Title
Semi-Mechanistic Pharmacokinetic-Pharmacodynamic Model of Camostat Mesylate-Predicted Efficacy against SARS-CoV-2 in COVID-19
Date Issued
01 April 2022
Access level
open access
Resource Type
journal article
Author(s)
Yale University School of Medicine
Publisher(s)
American Society for Microbiology
Abstract
The SARS-CoV-2 coronavirus, which causes COVID-19, uses a viral surface spike protein for host cell entry and the human cell-surface transmembrane serine protease, TMPRSS2, to process the spike protein. Camostat mesylate, an orally available and clinically used serine protease inhibitor, inhibits TMPRSS2, supporting clinical trials to investigate its use in COVID-19. A one-compartment pharmacokinetic (PK)/pharmacodynamic (PD) model for camostat and the active metabolite FOY-251 was developed, incorporating TMPRSS2 reversible covalent inhibition by FOY-251, and empirical equations linking TMPRSS2 inhibition of SARS-CoV-2 cell entry. The model predicts that 95% inhibition of TMPRSS2 is required for 50% inhibition of viral entry efficiency. For camostat 200 mg dosed four times daily, 90% inhibition of TMPRSS2 is predicted to occur but with only about 40% viral entry inhibition. For 3-fold higher camostat dosing, marginal improvement of viral entry rate inhibition, up to 54%, is predicted. Because respiratory tract viral load may be associated with negative outcome, even modestly reducing viral entry and respiratory tract viral load may reduce disease progression. This modeling also supports medicinal chemistry approaches to enhancing PK/PD and potency of the camostat molecule.
Volume
10
Issue
2
Language
English
OCDE Knowledge area
Farmacología, Farmacia
Virología
Subjects
Scopus EID
2-s2.0-85129264046
PubMed ID
Source
Microbiology Spectrum
ISSN of the container
21650497
DOI of the container
10.1128/spectrum.02167-21
Source funding
Prostate Cancer Foundation
National Center for Research Resources
U.S. Public Health Service
Sponsor(s)
This investigator-initiated study was supported by Kenneth C. Griffin, the Prostate Cancer Foundation, the COVID-19 Early Treatment Fund, and the Harrington Discovery Institute, institutional funds from the Department of Internal Medicine at the Yale School of Medicine, and the Yale Center for Clinical Investigation. This study was partially supported by the United State Public Health Service grant, 5UL1RR024139. Ono Pharmaceuticals provided the study drug, FOIPAN, at no cost to the study but had no input into study design or the writing or content of the manuscript.
Sources of information:
Directorio de Producción Científica
Scopus