Evidence Hub

Safety, tolerability, pharmacokinetics, and pharmacodynamics of zapnometinib: results from a phase I clinical study

Stenglein S, Volk J, Füll Y, Reh C, Haffner S, Canisius S, Overend T, Planz O

Frontiers in pharmacology, 2026

42 participants

Abstract

Introduction: Zapnometinib (ATR-002) is a selective MEK inhibitor designed to modulate the MAPK/ERK pathway, which plays a key role in viral infections and inflammatory diseases. Clinical characterization of its safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) is essential to support further development. This Phase I clinical trial was registered under EudraCT number 2021-005225-25.

Methods: This was a Phase I, single-center, randomized, double-blind, placebo-controlled trial conducted in healthy adults. The study included three parts: a single ascending dose (SAD) phase, a multiple ascending dose (MAD) phase, and a drug-drug interaction (DDI) as well as a food-drug interaction (FDI) phase. In the SAD phase, 42 participants received single oral doses of 600, 900, 1,200, or 1,500 mg. In the MAD phase, 29 participants received daily oral doses of 900, 1,200, or 1,500 mg for 7 days. The DDI phase assessed the effect of zapnometinib on CYP2C8 and CYP2C9 activity using repaglinide and celecoxib as probe substrates.

Results: Zapnometinib was well tolerated with no serious adverse events reported. Most treatment-emergent adverse events (TEAEs) were mild to moderate, including gastrointestinal symptoms (e.g., diarrhea, nausea) and headache. PK analysis showed dose-proportional increases in Cmax and AUC, with a notable food effect that increases bioavailability. PD evaluation demonstrated significant MEK inhibition, evidenced by reduced ERK phosphorylation.…

How strong is the evidence?

Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 42 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

Read the paper

Related studies

Go deeper in Evidence Hub

Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.

Open this study Sign up free