (Dr. Chen), Wyeth Research, Cambridge, MA; Fort Dodge Animal Health, Princeton, New Jersey (Dr. Rock); College of Pharmacy, University of Iowa, Iowa City, Iowa (Dr. Fleckenstein, Dr. Vanapalli); and Department of Medicine, Division of Infectious Disease, University of Pennsylvania, Philadelphia, Pennsylvania (Dr. Brown).

A study in healthy male volunteers was completed to evaluate the safety, tolerability, and pharmacokinetics of a single oral dose of the antiparasitic moxidectin (MOX). This drug is registered worldwide as a veterinary antiparasitic agent for use in companion and farm animals. This is the first study of MOX in humans. All subjects were between the ages of 18 and 45 years, with normal cardiac, hematologic, hepatic, and renal function. Doses of MOX studied were 3, 9, 18, and 36 mg in cohorts of 6 subjects each (5:1, MOX:placebo). At the 9-mg and 36-mg doses, two separate cohorts were completed, one in the fasted state and one after the consumption of a high-fat breakfast. For all other cohorts, administration was in the fasted state. Safety and tolerability were assessed by physical examinations, ongoing evaluation of adverse events (AEs), and measurement of laboratory values. Pharmacokinetic (PK) samples were collected just prior to dosing and at various time points until 80 days postdose. Safety assessments from all dose groups studied suggested that MOX was generally safe and well tolerated, with a slightly higher incidence of transient, mild, and moderate central nervous system AEs as the dose increased as compared to placebo. The PKs of MOX were dose proportional within the dose range studied, and the elimination half-life (t_{1/2 elim}) was long (mean: 20.2-35.1 days). At the 9-mg and 36-mg doses, a high-fat breakfast was shown to delay and increase the overall absorption but did not increase maximal concentrations when compared to administration in the fasted state. In summary, the results from this study indicate that MOX is safe and well tolerated in humans between the doses of 3 mg and 36 mg.

Key Words: Moxidectin • pharmacokinetics • onchocerciasis • parasites

Address for reprints: Monette M. Cotreau, PhD, Experimental Medicine, Wyeth Research, 87 CambridgePark Drive, Cambridge, MA 02140.

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