Cardiovascular Effects of Torcetrapib in Conscious and Pentobarbital-anesthetized Dogs

Torcetrapib is a cholesteryl ester transfer protein inhibitor with an undesired response of increasing arterial pressure in humans. Pressor responses to torcetrapib have been demonstrated in multiple preclinical species. However, these studies have not related plasma concentrations to observed effects. Our purpose was to 1) characterize the cardiovascular responses of torcetrapib in conscious and anesthetized dogs with measured plasma concentrations; and 2) characterize the hemodynamic effects contributing to hypertension using comprehensively instrumented anesthetized dogs. Torcetrapib was dosed orally (3, 30 mg/kg) and intravenously (0.01, 0.33, 0.1 mg/kg) in conscious and anesthetized dogs, respectively. Mean arterial pressure and heart rate were monitored in both models; additional parameters were measured in anesthetized dogs. Plasma drug concentrations were assessed in both models. In conscious and anesthetized dogs, torcetrapib increased mean arterial pressure 25 and 18 mm Hg and heart rate 35 and 21 beats/min, at 2.94 and 3.99 μg/mL, respectively. In anesthetized dogs, torcetrapib increased pulmonary arterial pressure, both systemic and pulmonary hypertension driven by increases in vascular resistance. The compound increased rate pressure product and myocardial contractility while decreasing time to systolic pressure recovery and ejection time. Thus, torcetrapib-induced pressor responses are mediated by systemic and pulmonary vasoconstriction and are associated with increased myocardial oxygen consumption and positive inotropy.

[1]  Robert A Hegele,et al.  The end of the road for CETP inhibitors after torcetrapib? , 2009, Current opinion in cardiology.

[2]  P. Yildiz Molecular mechanisms of pulmonary hypertension. , 2009, Clinica chimica acta; international journal of clinical chemistry.

[3]  R. Obach,et al.  Pharmacokinetics, Metabolism, and Excretion of Torcetrapib, a Cholesteryl Ester Transfer Protein Inhibitor, in Humans , 2008, Drug Metabolism and Disposition.

[4]  C. Prakash,et al.  Metabolism, Pharmacokinetics, and Excretion of a Cholesteryl Ester Transfer Protein Inhibitor, Torcetrapib, in Rats, Monkeys, and Mice: Characterization of Unusual and Novel Metabolites by High-Resolution Liquid Chromatography-Tandem Mass Spectrometry and 1H Nuclear Magnetic Resonance , 2008, Drug Metabolism and Disposition.

[5]  Jean-Pierre Valentin,et al.  Safety and secondary pharmacology: successes, threats, challenges and opportunities. , 2008, Journal of pharmacological and toxicological methods.

[6]  P. Baldrick Safety evaluation to support First-In-Man investigations I: kinetic and safety pharmacology studies. , 2008, Regulatory toxicology and pharmacology : RTP.

[7]  J. Ehrhart,et al.  Torcetrapib-induced blood pressure elevation is independent of CETP inhibition and is accompanied by increased circulating levels of aldosterone , 2008, British journal of pharmacology.

[8]  S. Doggrell The failure of torcetrapib: is there a case for independent preclinical and clinical testing? , 2008, Expert opinion on pharmacotherapy.

[9]  M. Caulfield,et al.  Effects of torcetrapib in patients at high risk for coronary events. , 2007, The New England journal of medicine.

[10]  Jean-Claude Tardif,et al.  Effect of torcetrapib on the progression of coronary atherosclerosis. , 2007, The New England journal of medicine.

[11]  A. Tall,et al.  The failure of torcetrapib: was it the molecule or the mechanism? , 2006, Arteriosclerosis, thrombosis, and vascular biology.

[12]  J. Mckenney,et al.  Efficacy and safety of torcetrapib, a novel cholesteryl ester transfer protein inhibitor, in individuals with below-average high-density lipoprotein cholesterol levels. , 2006, Journal of the American College of Cardiology.

[13]  D. Rader,et al.  Effects of an inhibitor of cholesteryl ester transfer protein on HDL cholesterol. , 2004, The New England journal of medicine.

[14]  T. Sand,et al.  Raising High-Density Lipoprotein in Humans Through Inhibition of Cholesteryl Ester Transfer Protein: An Initial Multidose Study of Torcetrapib , 2004, Arteriosclerosis, thrombosis, and vascular biology.

[15]  A. Camm,et al.  Relationships between preclinical cardiac electrophysiology, clinical QT interval prolongation and torsade de pointes for a broad range of drugs: evidence for a provisional safety margin in drug development. , 2003, Cardiovascular research.

[16]  R H Fagard,et al.  Pulse pressure not mean pressure determines cardiovascular risk in older hypertensive patients. , 1999, Archives of internal medicine.

[17]  J D Thomas,et al.  Noninvasive assessment of the ventricular relaxation time constant (tau) in humans by Doppler echocardiography. , 1997, Circulation.

[18]  G. Assmann,et al.  Relation of high-density lipoprotein cholesterol and triglycerides to incidence of atherosclerotic coronary artery disease (the PROCAM experience). Prospective Cardiovascular Münster study. , 1992, The American journal of cardiology.

[19]  R S Reneman,et al.  An improved method to correct the QT interval of the electrocardiogram for changes in heart rate. , 1989, Journal of pharmacological methods.

[20]  R. Fryer,et al.  Comparative effects of levosimendan, OR-1896, OR-1855, dobutamine, and milrinone on vascular resistance, indexes of cardiac function, and O2 consumption in dogs. , 2008, American journal of physiology. Heart and circulatory physiology.

[21]  D. Gordon,et al.  High-density lipoprotein cholesterol and cardiovascular disease. Four prospective American studies. , 1989, Circulation.