A first-in-human study of the anti-inflammatory profibrinolytic TMS-007,
an SMTP family triprenyl phenol
Abstract
Background: TMS-007, an SMTP family member, modulates plasminogen
conformation and enhances plasminogen-fibrin binding, leading to
promotion of endogenous fibrinolysis. Its anti-inflammatory action
mediated by soluble epoxide hydrolase inhibition contributes to the
efficacy. Evidence suggests that TMS-007 can effectively treat
experimental thrombotic and embolic strokes with a wide time window
while reducing hemorrhagic transformation. Aims: To evaluate the safety,
pharmacokinetics, and pharmacodynamics of TMS-007 in healthy volunteers.
Methods: A randomized, placebo-controlled, double blind, dose-escalation
study, administered as a single intravenous infusion of TMS-007 in
cohorts of healthy male Japanese subjects. There were 6 cohorts planned,
but 5 were completed. In each cohort (n = 8), individuals were
randomized to receive one of 5 doses of TMS-007 (3, 15, 60, 180, or 360
mg; n = 6) or placebo (n = 2). Results: TMS-007 was
generally well-tolerated, and no serious adverse events attributed to
the drug. A linear dose-dependency was observed for plasma TMS-007
levels. No symptoms of bleeding were observed in brain MRI analysis, and
no bleeding-related responses in laboratory testing were found. The
plasma levels of the coagulation factor fibrinogen and the
anti-fibrinolysis factor 2-antiplasmin levels were unchanged after the
TMS-007 dosing. A slight increase in the plasma level of
plasmin-α2-antiplasmin complex, an index of plasmin
formation, was observed in some subjects who received 360 mg of TMS-007
(≈ 6 mg kg−1). Conclusions: TMS-007 is generally
well-tolerated and exhibits favorable pharmacokinetic profiles that
warrant further clinical development.