The novel ghrelin receptor inverse agonist PF-5190457 administered with alcohol: Preclinical safety experiments and a phase 1b human laboratory study
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Rodent studies indicate that ghrelin receptor blockade reduces alcohol consumption. However, no ghrelin receptor blockers have been administered to heavy alcohol drinking individuals. Therefore, we evaluated the safety, tolerability, pharmacokinetic (PK), pharmacodynamic (PD) and behavioral effects of a novel ghrelin receptor inverse agonist, PF-5190457, when co-administered with alcohol. We tested the effects of PF-5190457 combined with alcohol on locomotor activity, loss-of-righting reflex (a measure of alcohol sedative actions), and on blood PF-5190457 concentrations in rats. Then, we performed a single-blind, placebo-controlled, within-subject human study with PF-5190457 (placebo/0 mg b.i.d., 50 mg b.i.d., 100 mg b.i.d.). Twelve heavy drinkers during three identical visits completed an alcohol administration session, subjective assessments, and an alcohol cue-reactivity procedure, and gave blood samples for PK/PD testing. In rats, PF-5190457 did not interact with the effects of alcohol on locomotor activity or loss-of-righting reflex. Alcohol did not affect blood PF-5190457 concentrations. In humans, all adverse events were mild or moderate and did not require discontinuation or dose reductions. Drug dose did not alter alcohol concentration or elimination, alcohol-induced stimulation or sedation, or mood during alcohol administration. Potential PD markers of PF-5190457 were acyl-to-total ghrelin ratio and insulin-like growth factor-1. PF-5190457 (100 mg b.i.d.) reduced alcohol craving during the cue-reactivity procedure. This study provides the first translational evidence of safety and tolerability of the ghrelin receptor inverse agonist PF-5190457 when co-administered with alcohol. PK/PD/behavioral findings support continued research of PF-5190457 as a potential pharmacological agent to treat alcohol use disorder.
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In a small initial clinical trial of 12 heavy drinkers, PF-5190457 lessened alcohol cravings and reactivity to alcohol-related cues compared to placebo.
“In a small initial clinical trial involving 12 heavy drinkers, PF-5190457, when compared to a placebo, lessened alcohol cravings and reactivity to alcohol-related cues.”
From A Narrative Review of Current and Emerging Trends in the Treatment of Alcohol Use Disorder (2024) · cites this paper as [93]
The Results (Human laboratory study, CR procedure) report that PF-5190457 reduced alcohol cue-elicited craving compared with placebo in the 12-heavy-drinker study. But the Results also say it did not reduce craving in the regular hospital room; describing the effect as reduced alcohol craving and cue reactivity generally is broader than the measured findings. (LLM, conf=0.84)
Experimental — accuracy not yet measuredIn that trial, PF-5190457 was safe and well tolerated when used with alcohol, with no adverse interactions.
“Furthermore, when used in conjunction with alcohol, PF-5190457 proved safe and well tolerated, showing no adverse interactions between the drug and alcohol”
From A Narrative Review of Current and Emerging Trends in the Treatment of Alcohol Use Disorder (2024) · cites this paper as [93]
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Kirsch, D. E., Grodin, E. N., Leggio, L., McKee, S. A., Meredith, L. R., Mereish, E. H., Miranda, R., Nieto, S. J., O’Malley, S. S., Schacht, J. P., et al. (2025) · Alcoholism Clinical and Experimental Research · doi:10.1111/acer.70170 · Cited by 2 · see citing works
Self-citation
- Authors
- Lee, M. R., Tapocik, J. D., Ghareeb, M., Schwandt, M. L., Dias, A. A., Le, A. N., Cobbina, E., Farinelli, L. A., Bouhlal, S., Farokhnia, M., Heilig, M., Akhlaghi, F., & Leggio, L.
- Affiliations
- National Institutes of Health (US)
- University of Rhode Island (US)
- Linköping University (SE)
- Corresponding author
- Leggio, Lorenzo
- ORCID
- Venue
- Molecular Psychiatry
- Published
- 2018-05-04
- Volume
- 25
- Issue
- 2
- Pages
- 461-475
- ISSN
- 1359-4184 (ISSN-L)
- 1476-5578
- PMC
- PMC6215751
- OpenAlex
- W2799409941
- Cited by
- 129
- References
- 69
- Citations by year
- 2026: 8 · 2025: 13 · 2024: 22 · 2023: 12 · 2022: 19 · 2021: 16 · 2020: 15 · 2019: 14 · 2018: 10
- FWCI
- 7.76
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Molecular Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Journal of Media Literacy Education (submittedVersion, cc-by)
- Funders
- National Institutes of Health (UH2TR000963, UH3TR000963)
- National Institute on Alcohol Abuse and Alcoholism (ZIAAA000218)
- National Center for Advancing Translational Sciences
- Topics
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- alcoholism, alcohol craving, alcohol cue reactivity, pharmacokinetics, pharmacodynamics, drug safety and tolerability, heavy drinkers, insulin-like growth factor I, locomotor activity
- MeSH terms
- Adult, Alcohol Drinking, Ethanol, Alcoholic Intoxication, Alcoholism, Animals, Azetidines, Female, Humans, Male, Middle Aged, Research Design, Spiro Compounds, Single-Blind Method, Rats, Wistar, Rats, Ghrelin, Receptors, Ghrelin
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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