Predicting Drug-Drug Interactions Involving Rifampicin Using a Semi-mechanistic Hepatic Compartmental Model

© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature..

AIMS: To develop a semi-mechanistic hepatic compartmental model to predict the effects of rifampicin, a known inducer of CYP3A4 enzyme, on the metabolism of five drugs, in the hope of informing dose adjustments to avoid potential drug-drug interactions.

METHODS: A search was conducted for DDI studies on the interactions between rifampicin and CYP substrates that met specific criteria, including the availability of plasma concentration-time profiles, physical and absorption parameters, pharmacokinetic parameters, and the use of healthy subjects at therapeutic doses. The semi-mechanistic model utilized in this study was improved from its predecessors, incorporating additional parameters such as population data (specifically for Chinese and Caucasians), virtual individuals, gender distribution, age range, dosing time points, and coefficients of variation.

RESULTS: Optimal parameters were identified for our semi-mechanistic model by validating it with clinical data, resulting in a maximum difference of approximately 2-fold between simulated and observed values. PK data of healthy subjects were used for most CYP3A4 substrates, except for gilteritinib, which showed no significant difference between patients and healthy subjects. Dose adjustment of gilteritinib co-administered with rifampicin required a 3-fold increase of the initial dose, while other substrates were further tuned to achieve the desired drug exposure.

CONCLUSIONS: The pharmacokinetic parameters AUCR and CmaxR of drugs metabolized by CYP3A4, when influenced by Rifampicin, were predicted by the semi-mechanistic model to be approximately twice the empirically observed values, which suggests that the semi-mechanistic model was able to reasonably simulate the effect. The doses of four drugs adjusted via simulation to reduce rifampicin interaction.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:41

Enthalten in:

Pharmaceutical research - 41(2024), 4 vom: 22. Apr., Seite 699-709

Sprache:

Englisch

Beteiligte Personen:

Li, Jingxi [VerfasserIn]
Li, Xue [VerfasserIn]
Wu, Keheng [VerfasserIn]
Long, Sihui [VerfasserIn]
Zhao, Youni [VerfasserIn]
Jin, Xiong [VerfasserIn]
Zhang, Mengjun [VerfasserIn]
Wu, Xinyi [VerfasserIn]
Huang, Zhijun [VerfasserIn]
Zhou, Zhou [VerfasserIn]
Liu, Jack [VerfasserIn]
Liu, Bo [VerfasserIn]

Links:

Volltext

Themen:

66D92MGC8M
Aniline Compounds
CYP3A4
Cytochrome P-450 CYP3A
Drug-drug interactions
EC 1.14.14.1
Gilteritinib
Inducer
Journal Article
Pyrazines
Rifampicin
Rifampin
Semi-mechanistic hepatic compartmental model
VJT6J7R4TR

Anmerkungen:

Date Completed 18.04.2024

Date Revised 18.04.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1007/s11095-024-03691-5

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM370093860