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.

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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