cenicriviroc and Liver-Diseases

Cenicriviroc, a dual CCR2/CCR5 antagonist, is being evaluated for treatment of nonalcoholic steatohepatitis and liver fibrosis (CENTAUR; NCT02217475). As it is metabolized by the liver, cenicriviroc was investigated in hepatic-impaired participants for pharmacokinetic changes. Participants with mild-to-moderate hepatic impairment (HI) (Child-Pugh class A (N  =  7) or B (N = 8)) and matched controls (N = 15) received cenicriviroc 150 mg once daily for 14 days. Serial blood samples were obtained on Days 1 and 14. Safety, tolerability, and effects on CCR2/CCR5 ligands, cytokines, and bacterial translocation biomarkers were evaluated. Cenicriviroc exposures were increased by moderate HI (AUC0-τ  55%, Cmax 29% higher) but were not with mild HI (AUC0-τ 38%, Cmax 40% lower). Cenicriviroc was well tolerated. Rapid and potent CCR2/CCR5 blockade was observed, not associated with increases in hepatic inflammation or bacterial translocation biomarkers. Study findings suggest that cenicriviroc 150 mg can be used in patients with mild-to-moderate HI.

Topics: Bacterial Translocation; Biomarkers; Case-Control Studies; Cytokines; Demography; Fatty Acid-Binding Proteins; Female; Flagellin; Humans; Imidazoles; Inflammation Mediators; Intestines; Liver Diseases; Male; Middle Aged; Permeability; Receptors, CCR2; Receptors, CCR5; Sulfoxides; Time Factors

Cholestatic liver injury is mediated by bile acid-induced inflammatory responses. We hypothesized that superior therapeutic effects might be achieved by combining treatments that reduce the bile acid pool size with one that blocks inflammation.. All-trans retinoic acid alone reduced bile acid pool size and liver necrosis in BDL rats. However, the combination with CVC further reduced liver to body weight ratio, bile acid pool size, plasma liver enzyme, bilirubin, liver necrosis and fibrosis when compared to the atRA treatment. The assessment of hepatic hydroxyproline content further confirmed the reduced liver injury concurrent with reduction of pro-inflammatory cytokines emphasizing the synergistic effects of these two agents. Profiling of hepatic inflammatory cells revealed that combination therapy reduced neutrophils and T cells but not macrophages. The superior therapeutic effects of combination treatment were also confirmed in Mdr2. Multitargeted therapy is an important paradigm for treating cholestatic liver injury. The combination of CVC with atRA or other FXR activators may warrant a clinical trial in patients with cholestatic liver disease.

Topics: Animals; ATP Binding Cassette Transporter, Subfamily B; ATP-Binding Cassette Sub-Family B Member 4; Bile Acids and Salts; Cholestasis; Disease Models, Animal; Drug Therapy, Combination; Imidazoles; Ligation; Liver; Liver Diseases; Male; Mice; Mice, Knockout; Rats; Rats, Sprague-Dawley; Receptors, Cytokine; Sulfoxides; Tretinoin

Topics: Animals; Imidazoles; Liver Diseases; Receptors, Cytokine; Rodentia; Sulfoxides; Tretinoin

Topics: Anti-Inflammatory Agents; Antibodies, Monoclonal, Humanized; Antiviral Agents; Bezafibrate; Budesonide; CCR5 Receptor Antagonists; Congresses as Topic; Fibroblast Growth Factors; Gastrointestinal Agents; Humans; Imidazoles; Liver Diseases; Pyridazines; Sulfoxides; Uracil; Ursodeoxycholic Acid