Franchi F Schneider DJ Prats J Fan W Rollini F Been L Taatjes Sommer HS Deliargyris EN Angiolillo DJ TCT 2021 Background Immediate release IR aspirin IRASA is associated with risk of mucosal damage in the upper gastrointestinal GI tract ID: 914875
Download Presentation The PPT/PDF document "Pharmacodynamic Profile of PL-ASA, a Nov..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Pharmacodynamic Profile of PL-ASA, a Novel Phospholipid-Aspirin Complex Liquid Formulation, Compared to Enteric-coated Aspirin at an 81 mg Dose ─ Results from a Prospective, Randomized, Crossover Study
Franchi F, Schneider DJ, Prats J, Fan W,
Rollini
F, Been L,
Taatjes
-Sommer HS,
Deliargyris
EN,
Angiolillo
DJ
TCT 2021
Slide2Background
Immediate release (IR) aspirin (IR-ASA) is associated with risk of mucosal damage in the upper gastrointestinal (GI) tract.
Enteric coated aspirin (EC-ASA) was designed to reduce GI injury by bypassing the stomach and releasing ASA in the duodenum and is today the standard of care in secondary prevention. However, evidence shows that EC-ASA results in greater variability in absorption and antiplatelet effect than IR-ASA.
PL-ASA (VAZALORE, PLx Pharma Inc.), a novel FDA-approved, liquid-filled phospholipid-ASA capsule, is an IR formulation, designed to release aspirin in the duodenum, thus limiting GI injury, while still providing fast and complete drug absorption and potent and reliable COX-1 inhibition. Previous studies have compared the 325-mg dose of PL-ASA to IR-ASA and EC- ASA; this study is the first to investigate the pharmacokinetics (PK) of the 81-mg dose of PL-ASA. We also sought to assess the early pharmacodynamic (PD) effects of PL-ASA compared to EC-ASA
Franchi F et al TCT 2021
Slide3Methods
This is a randomized, open-label, crossover study assessing PK and PD after a single 81-mg dose of PL-ASA vs. EC-ASA under fasting conditions in 36 subjects between 18 and 75 years of age.
Subjects were randomly assigned 1:1 to either PL-ASA followed by EC-ASA or EC-ASA followed by PL-ASA with a 14-day washout
period between the two study drugs. PK parameters for acetylsalicylic acid and salicylic acid were obtained. PD assessments included the comparison between PL-ASA and EC-ASA for platelet aggregation following arachidonic acid (AA) and collagen stimuli, and measurement of thromboxane B2 (TxB2)
Franchi F et al TCT 2021
Slide4Demographic Results
36 subjects were randomized and completed the study
mean age: 48.8 years (range: 22 - 69)
females: 26 (72.2%) race: 26 white, 6 black mean BMI: 34.5 kg/m2
Franchi F et al TCT 2021
Slide5Pharmacokinetic Profile
Plasma concentrations over time (mean, n=36)
Acetylsalicylic Acid
Acetylsalicylic Acid
Salicylic Acid
Franchi F et al TCT 2021
PL-ASA Provides Faster Absorption and More Complete Bioavailability vs. EC Aspirin
Slide6PK Parameters
EC ASA
PL-ASA
P-
value
a
Acetylsalicylic acid
(N=23)
(N=34)
C
max
(ng/mL)
367.86
720.10
<0.0001
AUC
0-t
(
hr*ng/mL)416.13600.730.001 Tmax (hr)4.00 (1.50, 6.63)1.01 (0.47, 3.03)<0.0001Salicylic acid (N=36) (N=36) Cmax (ng/mL)2940.934095.24<0.0001 AUC0-t (hr*ng/mL)13123.9614848.450.02 Tmax (hr)4.89 (2.00, 11.9)1.52 (0.55, 5.92)<0.0001
Cmax and AUC are presented as geometric least-square mean; Tmax is presented as median (minimum, maximum).a: All p-values were calculated by using mixed-effect, repeated measure ANOVA model with sequence, period, and treatment as fixed effects, and subject as random effect.
Cmax and AUC are presented as geometric least-square mean; Tmax is presented as median (minimum, maximum).a: All p-values were calculated by using mixed-effect, repeated measure ANOVA model with sequence, period, and treatment as fixed effects, and subject as random effect.
Franchi F et al TCT 2021
Slide7Pharmacodynamic Profile: LTA
Arachidonic Acid-Induced Light Transmission Aggregometry
(LTA) over Time (median, n=36)
Franchi F et al TCT 2021
PL-ASA Provides Faster and Stronger Platelet Inhibition with Lower Levels of AA-induced Platelet Aggregation vs. EC-ASA
Slide8Conclusions
Table: PK Parameters
EC ASA
PL-ASA
P-
value
a
Acetylsalicylic acid
(N=23)
(N=34)
C
max
(ng/mL)
367.86
720.10
<0.0001
AUC
0-t
(hr*ng/mL)416.13600.730.001 Tmax (hr)4.00 (1.50, 6.63)1.01 (0.47, 3.03)<0.0001Salicylic acid (N=36) (N=36) Cmax (ng/mL)2940.934095.24<0.0001 AUC0-t (hr*ng/mL)13123.9614848.450.02 Tmax (hr)4.89 (2.00, 11.9)1.52 (0.55, 5.92)<0.0001
Table: PK Parameters EC ASA PL-ASAP-valuea
Acetylsalicylic acid(N=23) (N=34)
C
max
(ng/mL)
367.86
720.10
<0.0001
AUC
0-t
(
hr*ng/mL)416.13600.730.001 Tmax (hr)4.00 (1.50, 6.63)1.01 (0.47, 3.03)<0.0001Salicylic acid (N=36) (N=36) Cmax (ng/mL)2940.934095.24<0.0001 AUC0-t (hr*ng/mL)13123.9614848.450.02 Tmax (hr)4.89 (2.00, 11.9)1.52 (0.55, 5.92)<0.0001
Table: PK Parameters EC ASA PL-ASAP-valueaAcetylsalicylic acid(N=23) (N=34) Cmax (ng/mL) 367.86720.10<0.0001 AUC0-t (hr*ng/mL)416.13600.730.001 Tmax (hr)4.00 (1.50, 6.63)1.01 (0.47, 3.03)<0.0001Salicylic acid (N=36) (N=36) Cmax (ng/mL)2940.934095.24<0.0001 AUC0-t (hr*ng/mL)13123.9614848.450.02 Tmax (hr)4.89 (2.00, 11.9)1.52 (0.55, 5.92)<0.0001
PK Profile: PL-ASA, a novel phospholipid-aspirin formulation in a liquid-filled capsule that has been shown to be bioequivalent to IR-ASA, results in faster and more complete absorption after a single 81 mg dose compared to EC-ASA.PD Profile: In arachidonic acid-induced platelet aggregation, as assessed by light transmission aggregometry, PL-ASA provides more potent and earlier inhibition of platelet aggregation compared to EC-ASA. Assessments of TxB2 (data not shown) were consistent with LTA results. The observations of the current study are consistent with previous findings from published comparative studies with the 325 mg dose.1,2 PL-ASA is a novel aspirin formulation that provides more predictable PK and PD effects compared with enteric-coated aspirin.
1Angiolillo et al, J Thromb Thrombolysis 2019;48:554–622Bhatt DL, Grosser T, Dong J et al JACC
Franchi F et al TCT 2021