Post-hoc cross-study PK analysis of first-in-class Bersiporocin: Impact of high variability on ethnic exposure patterns
Bersiporocin, a first-in-class prolyl-tRNA-synthetase inhibitor for idiopathic pulmonary fibrosis (IPF), exhibits high pharmacokinetic variability. This post-hoc analysis compared the pharmacokinetic characteristics of the 200 mg dose under fasting conditions between a global first-in-human (FIH) study and a Korean food-effect study to assess ethnic robustness for global development. Pharmacokinetic data from FIH study (Australia, N=6) and the food-effect study (Korea, N=35) were compared for the 200 mg fasting dose. Bersiporocin and its active metabolite M8 exposure was calculated using noncompartmental analysis with WinNonlin. GMRs and 90% CIs were determined and interpreted in the context of the reported variability (CV up to 129%). Parent bersiporocin exposure was higher in the FIH study (AUC0-12h GMR 1.64; Cmax GMR 1.53). However, this finding is consistent with previously reported pharmacokinetic variability of bersiporocin (CV up to 129%) in the Australian FIH study and is likely influenced by the small sample size (N=6). In contrast, M8 demonstrated high comparability between studies (AUC0-12h GMR 0.88; Cmax GMR 0.78). Despite relatively wide 90% CIs due to the limited sample size, the point estimates for M8 remained close to unity, indicating consistent metabolic exposure across populations. The comparable exposure of the M8 suggests that the observed differences in parent bersiporocin exposure are more likely attributable to statistical variability arising from high pharmacokinetic variability and the small sample size rather than true ethnic differences. These findings support the ethnic robustness of bersiporocin pharmacokinetics and suggest that ethnicity-based dose adjustment may not be necessary in ongoing global Phase 2 trials or future Phase 3 development.
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