After
two decades teetering at the intersection of laboratory tool
and therapeutic reality, with two siRNA drugs now clinically approved,
this modality has finally come into fruition. Consistent with other
emerging modalities, initial proof-of-concept efforts concentrated
on coupling pharmacologic efficacy with desirable safety profiles.
Consequently, thorough investigations of siRNA absorption, distribution,
metabolism, and excretion (ADME) properties are lacking. Advancing
ADME knowledge will aid establishment of in vitro–in vivo correlations and pharmacokinetic–pharmacodynamic
relationships to optimize candidate selection through discovery and
translation. Here, we outline the emerging siRNA design principles
and discuss the consequences for siRNA disposition and biotransformation.
We propose a conceptual framework for siRNA ADME evaluation, contextualizing
the site of biotransformation product formation with PK–PD
modulation, and end with a discussion around safety and regulatory
considerations and future directions for this modality.