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Published on: September 25, 2017
Tofacitinib Is a Mechanism-Based Inactivator of Cytochrome P450 3A4
Xiucai Guo, Wei Li, Qingmei Li
1State Key Laboratory of Functions and Applications of Medicinal Plants, Key Laboratory of Pharmaceutics of Guizhou Province , Guizhou Medical University , Guiyang , Guizhou 550004 , P. R. China.
Abstract:
Tofacitinib (TFT) is an oral JAK inhibitor which has been approved for the treatment of moderately and severely active rheumatoid arthritis. TFT was found to show concentration-, time-, and NADPH-dependent inhibition of CYP3A4, and irreversibility of the inactivation was also observed. Incubation (40 min, 37 °C) of recombinant CYP3A4 with TFT at 200 μM resulted in >70% loss of CYP3A4 activity. Estimated kinact and KI were 0.037 min-1 and 93.2 μM, respectively. GSH and superoxide dismutase/catalase revealed minor or little protection against the CYP3A4 inactivation. Furthermore, ketoconazole attenuated TFT-mediated CYP3A4 inactivation. Epoxide and α-keto-aldehyde intermediates of TFT were trapped and characterized in microsomal incubations, respectively. The aldehyde intermediate is believed to be the key for the enzyme inactivation. Multiple P450 enzymes, including CYPs2C19, 3A4, 2D6, and 1A2, participated in the metabolism of TFT to the epoxide, while the formation of the aldehyde was mainly catalyzed by CYP3A4. In conclusion, TFT was proven to be a mechanism-based inactivator of CYP3A4.
Insights
Tofacitinib (TFT) irreversibly inhibits CYP3A4, a key enzyme in drug metabolism. This mechanism-based inactivation, driven by an aldehyde intermediate, is crucial for understanding TFT
Area of Science:
- Pharmacology
- Drug Metabolism
- Enzyme Kinetics
Background:
- Tofacitinib (TFT) is an oral Janus kinase (JAK) inhibitor used for rheumatoid arthritis.
- Understanding drug-drug interactions and metabolic pathways is vital for safe and effective drug use.
Purpose of the Study:
- To investigate the mechanism by which Tofacitinib (TFT) affects Cytochrome P450 3A4 (CYP3A4) activity.
- To characterize the interaction between TFT and CYP3A4, including the kinetics and intermediates involved.
Main Methods:
- Incubation of recombinant CYP3A4 with TFT to assess enzyme activity loss.
- Kinetic analysis to determine inactivation rate (k_inact) and inhibition constant (K_I).
- Trapping and characterization of TFT metabolites (epoxide and aldehyde) using microsomal incubations.
Main Results:
- TFT demonstrated concentration-, time-, and NADPH-dependent inactivation of CYP3A4, with observed irreversibility.
- Significant loss of CYP3A4 activity (>70%) occurred upon incubation with TFT (200 μM).
- An aldehyde intermediate of TFT, primarily formed by CYP3A4, was identified as the likely cause of enzyme inactivation.
Conclusions:
- Tofacitinib (TFT) is a mechanism-based inactivator of Cytochrome P450 3A4 (CYP3A4).
- The inactivation is mediated by an aldehyde metabolite of TFT, highlighting a significant drug-metabolizing enzyme interaction.
- Findings are critical for predicting and managing potential drug-drug interactions involving Tofacitinib.
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