1. J Pharmacol Exp Ther. 2009 Sep;330(3):911-21. Epub 2009 Jun 5.
Arbaclofen placarbil, a novel R-baclofen prodrug: improved absorption,
distribution, metabolism, and elimination properties compared with R-baclofen.
Lal R, Sukbuntherng J, Tai EH, Upadhyay S, Yao F, Warren MS, Luo W, Bu L, Nguyen
S, Zamora J, Peng G, Dias T, Bao Y, Ludwikow M, Phan T, Scheuerman RA, Yan H, Gao
M, Wu QQ, Annamalai T, Raillard SP, Koller K, Gallop MA, Cundy KC.
XenoPort, Inc., 3410 Central Expressway, Santa Clara, CA 95051, USA.
[email protected]
Baclofen is a racemic GABA(B) receptor agonist that has a number of significant
pharmacokinetic limitations, including a narrow window of absorption in the upper
small intestine and rapid clearance from the blood. Arbaclofen placarbil is a
novel transported prodrug of the pharmacologically active R-isomer of baclofen
designed to be absorbed throughout the intestine by both passive and active
mechanisms via the monocarboxylate type 1 transporter. Arbaclofen placarbil is
rapidly converted to R-baclofen in human and animal tissues in vitro. This
conversion seems to be primarily catalyzed in human tissues by human
carboxylesterase-2, a major carboxylesterase expressed at high levels in various
tissues including human intestinal cells. Arbaclofen placarbil was efficiently
absorbed and rapidly converted to R-baclofen after oral dosing in rats, dogs, and
monkeys. Exposure to R-baclofen was proportional to arbaclofen placarbil dose,
whereas exposure to intact prodrug was low. Arbaclofen placarbil demonstrated
enhanced colonic absorption, i.e., 5-fold higher R-baclofen exposure in rats and
12-fold higher in monkeys compared with intracolonic administration of
R-baclofen. Sustained release formulations of arbaclofen placarbil demonstrated
sustained R-baclofen exposure in dogs with bioavailability up to 68%. In clinical
use, arbaclofen placarbil may improve the treatment of patients with
gastroesophageal reflux disease, spasticity, and numerous other conditions by
prolonging exposure and decreasing the fluctuations in plasma levels of
R-baclofen.
PMID: 19502531 [PubMed - indexed for MEDLINE]