Koele, S.E.* ; Heinrich, N.* ; De Jager, V.R.* ; Dreisbach, J.* ; Phillips, P.P.J.* ; Gross-Demel, P.* ; Dawson, R.* ; Narunsky, K.* ; Wildner, L.M.* ; McHugh, T.D.* ; Te Brake, L.H.M.* ; Diacon, A.H.* ; Aarnoutse, R.E.* ; Hoelscher, M. ; Svensson, E.M.*
Population pharmacokinetics and exposure-response relationship of the antituberculosis drug BTZ-043.
J. Antimicrob. Chemother. 80, 1315-1323 (2025)
INTRODUCTION: BTZ-043 is a first-in-class benzothiazinone for the treatment of TB with demonstrated early bactericidal activity. BTZ-043 is metabolized into two major metabolites: M1 and M2. The aim of this study was to characterize the pharmacokinetics (PK) and early exposure-response (pharmacokinetic/pharmacodynamic, PK/PD) relationship for BTZ-043. METHODS: A population PK/PD model for BTZ-043 and its metabolites was developed using data from a sequential Phase 1b/2a, randomized, controlled clinical trial in participants with pulmonary TB. BTZ-043 was administered in daily doses ranging from 250 to 1750 mg over 14 days. The decrease in bacterial load was determined by culture of sputum samples to quantify cfu on solid medium, and time to positivity in liquid medium. RESULTS: In total, 77 participants received the experimental treatment. PK were best described by two-compartment disposition models for BTZ-043 and M2, and a one-compartment disposition model for M1. When given without food, the bioavailability was 54% (95% CI: 43%-65%) lower than with food. The decrease in bacterial load was described by a bilinear model with estimated node at 48 h. Participants in the highest dose group in Stage 2 (1000 mg) had a 2-fold faster decrease in mycobacterial load during the initial 2 days compared with participants in the lowest dose group (250 mg), driven by an Emax relationship to the BTZ-043total exposure (BTZ-043 + M2). CONCLUSIONS: We characterized the population PK/PD of BTZ-043 in trial participants with pulmonary TB. An exposure-response relationship was only apparent for the first 2 days on treatment, indicating the need for further dose-finding studies.
Impact Factor
Scopus SNIP
Web of Science
Times Cited
Scopus
Cited By
Altmetric
Publikationstyp
Artikel: Journalartikel
Dokumenttyp
Wissenschaftlicher Artikel
Typ der Hochschulschrift
Herausgeber
Schlagwörter
Early Bactericidal Activity; Mycobacterium-tuberculosis; Model
Keywords plus
Sprache
englisch
Veröffentlichungsjahr
2025
Prepublished im Jahr
0
HGF-Berichtsjahr
2025
ISSN (print) / ISBN
0305-7453
e-ISSN
1460-2091
ISBN
Bandtitel
Konferenztitel
Konferzenzdatum
Konferenzort
Konferenzband
Quellenangaben
Band: 80,
Heft: 5,
Seiten: 1315-1323
Artikelnummer: ,
Supplement: ,
Reihe
Verlag
Oxford University Press
Verlagsort
Great Clarendon St, Oxford Ox2 6dp, England
Tag d. mündl. Prüfung
0000-00-00
Betreuer
Gutachter
Prüfer
Topic
Hochschule
Hochschulort
Fakultät
Veröffentlichungsdatum
0000-00-00
Anmeldedatum
0000-00-00
Anmelder/Inhaber
weitere Inhaber
Anmeldeland
Priorität
Begutachtungsstatus
Peer reviewed
Institut(e)
Research Unit Global Health (UGH)
POF Topic(s)
30205 - Bioengineering and Digital Health
Forschungsfeld(er)
Enabling and Novel Technologies
PSP-Element(e)
G-540001-003
Förderungen
Swiss State Secretariat for Education, Research, and Innovation
Bavarian Ministry for Science and the Arts
German Center for Infection Research
Dutch Research Council
Copyright
Erfassungsdatum
2025-05-09