Model-Based Meta-analysis for the Population Pharmacokinetics of
Iberdomide and Its Major Active Metabolite in Healthy Subjects and
Subjects with Relapse and Refractory Multiple Myeloma
Abstract
Aim A parent-metabolite population pharmacokinetic (popPK) model of
iberdomide was developed and the influence of demographic and
disease-related covariates on popPK parameters was assessed based on
data from three clinical studies of iberdomide (dose range, 0.1 to 6 mg)
in healthy subjects (N=81) and subjects with relapsed and refractory
multiple myeloma (N=245). Methods Nonlinear mixed effects modeling was
used to develop the popPK model based on data from 326 subjects across 3
clinical studies. Results The pharmacokinetics (PK) of iberdomide were
adequately described with a two-compartment model with first-order
absorption and elimination. A first order conversion rate was used to
link the one-compartment linear elimination metabolite model with the
parent model. Subject type (multiple myeloma subjects vs. healthy
subject) was a statistically significant covariate on apparent clearance
(CL/F) and apparent volume of distribution for the central compartment
(V1/F), suggesting different PK between subjects with multiple myeloma
and healthy subjects. Aspartate aminotransferase (AST), alkaline
phosphatase (ALP) and sex were statistically but not clinically relevant
covariates on CL/F. Metabolite (M12) PK tracked the PK of iberdomide.
The metabolite to parent ratio was consistent across doses and
combinations. Conclusion In conclusion, the parent-metabolite population
pharmacokinetic model adequately described the time course PK data of
iberdomide and M12. Iberdomide and M12 show robust PK exposure, not
complicated by demographic factors, combination, hepatic or (mild and
moderate) renal impairments. The model can be used to guide the dosing
strategy for special patient population and inform future iberdomide
study design.