Pharmacokinetics and Pharmacodynamics of the BACE1 Inhibitor Verubecestat (MK‐8931) in Healthy Japanese Adults: A Randomized, Placebo‐Controlled Study

β‐site amyloid precursor protein cleaving enzyme 1 (BACE1) is required for the production of β‐amyloid (Aβ) peptides and is considered a potential treatment target for Alzheimer's disease (AD). To support Japan's participation in the global clinical development program, we characterized the safety, pharmacokinetics (PKs), and pharmacodynamics of the BACE1 inhibitor verubecestat (MK‐8931) in 24 healthy Japanese adults in a two‐part, single‐center, randomized, placebo‐controlled phase I trial (protocol MK‐8931‐007) and compared the results with historical data from non‐Japanese subjects. Both single (20, 100, and 450 mg) and multiple (80 and 150 mg once daily for 14 days) doses of verubecestat were well tolerated. Verubecestat's PK profile was similar in Japanese and non‐Japanese subjects. Verubecestat also reduced mean cerebrospinal fluid concentrations of the Aβ proteins Aβ40, Aβ42, and soluble β fragment of amyloid precursor protein; the level of reduction was comparable between Japanese and non‐Japanese subjects. These results support the continued global development of verubecestat as a potential disease‐modifying agent for Japanese and non‐Japanese subjects who are at risk for developing AD.

[1]  J. Hardy,et al.  The amyloid hypothesis of Alzheimer's disease at 25 years , 2016, EMBO molecular medicine.

[2]  J. Hardy,et al.  The Amyloid Hypothesis of Alzheimer ’ s Disease : Progress and Problems on the Road to Therapeutics , 2009 .

[3]  T. Mizutani PM Frequencies of Major CYPs in Asians and Caucasians , 2003, Drug metabolism reviews.

[4]  John Hardy,et al.  A Hundred Years of Alzheimer's Disease Research , 2006, Neuron.

[5]  J. Hardy,et al.  A Critique of the Drug Discovery and Phase 3 Clinical Programs Targeting the Amyloid Hypothesis for Alzheimer Disease , 2014, Annals of neurology.

[6]  E. Siemers,et al.  A phase 3 trial of semagacestat for treatment of Alzheimer's disease. , 2013, The New England journal of medicine.

[7]  Qin Jiang,et al.  Discovery of the 3-Imino-1,2,4-thiadiazinane 1,1-Dioxide Derivative Verubecestat (MK-8931)-A β-Site Amyloid Precursor Protein Cleaving Enzyme 1 Inhibitor for the Treatment of Alzheimer's Disease. , 2016, Journal of medicinal chemistry.

[8]  Clifford J. Woolf,et al.  Pain: Moving from Symptom Control toward Mechanism-Specific Pharmacologic Management , 2004, Annals of Internal Medicine.

[9]  Michael Tanen,et al.  The BACE1 inhibitor verubecestat (MK-8931) reduces CNS β-amyloid in animal models and in Alzheimer’s disease patients , 2016, Science Translational Medicine.

[10]  K. Rhodes,et al.  The antibody aducanumab reduces Aβ plaques in Alzheimer’s disease , 2016, Nature.

[11]  D. Selkoe,et al.  Soluble oligomers of the amyloid β-protein impair synaptic plasticity and behavior , 2008, Behavioural Brain Research.

[12]  D. Selkoe Alzheimer Disease: Mechanistic Understanding Predicts Novel Therapies , 2004, Annals of Internal Medicine.

[13]  R. Vassar,et al.  Molecular Neurodegeneration BioMed Central Review The Alzheimer's disease β-secretase enzyme, BACE1 , 2007 .

[14]  R. Vassar,et al.  BACE1 structure and function in health and Alzheimer's disease. , 2008, Current Alzheimer research.

[15]  Robert A. Dean,et al.  Phase 3 solanezumab trials: Secondary outcomes in mild Alzheimer's disease patients , 2016, Alzheimer's & Dementia.

[16]  E. Siemers,et al.  Phase 3 trials of solanezumab for mild-to-moderate Alzheimer's disease. , 2014, The New England journal of medicine.

[17]  Nick C Fox,et al.  Two phase 3 trials of bapineuzumab in mild-to-moderate Alzheimer's disease. , 2014, The New England journal of medicine.