Lucinactant is a new synthetic peptide-containing surfactant for intratracheal use. It contains sinapultide, a novel, hydrophobic, 21-amino acid peptide (leucine and lysine repeating units, KL4 peptide) designed to mimic human surfactant protein-B (SB-P). More specifically, it mimics the C-terminal amphipathic helical domain of this protein. It also consists of phospholipids (dipalmitoylphosphatidylcholine, DPPC and palmitoyloleoyl phosphatidylglycerol, POPG) and a fatty acid (palmitic acid). It is completely devoid of animal-derived components. FDA approved on March 6, 2012.

Protein chemical formula

C ₁₂₆ H ₂₃₈ N ₂₆ O ₂₂

Protein average weight

2470.2 Da

Sequences

>Protein sequence for sinapultide
KLLLLKLLLLKLLLLKLLLLK

Download FASTA Format

Synonyms

ATI-02
KL4-surfactant

Categories

UNII

Not Available

CAS number

825600-90-6

Pharmacology

Indication

Intended for the prevention of respiratory distress syndrome (RDS) in premature infants at high risk for RDS.

Pharmacodynamics

Lucinactant is a new synthetic surfactant containing a protein that mimics human surfactant protein-B, is effective at preventing respiratory distress syndrome (RDS) and related complications in preterm infants. Lucinactant has been shown to have antiinflammatory properties, is resistant to proteolytic degradation and oxidation, and has no potential for transmitting animal-derived diseases. Lucinactant has proven safe and effective in the prevention of RDS in preterm infants and as a treatment for MAS in full-term infants and for adult ARDS.

Mechanism of action

Pulmonary surfactant is a lipoprotein complex that is produced naturally in the lungs, where it lines the alveolar epithelium and serves to reduce surface tension, which facilitates alveoli expansion and allows gas exchange. Human surfactants contain phospholipids, predominantly dipalmitoylphosphatidylcholine (DPPC), in addition to surfactant proteins A, B, C and D. Surfactant is also a physical barrier to inhaled particle and noxious agents, enhances particle clearance, is involved in host defense against infection and possesses antiinflammatory properties. Several serious respiratory disorders have been associated with a loss or lack of endogenous surfactant. Lucinactant was designed to mimic the essential endogenous human surfactant protein B (SP-B).

Absorption

Not Available

Volume of distribution

Not Available

Protein binding

Not Available

Metabolism

Not Available

Route of elimination

Not Available

Half life

Not Available

Clearance

Not Available

Toxicity

Most common adverse reactions associated with the use of lucinactant are endotracheal tube reflux, pallor, endotracheal tube obstruction, and need for dose interruption.

Affected organisms

Humans and other mammals

Pathways

Not Available

Pharmacogenomic Effects/ADRs

Not Available

Interactions

Drug Interactions

Drug	Interaction
Acebutolol	Acebutolol may increase the bradycardic activities of Lucinactant.
Amiodarone	Amiodarone may increase the bradycardic activities of Lucinactant.
Amlodipine	Lucinactant may increase the bradycardic activities of Amlodipine.
Atenolol	Atenolol may increase the bradycardic activities of Lucinactant.
Bendroflumethiazide	Bendroflumethiazide may increase the bradycardic activities of Lucinactant.
Beractant	Lucinactant may increase the bradycardic activities of Beractant.
Betaxolol	Betaxolol may increase the bradycardic activities of Lucinactant.
Bisoprolol	Bisoprolol may increase the bradycardic activities of Lucinactant.
Bretylium	Bretylium may increase the bradycardic activities of Lucinactant.
Calfactant	Lucinactant may increase the bradycardic activities of Calfactant.

Food Interactions

Not Available

References

General References

Sinha SK, Lacaze-Masmonteil T, Valls i Soler A, Wiswell TE, Gadzinowski J, Hajdu J, Bernstein G, Sanchez-Luna M, Segal R, Schaber CJ, Massaro J, d'Agostino R: A multicenter, randomized, controlled trial of lucinactant versus poractant alfa among very premature infants at high risk for respiratory distress syndrome. Pediatrics. 2005 Apr;115(4):1030-8. [PubMed:15805381]
Moya F, Sinha S, Gadzinowski J, D'Agostino R, Segal R, Guardia C, Mazela J, Liu G: One-year follow-up of very preterm infants who received lucinactant for prevention of respiratory distress syndrome: results from 2 multicenter randomized, controlled trials. Pediatrics. 2007 Jun;119(6):e1361-70. Epub 2007 May 28. [PubMed:17533176]
Halliday HL, Speer CP: Lucinactant versus poractant-alpha in premature lambs. Pediatrics. 2006 Jun;117(6):2324-5; author reply 2325. [PubMed:16740886]
Gastiasoro-Cuesta E, Alvarez-Diaz FJ, Rey-Santano C, Arnaiz-Renedo A, Loureiro-Gonzalez B, Valls-i-Soler A: Acute and sustained effects of lucinactant versus poractant-alpha on pulmonary gas exchange and mechanics in premature lambs with respiratory distress syndrome. Pediatrics. 2006 Feb;117(2):295-303. [PubMed:16452346]
Donn SM: Lucinactant: a novel synthetic surfactant for the treatment of respiratory distress syndrome. Expert Opin Investig Drugs. 2005 Mar;14(3):329-34. [PubMed:15833063]
Moen MD, Perry CM, Wellington K: Lucinactant: in neonatal respiratory distress syndrome. Treat Respir Med. 2005;4(2):139-45; discussion 146-7. [PubMed:15813666]
Doyle I: Lucinactant (Discovery Laboratories). IDrugs. 2002 Jul;5(7):696-702. [PubMed:12802703]

External Links

PubChem Substance: 347909842
ChEMBL: CHEMBL1963685
RxList: RxList Drug Page
Drugs.com: Drugs.com Drug Page
Wikipedia: Lucinactant

FDA label

Download (267 KB)

Clinical Trials

Clinical Trials

Phase	Status	Purpose	Conditions	Count
2	Completed	Treatment	Hypoxemic Acute Respiratory Failure	1
2	Terminated	Prevention	Chronic Lung Disease of Prematurity / Premature Births / Respiratory Distress Syndrome, Newborn	1
2	Terminated	Treatment	Respiratory Distress Syndrome (RDS)	1
3	Terminated	Treatment	Meconium Aspiration Syndrome	1

Pharmacoeconomics

Manufacturers

Not Available

Packagers

Not Available

Dosage forms

Not Available

Prices

Not Available

Patents

Patent Number	Pediatric Extension	Approved	Expires (estimated)
US5407914	No	2012-03-06	2013-11-17

Properties

State: Liquid
Experimental Properties: Not Available

Taxonomy

Description: Not Available
Kingdom: Organic Compounds
Super Class: Organic Acids
Class: Carboxylic Acids and Derivatives
Sub Class: Amino Acids, Peptides, and Analogues
Direct Parent: Peptides
Alternative Parents: Not Available
Substituents: Not Available
Molecular Framework: Not Available
External Descriptors: Not Available

Drug created on October 21, 2007 16:23 / Updated on August 02, 2018 05:28