Physiologically Based Pharmacokinetic Modeling for Predicting the Effect of Intrinsic and Extrinsic Factors on Darunavir or Lopinavir Exposure Coadministered With Ritonavir

© 2017, The American College of Clinical Pharmacology..

Management of comorbidities and medications is complex in HIV-1-infected patients. The overall objective of this project was to develop separate physiologically based pharmacokinetic (PBPK) substrate models for the protease inhibitors darunavir and lopinavir. These protease inhibitors are used in the treatment of HIV infection. Both darunavir and lopinavir are coadministered with another medication that inhibits cytochrome (CYP) 3A. The current project focused on PBPK modeling for darunavir and lopinavir coadministered with ritonavir. Darunavir and lopinavir PBPK models that accounted for ritonavir CYP3A inhibition effects (linked PBPK models) were developed. The linked PBPK models were then used to predict the effect on darunavir or lopinavir exposure from CYP modulators. In the next step, the predicted effect of hepatic impairment was evaluated. Additional exploratory analyses predicted CYP3A inhibition effects on darunavir or lopinavir exposure in simulated hepatically impaired subjects. The linked PBPK models reasonably predicted darunavir or lopinavir exposure based on simulations with CYP inhibitors or inducers. Exploratory simulations using the linked darunavir or lopinavir PBPK models indicated CYP3A inhibition may further increase darunavir or lopinavir exposure in patients with hepatic impairment.

Medienart:

E-Artikel

Erscheinungsjahr:

2017

Erschienen:

2017

Enthalten in:

Zur Gesamtaufnahme - volume:57

Enthalten in:

Journal of clinical pharmacology - 57(2017), 10 vom: 26. Okt., Seite 1295-1304

Sprache:

Englisch

Beteiligte Personen:

Wagner, Christian [VerfasserIn]
Zhao, Ping [VerfasserIn]
Arya, Vikram [VerfasserIn]
Mullick, Charu [VerfasserIn]
Struble, Kimberly [VerfasserIn]
Au, Stanley [VerfasserIn]

Links:

Volltext

Themen:

2494G1JF75
Cytochrome P-450 Enzyme Inducers
Cytochrome P-450 Enzyme Inhibitors
Darunavir
Drug interactions
HIV Protease Inhibitors
Hepatic impairment
Journal Article
Lopinavir
O3J8G9O825
Physiologically based pharmacokinetic modeling
Protease inhibitors
Research Support, U.S. Gov't, P.H.S.
Ritonavir
YO603Y8113

Anmerkungen:

Date Completed 31.05.2018

Date Revised 08.10.2019

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1002/jcph.936

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM272506184