Negative in Ames, rat micronucleus and alkaline comet assays
“Acoramidis showed no mutagenic or clastogenic activity in a standard battery of genotoxicity studies, which included a bacterial reverse-mutation study and rat micronucleus and alkaline comet assays (Table 70).”
2-year rat and 26-week rasH2 mouse: no carcinogenic potential
“A two-year oral carcinogenicity study in rats did not identify any carcinogenic potential at doses up to 50 mg/kg/day (males) or 350 mg/kg/day (females), doses producing exposures that approximated the clinical AUC or were 11-times the clinical AUC, respectively, at the MRHD. No acoramidis-related tumors were observed in a 26-week oral carcinogenicity study in Tg rasH2 mice.”
Rat PPND: reduced pup weight gain and learning deficits at 1,000 mg/kg/day; no adverse effects at 350 mg/kg/day (~18x AUC)
“Decreased body weight gain from the neonatal period to weaning and learning deficits were observed in the offspring of dams given 1,000 mg/kg/day. No adverse effects on pre- and postnatal development were observed at 350 mg/kg/day, approximately 18-times the clinical exposure at the MRHD based on AUC.”
hERG IC50 >50 µM (>33-fold margin over free clinical exposure); no QT effect in dog telemetry
“The reported IC50 of >50 µM represents a >33-fold margin over the free fraction of the high clinical exposure estimated at 12,300 ng/mL. A GLP dog telemetry study demonstrated no concentration QT effect at multiple plasma concentrations above the high clinical exposure estimated at 12,300 ng/mL”
Not genotoxic overall: Ames negative; in vitro chromosome aberration positive without (not with) metabolic activation; rat micronucleus and comet negative