Nonclinical precedent Request an invite

Orzeyful

oveporexton
small moleculeOrexin OX2 receptor agonistOral brain-penetrant small-molecule orexin 2 receptor agonistNarcolepsy type 1
Species
MonkeyRat
Longest study
39 wk
Genotox
Conducted Conducted
Carcinogenicity
Conducted Conducted
Repro
Conducted Conducted
First dose
Not conducted Not stated publicly

Speciesopen answer page →

Species
Rat and cynomolgus monkey
“Single-dose and repeat-dose general toxicity studies were performed in Sprague-Dawley rats (up to 26-weeks duration) and in cynomolgus monkeys (up to 39-weeks duration). In rats, the primary target organs of toxicity included incisors, kidneys, and liver.”
✓ VerifiedFDA multi-discipline review, p. 47Source ↗
Why that species
Not stated in public reviews

The reviews list the species but not why. For small molecules, ICH M3(R2) expects one rodent and one non-rodent species, chosen with in vitro metabolism, protein binding and exposure data compared with human.

“In vitro metabolic and plasma protein binding data for animals and humans and systemic exposure data (ICH S3A, Ref. 7) in the species used for repeated-dose toxicity studies generally should be evaluated before initiating human clinical trials.”
✓ VerifiedICH 2009: ICH M3(R2): Guidance on Nonclinical Safety Studies for the Conduct…, p. 11Source ↗

Pre-IND readiness checklist →

Surrogate molecule
No surrogate; the clinical compound was tested
“Single-dose toxicity studies and repeat-dose toxicity studies were performed in Sprague-Dawley rats (2-, 4-, 13- and 26-weeks duration) and in Cynomolgus monkeys (2-, 4-, 13- and 39-weeks duration).”
✓ VerifiedFDA multi-discipline review, p. 65Source ↗

Study lengthopen answer page →

Longest pivotal study
39 (39-week monkey)
“Single-dose toxicity studies and repeat-dose toxicity studies were performed in Sprague-Dawley rats (2-, 4-, 13- and 26-weeks duration) and in Cynomolgus monkeys (2-, 4-, 13- and 39-weeks duration).”
✓ VerifiedFDA multi-discipline review, p. 65Source ↗
Pivotal GLP studies
26-week rat and 39-week cynomolgus monkey repeat-dose studies
“Single-dose toxicity studies and repeat-dose toxicity studies were performed in Sprague-Dawley rats (2-, 4-, 13- and 26-weeks duration) and in Cynomolgus monkeys (2-, 4-, 13- and 39-weeks duration).”
✓ VerifiedFDA multi-discipline review, p. 65Source ↗
Route in tox
Oral gavage
“Route of administration: Oral gavage”
✓ VerifiedFDA multi-discipline review, p. 68Source ↗

Skipped studiesopen answer page →

Genotoxicity
Negative in Ames and in vivo micronucleus; positive in vitro micronucleus (24-hour); overall non-genotoxic
“Oveporexton was found to be negative in an Ames assay and in an in vivo micronucleus assay; however, it was found to be positive for induction of micronuclei in an in vitro micronucleus assay following 24-hours of continuous treatment. Overall oveporexton was determined to be non-genotoxic.”
✓ VerifiedFDA multi-discipline review, p. 48Source ↗
Carcinogenicity
2-year rat and 6-month transgenic mouse: not carcinogenic
“Oveporexton was also found to be non-carcinogenic in a GLP 2-year rat and a GLP 6-month transgenic mouse carcinogenicity study.”
✓ VerifiedFDA multi-discipline review, p. 48Source ↗
Reproductive & developmental
Rat and rabbit EFD: no drug-related malformations or embryo-fetal lethality
“There were no drug-related effects on the incidence of congenital malformations or embryo-fetal lethality in either rats or rabbits.”
✓ VerifiedFDA multi-discipline review, p. 48Source ↗
Safety pharmacology
Rats: CNS (body temperature changes, hyperactivity at ≥20 mg/kg) and respiratory effects; monkeys: increased blood pressure and LV pressure at ≥3 mg/kg
“Results from GLP-compliant safety pharmacology studies indicated that oveporexton can affect the CNS (increased body temperature at 20 and 100 mg/kg, decreased body temperature at 1000 mg/kg, and hyperactivity at ≥20 mg/kg in rats), the cardiovascular system (increased blood pressure and left ventricular pressure at ≥3 mg/kg in monkeys), and the respiratory system”
✓ VerifiedFDA multi-discipline review, p. 46Source ↗

First doseopen answer page →

First-in-human starting dose
Not stated in public reviews
Why it's blank

The public FDA and EMA reviews of Orzeyful don't say how the first human dose was chosen. That rationale is in the IND, which is confidential, so it is missing for most approved products.

How it's usually set for small molecules outside oncology

Find the highest dose with no adverse effects (NOAEL) in each animal species, convert it to a human equivalent dose, usually by body surface area, pick the most appropriate species, then divide by a safety factor (default 10) to get the maximum recommended starting dose.

“In general, one should consider using a safety factor of at least 10. The MRSD should be obtained by dividing the HED by the safety factor.”
✓ VerifiedFDA 2005: Estimating the Maximum Safe Starting Dose in Initial Clinical…, p. 7Source ↗
This product's starting point

NOAEL / key findings: 26-week rat NOAEL 100 mg/kg in both sexes (FDA multi-discipline review, p. 68)

Full method, every step sourced →

NOAEL / key findings
26-week rat NOAEL 100 mg/kg in both sexes
“• NOAEL: 100 mg/kg for both sexes, associated with a mean Cmax of 7860 and 11,800 ng/mL, and a mean AUC24h of 115,000 and 168,000 h*ng/mL in males and females, respectively, in Week 26 of dosing.”
✓ VerifiedFDA multi-discipline review, p. 68Source ↗

Risksopen answer page →

Immune & cytokine safety
Not stated in public reviews
Not reported in the public reviews. Reviewers summarise selectively, so this usually means it wasn't discussed publicly, not that it wasn't studied.
Biodistribution & persistence
No melanin binding; placental transfer to fetus and secretion into milk in rats
“liver, with no evidence of binding to melanin-containing tissues. Oveporexton can be transferred into the fetus via the placenta during gestation and is also secreted into milk in lactating rats.”
✓ VerifiedFDA multi-discipline review, p. 46Source ↗
Modality-specific risk
Tooth fluorosis from increased fluoride, considered a rodent-specific metabolism-related change
“This finding was indicative of tooth fluorosis caused by increased fluoride concentrations which disrupts enamel formation. The tooth fluorosis is considered a species-specific metabolism-related change for rodents.”
✓ VerifiedFDA multi-discipline review, p. 47Source ↗

Similar precedents