Negative in Ames, in vitro chromosomal aberration and in vivo rat micronucleus assays
“There was no evidence of mutagenicity or clastogenicity for aprocitentan in a standard battery of tests that included in vitro bacterial reverse mutation and chromosomal aberration assays, and an in vivo rat micronucleus study.”
Not conducted with aprocitentan; assessment relied on macitentan carcinogenicity studies
“The carcinogenicity assessment of aprocitentan was based on carcinogenicity studies conducted with another ERA, macitentan, for which its major metabolite is aprocitentan. No carcinogenicity studies were conducted with aprocitentan alone.”
Not reported in the public reviews. Reviewers summarise selectively, so this usually means it wasn't discussed publicly, not that it wasn't studied.
Instead of genotoxicity
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.
DRG histopathology
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.
Reproductive & developmental
Macitentan rat and rabbit EFD: teratogenic at all doses, no NOAEL; risk extrapolated to aprocitentan
“In embryo-fetal developmental (EFD) toxicity studies, treatment with macitentan (for which aprocitentan is a major metabolite) in pregnant rats and rabbits revealed teratogenicity and developmental toxicity at all doses tested, and therefore a no observed adverse effect level (NOAEL) for embryo fetal toxicity in the rat and rabbits could not be established.”
“There was no evidence of mutagenicity or clastogenicity for aprocitentan in a standard battery of tests that included in vitro bacterial reverse mutation and chromosomal aberration assays, and an in vivo rat micronucleus study.”
“There was no evidence of mutagenicity or clastogenicity for aprocitentan in a standard battery of tests that included in vitro bacterial reverse mutation and chromosomal aberration assays, and an in vivo rat micronucleus study.”
“There was no evidence of mutagenicity or clastogenicity for aprocitentan in a standard battery of tests that included in vitro bacterial reverse mutation and chromosomal aberration assays, and an in vivo rat micronucleus study.”
2-year mouse and rat with macitentan: negative (~30x and 11x aprocitentan AUC at MRHD)
“Two-year carcinogenicity studies with macitentan did not identify any carcinogenic potential at doses up to 100 mg/kg/day and 250 mg/kg/day in mice and rats, where aprocitentan exposures represented approximately 30-fold and 11-fold, respectively, the clinical aprocitentan exposure at the MRHD based on AUC.”
2-year mouse and rat studies with macitentan (parent drug) completed before the marketing application
“Two-year carcinogenicity studies with macitentan did not identify any carcinogenic potential at doses up to 100 mg/kg/day and 250 mg/kg/day in mice and rats”
Not genotoxic overall: Ames negative; in vitro chromosome aberration positive without (not with) metabolic activation; rat micronucleus and comet negative