Journal
JOURNAL OF CLINICAL PHARMACOLOGY
Volume 50, Issue 6, Pages 647-658Publisher
WILEY
DOI: 10.1177/0091270009349379
Keywords
acetylation; triethylenetetramine; metabolism; pharmacokinetics; pharmacodynamics
Categories
Funding
- Foundation for Research Science and Technology, New Zealand
- Endocore Research Trust
- Health Research Council of New Zealand
- Maurice & Phyllis Paykel Trust
- National Heart Foundation of New Zealand
- Auckland Medical Research Foundation
- Protemix Corporation
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The selective Cu-II-chelator, triethylenetetramine (TETA), is undergoing clinical trials for the treatment of heart failure in patients with diabetes. Recently, the authors showed that 2 acetylated metabolites, N-1-acetyltriethylenetetramine (MAT) and N-1,N-10-diacetyltriethylenetetramine (DAT), are formed in humans following oral TETA administration. Thus, it became necessary to determine whether the N-acetyltransferase (NAT) 2 phenotype has any effects on the pharmacological properties and safety profile of TETA. Twelve fast and 12 slow NAT2-phenotype healthy participants were recruited. After oral drug administration, the authors collected plasma and urine samples, measured plasma concentrations of TETA and its 2 metabolites along with concomitant urinary copper concentrations, and performed safety tests. They present, for the first time, the complete 24-hour pharmacokinetic profiles of TETA, MAT, and DAT in humans. There was no evidence for clear-cut differences in pharmacokinetic profiles between fast and slow acetylators. Pharmacodynamic analysis showed no significant differences in cupruresis between the 2 NAT2 phenotypes. Safety results were consistent with TETA being well tolerated, and no significant differences in safety profiles were observed between the 2 phenotypes. Based on these data, NAT2 phenotype does not affect TETA's pharmacokinetic, pharmacodynamic, or safety profiles. TETA may be acetylated via an alternative mechanism, such as that catalyzed by spermidine/spermine N-1-acetyltranferase.
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