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Table 1. Healthy volunteers of the studies on NM441 Table 2. Examination items 1. Symptoms 2. Blood pressure, Pulse rate, Respiratory rate 1), Body temperature, Body weight, ECG 3. Labolatory test 1) Hematology: RBC, Hb, Ht, WBC, differential WBC, Platelets, Reticulocyte 2) Biochemistry: GOT, GPT, ALP, LDH, LAP, ć-gtp, ChE, CK, Amylase, Total cholesterol, Triglyceride, Glucose (fasting state), Total protein, A/G ratio, Albumin, Protein fraction, TTT, ZTT, Total and direct bilirubin, BUN, Creatinin, Uric acid, Na, K, Cl, Ca, P 3) Immunology: CRP, Coombs' test 4) Urinalysis: Specific gravity, ph, Glucose, Protein, Urobilinogen, Bilirubin, Urobilin, Ketone, Sediment,NAG, Ĉ2-microgloblin 4. Equilibrium test (stabilography)4)5), EEG 5) 5. Crystal in urine (macroscopy and microscopy) 3)4) 6. Plasma concentration2) `5), Urinary concentration (excretion) 2) `5 Salivary concentration3)4), Fecal concentration (excretion) 4), Urinary metabolite 2) `4), Protein bindings 5) Performed in 1) single oral administration 2) 100mg single oral administration 3) 200mg single oral administration 4) 400mg single oral administration 5) multiple oral administration

Fig. 1. Study schedule (single oral administration) Fig. 2. Study schedule (multiple oral administration) [HPLC conditions] Apparatus: Pump Model M 45 J (Waters) or Model 510 (Waters) Detector 484 Tunable Absorbance Detector (Waters) or JASCO UVIDEC-100-IV (Jasco) Autosampler 712 WISP (Waters) Recorder C-R5A Chromatopac(Shimadzu) Column Oven 860 CO(Jasco) Guard column: Guard-pak precolumn module (Waters), precolumn cartridge Nova-PaK C 18 Column: Capcell Pak C18 SG12O 4.6mm0 ~250mm (Shiseido) Mobile phase: 0.05M phosphate buffer (ph 2.0)/acetonitrile/methanol (plasma and saliva sample ; 10: 5: 6, urine 0.1ml sample ; 10: 7: 7, urine 0.5ml sample ; 10: 6: 6) Column temperature : 40 Ž Flow rate : 1.0ml/min Detection : UV 275nm [Calibration range] Plasma : 0.025 `2.5pg/0.5ml thiazeto[3,2-a]quinoline-3-carboxylic acid] in 0.05M phosphate Urine : 0.5 `50ƒÊg/0.1ml or 0.25 `25ƒÊg/0.5ml buffer (ph 7.4) Saliva. 0.025 `1ƒÊg/0.5ml Fig. 3-1. Determination procedure of NM394 in plasma, urine and saliva by HPLC method

[HPLC conditions] Apparatus: Same as Fig. 3-1 Guard column: Guard-pak precolumn module (Waters). Precolumn cartridge Nova-PaK C18 Column: Capcell Pak C18 SG120 4.6mm0 ~250mm (Shiseido) Mobile phase: 0.05M phosphate buffer (ph 2.0)/acetonitrileimethanol (16 : 3: 3) Column temperature: 40 Ž Flow rate: 1.0ml/min Detection : UV 275nm [Calibration Blood: range] 0.025 `2.5/2g/0.5ml Fig. 3-2. Determination procedure of NM441 in blood by HPLC method NAD-312: Ethyl 6-fluoro-7-(4-methyl-1-piperazinyl)-4-oxo-1- phenyl-4h-[1,3] thiazeto [3,2-a]quinoline-3-carboxyrate [HPLC conditions] Apparatus: Same as Fig. 3-1 Guard column: Guard-pak precolumn module (Waters), precolumn cartridge Nova-PaK C18 Column: Capcell Pak C18 SG120 4.6mmƒÓ ~250mm (Shiseido) Mobile phase: Method [1] 0.05M phosphate buffer (ph 2.0)/acetonitrile (4: 1) Method [2] 0.05M phosphate buffer (ph 2.0)/acetonitrile/methanol (10 : 4 : 1) Method [3] 0.05M phosphate buffer (ph 2.0)/acetonitrile (21: 2) Column temperature: 40 Ž Flow rate: 1.0ml/min Detection: UV 275nm [Calibration range] Oxo, amino: 0.25 `30ƒÊg/0.5ml Ethylene diamino: 0.02 `3ƒÊg/0.1ml NM394 glucuronide: 0.025 `1ƒÊg/0.5ml Fig. 3-3. Determination procedure of oxo and amino compounds (method [1]), ethylene diamino compound (method [2]) and NM394 glucuronide (method [3]) in urine by HPLC method

[HPLC conditions] Guard column : Guard-pak precolumn module (Waters), precolumn cartridge Nova-PaK C18 Column: Capcell Pak C18 SG120 4.6mm0 ~250mm (Shiseido) Mobile phase 0.05M phosphate buffer (ph 2.0)/acetonitrile (10: 3.5) Flow rate 1.0mlimin Column temperature: 40 Ž Detection : Fluorescence Ex 280nm, Em 425nm (Scanning Fluorescence Detector) [Calibration NM441: NM394: range] 6 `600ƒÊg/g 6 `600ƒÊg/g Fig. 3-4. Determination procedure of NM441 and NM394 in feces by HPLC method [Determination Test organism methodi Strain: Escherichia coli Kp Bacterial suspension: test organism was incubated overnight in trypto-soy broth, diluted with fresh same broth, and adjusted to an absorbance of 0.5 at 660nm. Plate Medium: Pearlcore sensitivity test agar (Eiken) (ph 7.4) Container: Petri dish 90mm in diameter Amount of medium: seed layer 10ml Inoculum size : 2% (v/v) of the suspension Standard solution Undiluted solution : dissolve 1mg of the NM394 (potency) in 0.1ml of 1/10N NaOH and add 0.9ml distilled water Diluent for standard solution: plasma: blank plasma urine: 1/15 M phosphate buffer (ph 8.0) Incubation: about 18 hours at 37 Ž [Calibration Plasma: Urine range] 0.1 `0.8ƒÊg/ml. 0.1 `0.8ƒÊg/ml Fig. 4. Method for measurement of NM394 concentration in plasma and urine by bioassay method

Table 3-1. Vital signs (single oral administration)

Table 3-2. Vital signs (single oral administration)

Table 4-1. Vital signs (multiple oral administration)

Table 4-2. Vital signs (multiple oral administration)

Table 5-1. Clinical laboratory findings before and after single oral administration

Table 5-2. Clinical laboratory findings before and after single oral administration

Table 5-3. Clinical laboratory findings before and after single oral administration

Table 5-4. Clinical laboratory findings before and after single oral administration

Table 6-1. Clinical laboratory findings in multiple oral administration (300mg ~2/day ~7 days)

Table 6-2. Clinical laboratory findings in multiple oral administration (300mg ~2/day ~7 days)

Table 7-1. Increase of serum transaminase (multiple oral administration, Subject No. 4) Table 7-2. Increase of serum bilirubin (multiple oral administration, Subject No. 5) Fig. 5. Correlation between NM394 concentrations measured by HPLC method and bioassay method Fig. 6. Plasma concentrations of NM394 after single oral administration of NM441 (fasting)

Table 8. Plasma concentrations of NM394 after single oral administration of NM441 Table 9. Pharmacokinetic parameters of NM394 after single oral administration of NM441

Fig. 7. Urinary concentrations and cumulative excretion of NM394 after single oral administration of NM441 (fasting) Table 10. Urinary concentrations of NM394 after single oral administration of NM441

Table 11. Cumulative urinary excretion of NM394 after single oral administration of NM441 Fig. 8. Urinary metabolites of NM441 in various animal species

200 日本 化 学 療 法 学 会 雑 誌 Table TLC:DC-Alufolien 12. Cumulative urinary excretion of NM441 metabolites MAR.1996 after single oral administration of NM441 Kieselgel 60F254(Merck) Test organism: EscherrichiacoliKp A:Authentic NM394 (1)TLC:bioautogram B: Authentic NM441 of plasma Solvent:chloroform:methanol:acetic Fig.9.Thin-layer (2)TLC-bioautogram acid: water(4:3:0 chromatography-bioautograms Fig.10..1:0.7) of urine Solvent: dioxane:water;formic acid(3:1.5:0.01) of plasma and urine collected after single oral ad ministration of NM441(400mg. Plasma concentrations of NM394 after single oral administration of NM441(influence of meals) fasting)

VOL. 44 S-1 200mg single oral administration (n=6) (Mean) Fig. 11. Urinary concentrations and cumulative excretion of NM394 after single oral administration of NM441 (influence of meals) 300mg ~2/day ~7days (n=6) Fig. 12. Plasma concentrations of NM394 during and after multiple administration of NM441 Simulation curve was obtained from the mean plasma concentration after single oral adminstration for non-fasting. Fig. 13. Urinary concentrations and cumulative excretion of NM394 during and after multiple administration of NM441

Table 13. Plasma concentrations of NM394 after and during multiple oral administration of NM441 Table 14. Urinary concentrations and excretion of NM394 during and after multiple oral administration of NM441

Table 15. Pharmacokinetic parameters during and after multiple oral administration of NM441 Fig. 14. Salivary concentrations of NM394 after single oral administration of NM441 (fasting) Table 16. Salivary concentrations of NM394 after single oral administration of NM441 (fasting)

400mg single oral administration (n=6) (Mean }SE) Fig. 15. Fecal concentrations and cumulative excretion of NM394 and NM441 after single oral administration of NM441 (fasting) Table 17. Fecal concentrations and cumulative excretion of NM441 and NM394 after single oral administration of NM441 (fasting) Dose: 400mg Table 18. Serum protein binding of NM394 in multiple oral administration of NM441

1 ) Morino A, Okuyama Y, Momota K, Ohyabu M, Ushimaru K: Pharmacokinetics of NM441, a new quinolone, in laboratory animals. 32nd Interscience Conference on Antimicrobial Agents and Chemotherapy, Anaheim, October 1992 2 ) Ozaki M, et al: In vitro antibacterial activity of a new quinolone, NM394. Antimicrob Agents Chemother 35: 2490 `2495, 1991 3 ) Ozaki M, et al: In vivo evaluation of NM441, a new thiazeto-quinoline derivative. Antimicrob Agents Chemother 35: 2496 `2499, 1991 4 ) Melander A: Influence of food on the bioavailability of drugs. Clin Pharmacokinet 3: 337 `351, 1978 Pharmacokinetics and safety of NM441, a new quinolone, in healthy male volunteers Mitsuyoshi Nakashima, Toshihiko Uematsu# and Kazuhiro Kosuge## Department of Pharmacology, Hamamatsu University School of Medicine 3600 Handa-cho, Hamamatsu 431-31, Japan address: Department of Pharmacology, Gifu University School of Medicine address: Department of Clinical Pharmacology, Hamamatsu University School of Medicine The safety and pharmacokinetics of NM441, a prodrug of a new thiazeto-quinoline carboxylic acid derivative, NM394, were evaluated in healthy male volunteers given the drug orally in single doses of 20, 50, 100, 200 and 400mg, and multiple doses of 300mg twice daily for 6.5 days. No remarkable abnormalities were observed in symptoms, physical tests, laboratory tests, electrocardiogram (ECG), electroencephalogram (EEG) or equilibrium test. The mean plasma concentrations of active metabolite NM394 peaked between 0.5 and 1.0 hours, and the maximum concentrations were 0.68, 1.09 and 1.88/2g/ml at doses of 100, 200 and 400mg, respectively. The mean half-lives were 7.7 to 8.9 hours and were not affected by dose. The mean urinary excretion rates of NM394 were 46.0, 38.3 and 30.6% of the doses within 48 hours, respectively, and other metabolites were excreted in urine by 7% the doses. The salivary concentrations of NM394 were approximately 20% of the plasma concentrations. The mean fecal excretion rates of NM394 and NM441 were 52.9 and 4.2%, respectively within 72 hours after dosing of 400mg. The Cmax, AUC and urinary excretion rates were not altered by food intake, whereas the Tmax was prolonged slightly. In the multipledose study, the steady state of plasma concentration of NM394 was achieved on day 3 or 4, and further accumulation did not occur thereafter. The mean urinary excretion rate of NM394 was 49.0% during and 48 hours after the multiple administration. The acceptable safety and tolerance and defined pharmacokinetic characteristics of NM441 supports further testing.

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