Seratrodast

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Seratrodast (development name, AA-2414; marketed originally as Bronica)[1] is a thromboxane A2 (TXA2) receptor (TP receptor) antagonist used primarily in the treatment of asthma.[2][3] It was the first TP receptor antagonist that was developed as an anti-asthmatic drug and received marketing approval in Japan in 1997.[4] As of 2017 seratrodast was marketed as Bronica in Japan, and as Changnuo, Mai Xu Jia, Quan Kang Nuo in China.[5]

Unlike thromboxane synthase inhibitors such as ozagrel, seratrodast does not affect thrombus formation, time to occlusion and bleeding time.[6] Seratrodast has no effect on prothrombin time and activated partial thromboplastin time, thus ruling out any action on blood coagulation cascade.[7]

Medical uses

Seratrodast is used to treat asthma.[8][9]

There are no adequate and well-controlled studies of seratrodast in pregnant women. The drug should be used in pregnancy only if the potential benefits justify the risk to the fetus.[9] Seratrodast should not be used during lactation.[9]

The safety and efficacy of seratrodast has not been established in children (<18 years of age).[9]

Contraindications and interactions

Seratrodast should not be used in people with liver disease.[9]

Use with paracetamol or with cephem antibiotics increases the risk of liver damage. Use with aspirin increases the bioavailability of seratrodast.[9]

Adverse effects

The most frequently observed (0.1 to 5%) adverse reactions include elevated transaminases, nausea, loss of appetite, stomach discomfort, abdominal pain, diarrhea, constipation, dry mouth, taste disturbance, drowsiness, headache, dizziness, palpitations and malaise.[9] Less than 0.1% of patients experienced vomiting, thrombocytopenia, epistaxis, bleeding tendency, insomnia, tremor, numbness, hot flushes and edema.[9] All the adverse reactions reported were of mild to moderate severity, and resolved when the drug was discontinued.[9]

Pharmacology

Thromboxane A2 (TXA2) is generated in the lungs of people with asthma, and when it signals through the thromboxane receptor it causes bronchoconstriction, vasoconstriction, mucous secretion, and airway hyper-responsiveness. Seratrodast inhibits the activity of the thromboxane receptor, blocking the effects of TXA2.[10]

Pharmacokinetics

The pharmacokinetics of seratrodast have been studied in Japanese and Caucasian, including Indian, healthy volunteers.[11][12][13][14] The plasma concentrations of seratrodast increase with increasing doses. The absorption of seratrodast is relatively rapid with maximum plasma concentrations of 4.6–6 μg/ml obtained in 3 to 4 hours.[11] Steady state plasma concentrations of seratrodast are reached within 4–5 days.[13] Seratrodast is slowly cleared, mainly by hepatic biotransformation. The drug shows biexponential decay in plasma profiles with a mean elimination half-life of 22 hours.[11][13] Approximately 20% of the administered dose is recovered in the urine, with 60% of the urinary recovery being in the form of conjugates [12]

Chemistry

File:Seratrodast synth.png

Seratrodast can be prepared in five steps starting from pimelic acid monoester.[15]

History

Seratrodast was the first thromboxane receptor antagonist to reach the market as a treatment for asthma; it was approved in Japan in 1997.[8]

Society and culture

As of 2017 seratrodast was marketed as Bronica in Japan, Changnuo, Mai Xu Jia, Quan Kang Nuo in China and as Seretra & Seradair in India.[5]

Research

Seratrodast was studied in perennial allergic rhinitis, chronic bronchitis and chronic pulmonary emphysema but efforts to bring the drug to market in those indications was abandoned around 2000.[1]

References

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