Do We Need to Optimize Protein Binding in Drug Discovery? NEDMDG Summary Meeting June 4, 2013 Xingrong Liu, Ph.D. Genentech Free drug interacts with drug targets: Plasma Total IC50 = 0.3- 300x Ki Free IC50 = 0.1-10x Ki Liu et al., Drug Metab Dispos 37:1548–1556, 2009 100 100 80 80 SERT Occ (%) SERT Occ (%) Brain binding does not contribute to the activity: free drug interacts with drug targets 60 40 20 0 -20 0.01 60 40 20 0 0.1 1 10 100 1000 10000 -20 0.01 0.1 1 10 100 1000 10000 Total Brain Concentration/KI Unbound Brain Concentration/KI Total IC50 = 1-1000x Ki Free IC50 = 0.3-3x Ki Liu et al., Drug Metab Dispos 37:1548–1556, 2009 Different effects of protein binding on in vitro and in vivo free concentrations In vitro In vivo Scenario 1 fu=0.1 fu=0.5 fu ↑ fu=0.1 fu ↑ Clin↔ fu=0.5 Cu↔ Cbound fu=0.5 Cbound Cbound Cbound Cu ↑ Cu Cu Scenario 2 fu ↑ Clin↓ Cu ↑ Increase of free fraction by 15X increases IV free AUC by 3X R2 1 1 G-378895 IV 3 mg/kg R1 Cl Unbound Conc. (ug/mL) Total Conc. (ug/mL) 10 G-378242 IV 3 mg/kg fup=0.01 0.1 R2 0.01 fup=0.15 N G-378895 IV 3 mg/kg G-378242 IV 3 mg/kg 0.1 0.01 0.001 R1 0.001 0.0001 0 6 12 Time (h) 18 24 0 6 12 Time (h) • 3X increase was due to reduced clearance 18 24 Increase of free fraction by 15X increases oral free AUC 2X 1 G-378895 PO 10 mg/kg R2 Unbound Conc. (ug/mL) Total Conc. (ug/mL) 10 G-378242 PO 10 mg/kg R1 1 Cl fup=0.01 R2 0.1 N R1 fup=0.15 G-378242 PO 10 mg/kg 0.1 0.01 0.001 0.01 0 G-378895 PO 10 mg/kg 6 12 Time (h) 18 24 0 6 12 Time (h) • 2X increase was due to reduced clearance 18 24 Protein binding vs. intrinsic clearance H N O O C2H5 HN R O R = -(CH2)nCH3 n = 0-8 Data form Blakey et al., J Pharmacokinet Biopharm 25:277–312, 1997 Protein binding vs. Vdss H N O fu plasma Vd Vc Vt fu tissue O C2H5 HN R O R = -(CH2)nCH3 n = 0-8 Data form Blakey et al., J Pharmacokinet Biopharm 25:277–312, 1997 Protein binding vs. t1/2 H N O O C2H5 HN R O R = -(CH2)nCH3 n = 0-8 Data form Blakey et al., J Pharmacokinet Biopharm 25:277–312, 1997 Protein binding vs. intrinsic clearance 100000 Acids 10000 Clin (ml/min/kg) Clin (ml/min/kg) 100000 1000 100 10 Bases 10000 1000 100 10 1 1 0.1 0.0001 0.001 0.01 0.1 0.1 0.0001 1 0.001 fu 0.1 1 fu Neutrals 1000 10000 Clin (ml/min/kg) Clin (ml/min/kg) 100000 0.01 1000 100 10 Zwitterions 100 10 1 0.1 0.001 0.01 0.1 fu 1 1 0.01 0.1 1 fu Data form Obach et al., Drug Metab Dispos 36:1385–1405, 2008 Protein binding vs. Vdss fu plasma Vd Vc Vt fu tissue Data form Obach et al., Drug Metab Dispos 36:1385–1405, 2008 Protein binding not associate with t1/2 Acids 10000 100 t1/2 (hr) 1000 t1/2 (hr) Bases 1000 100 10 1 10 1 0.1 0.1 0.0001 0.001 0.01 0.1 0.01 0.0001 1 0.001 fu 1000 0.01 0.1 1 fu Neutrals 100 Zwitterions 100 t1/2 (hr) t1/2 (hr) 10 10 1 1 0.1 0.001 0.01 0.1 fu 1 0.1 0.01 0.1 1 fu Data form Obach et al., Drug Metab Dispos 36:1385–1405, 2008 Brain unbound conc. is governed by the BBB and plasma unbound conc. Cu ,brain 1 1 Cu , plasma Clefflux PS Clefflux: efflux transport activity at the BBB PS: diffusion permeability at the BBB Protein binding does not associate with brain penetration R2=0.077 R2=0.087 Modified from Maurer et al, Drug Metab Dispos 33: 165, 2005 Significant effects of P-gp on brain concentration Compound Efflux Compound 18 CsA Desloratadine 14 Verapamil 8 Efflux Digoxin 16-28 Ivermectin 14-27 Chen et al, Curr Drug Metab, 4: 272, 2003 Considerations of protein binding in drug discovery • No need to specifically optimize plasma binding – Reduction of plasma protein binding alone does not increase free drug concentration – Reduction of clearance increases free drug concentration – Reduction of plasma protein binding tends to associated with reduction of clearance, as both of the parameters are governed by lipophilicity • No need to specifically optimize brain binding • • Reduction of brain tissue binding alone does not increase free brain drug concentration Reduction of efflux activity enhance free brain drug concentration • Need to consider protein binding in … – PK/PD, human PK/dose/DDI prediction, drug transporter/tissue penetration, safety margin calculation, regulatory filing, etc. Acknowledgements • Marcel Hop • • Bruce Roth Joe Lyssikatos • • • R. Scott Obach Franco Lombardo Nigel J. Waters • Dennis A. Smith Protein binding of marketed drugs 30% n = 267 25% Drugs (%) 20% 15% 10% 5% 0% <0.001 0.001-0.01 0.01-0.05 0.05-0.1 0.1-0.3 0.3-0.6 0.6-1 Unbound Fraction n=14, fu<0.1 Data from Goodman & Gilman’s The Pharmacological Basis of Therapeutics, 11th 0.0001 Modified from Maurer et al, Drug Metab Dispos 33: 165, 2005 Meprobamate Sulpiride Hydrocodone Caffeine Morphine Metocloperamide Methylphenidate Lamotrigine Buspirone Venlafaxinec Carisoprodol Zolpidema Thiopentalc Carbamazepine 9-OH-Risperidone Phenytoin Risperidone Selegiline Diazepam Trazodone Propoxyphene Citalopram Midazolam Hydroxyzine Clozapine Fluvoxamine Cyclobenzaprine Haloperidol Nortriptylinea Paroxetine Fluoxetine Chlorpromazine Sertraline Brain fu Many successful CNS drugs show high brain binding 1 0.1 0.01 0.001 th io p ph ent en al yt s u oi n lp ir z o i de lp id m em or p tra hi n zo e ris do pe ne rid m la m on et e o c otr lo igi pe ne ra bu mid hy s pi e dr ron pr o co e op d ox on yp e pa he n ro e xe s e tine le g c l i li n oz e v e ap nl ine af a c i xin ta e fl u l op vo ram xa hy m dr i o x ne no y zi cy ne r t r cl ob ipty en li n za e p m fl u rine et h y oxe lp ti n he e ni d h c h al o ate p lo rp eri ro do m l a s e z ine rtr a m l i d ine c a azo c a ri so lam rb p r a m od az o l ep c a ine et ho ffein su e xi m di i az de ep am AUCbrain/AUCplasma (0-5h) 240x th io pe ph nta en l yt o su in lp i ri z o de lp id m em or ph tra i n zo e ris do pe ne rid m la m one et o c otr lo igi n pe ra e bu mid e s hy pir on dr pr o co e op do ox n yp e pa he n e ro xe s e tine le g c l i li ne oz v e api n nl af e a c i xin ta e fl u l op vo ram xa hy m i dr o x ne no y zi cy rtr ne cl ob ipty en li n za e pr m fl uo ine et h y xet in lp he e n ha id a t ch lo p e lo rp erid ro o l m az s e ine rtr a l m i d ine c a azo ri s la m ca o rb p ro am d az o l ep c a ine ffe di ine az ep am 34x AUCu,brain/AUCu,plasma (0-5h) Plasma and brain binding has a significant impact on the B/P ratio 25 20 Total Brain/Plasma Ratio 15 10 5 Acid: 0.5 (0.4-0.6) Base: 6 ± 7 (0.1-24) Neutral: 0.9 ± 0.7 (0.2-0.8) 0 25 20 Unbound Brain/Plasma Ratio 15 Acid: 0.2 (0.2-0.3) Base: 1 ± 0.7 (0.1-3.4) Neutral: 0.5 ± 0.3 (0.1-1) 10 5 0 Modified from Maurer et al, Drug Metab Dispos 33: 165, 20 Protein binding vs. clearance Data form Obach et al., Drug Metab Dispos 36:1385–1405, 2008 Protein binding vs. free Vdss Data form Obach et al., Drug Metab Dispos 36:1385–1405, 2008 Questions for protein binding • PPB non-linearity – saturation of PPB as a strategy to increase unbound concentration – is this a viable strategy? • Covalent modifiers – does PPB even matter? Is it always total plasma concentration? • What about "exceptions to the rule"? - e.g. Active transport? Nonwell stirred assumption? • Impact on Cmax and Cmin – this could be sensitive to fu – see Derendorf paper I circulated • Determination of unbound PK parameters (Clunbound – Vd,ssunbound) – does this simplify or complicate things? • Species differences? • What should we use PPB data for in drug discovery?