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Antimicrobial Agents and Chemotherapy, June 2007, p. 1912-1917, Vol. 51, No. 6
0066-4804/07/$08.00+0     doi:10.1128/AAC.01223-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Lack of Effect of DX-619, a Novel Des-Fluoro(6)-Quinolone, on Glomerular Filtration Rate Measured by Serum Clearance of Cold Iohexol

Daiichi Sankyo Pharma Development, Edison, New Jersey,¹ Daiichi Sankyo Pharma Development, Chiltern Place, United Kingdom²

Received 28 September 2006/ Returned for modification 29 January 2007/ Accepted 8 March 2007

DX-619 is a novel des-fluoro(6)-quinolone with activity against a broad range of bacterial strains, including methicillin-resistant Staphylococcus aureus. The effects of DX-619 on the glomerular filtration rate (GFR) were evaluated because drug-related increases in serum creatinine levels were observed in studies with healthy volunteers. Forty-one healthy subjects were randomized to receive intravenous DX-619 at 800 mg or placebo once daily for 4 days, and the GFR was directly measured by determination of the clearance of a bolus iohexol injection in 33 subjects who completed the study per protocol. DX-619 was noninferior to placebo for the GFR on the basis of a criterion for a clinically significant difference of –12 ml/min/1.73 m². The mean GFRs on day 4 were 101.1 ± 14.2 ml/min/1.73 m² and 100.2 ± 15.6 ml/min/1.73 m² for the volunteers receiving placebo and DX-619, respectively. On day 4 the mean serum creatinine concentration for volunteers receiving DX-619 increased by 30 to 40%, with a corresponding decrease in mean creatinine clearance. Both parameters normalized within 7 days after the cessation of DX-619 treatment. Nonclinical studies suggest that DX-619 increases the serum creatinine concentration by inhibiting excretory tubular transporters. In conclusion, DX-619 administered intravenously at 800 mg once a day for 4 days did not affect the GFR in healthy volunteers. Glomerular toxicity is not expected to present a risk to patients receiving DX-619 in clinical trials, but monitoring of the renal function, with an emphasis on the serum creatinine concentration, is still warranted.

Published ahead of print on 19 March 2007.