Pharmacokinetics, mass balance, and metabolism of [14C]vicagrel, a novel irreversible P2Y12 inhibitor in humans

Yuan-dong Zheng1,2, Hua Zhang3,4, Yan Zhan1,2, Yi-cong Bian3,4, Sheng Ma3,4, Hai-xian Gan1, Xiao-juan Lai5, Yong-qiang Liu5, Yan-chun Gong5, Xue-fang Liu5, Hong-bin Sun6, Yong-guo Li7, Da-fang Zhong1,2, Li-yan Miao3,4, Xing-xing Diao1,2
1 State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201210, China
2 University of Chinese Academy of Sciences, Beijing 100049, China
3 Department of Clinical Pharmacology, the First Affiliated Hospital of Soochow University, Suzhou 215123, China
4 Institute for Interdisciplinary Drug Research and Translational Sciences, Soochow University, Suzhou 215006, China
5 Jiangsu Vcare PharmaTech Co. Ltd., Nanjing 211800, China
6 State Key Laboratory of Natural Medicines and Center of Drug Discovery, College of Pharmacy, China Pharmaceutical University, Nanjing 210009, China
7 Guangzhou JOYO Pharma Ltd., Shanghai 201203, China
Correspondence to: Da-fang Zhong:, Li-yan Miao:, Xing-xing Diao:,
DOI: 10.1038/s41401-020-00547-7
Received: 23 June 2020
Accepted: 23 September 2020
Advance online: 26 November 2020


Vicagrel, a novel irreversible P2Y12 receptor inhibitor, is undergoing phase III trials for the treatment of acute coronary syndromes in China. In this study, we evaluated the pharmacokinetics, mass balance, and metabolism of vicagrel in six healthy male Chinese subjects after a single oral dose of 20 mg [14C]vicagrel (120 μCi). Vicagrel absorption was fast (Tmax = 0.625 h), and the mean t1/2 of vicagrel-related components was ~38.0 h in both plasma and blood. The blood-to-plasma radioactivity AUCinf ratio was 0.55, suggesting preferential distribution of drug-related material in plasma. At 168 h after oral administration, the mean cumulative excreted radioactivity was 96.71% of the dose, including 68.03% in urine and 28.67% in feces. A total of 22 metabolites were identified, and the parent vicagrel was not detected in plasma, urine, or feces. The most important metabolic spot of vicagrel was on the thiophene ring. In plasma pretreated with the derivatization reagent, M9-2, which is a methylated metabolite after thiophene ring opening, was the predominant drug-related component, accounting for 39.43% of the radioactivity in pooled AUC0–8 h plasma. M4, a mono-oxidation metabolite upon ring-opening, was the most abundant metabolite in urine, accounting for 16.25% of the dose, followed by M3-1, accounting for 12.59% of the dose. By comparison, M21 was the major metabolite in feces, accounting for 6.81% of the dose. Overall, renal elimination plays a crucial role in vicagrel disposition, and the thiophene ring is the predominant metabolic site.
Keywords: vicagrel; [14C]vicagrel; vicagrel pharmacokinetics; vicagrel metabolism; mass balance; P2Y12 receptor inhibitor

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