使用生理学基础的药物动力学建模,评估elexacaftor-tezacaftor-ivacaftor和他类药物之间的复杂药物相互作用
Eunjin Hong1,2, Peter S Chung3,4, Adupa P Rao3,4
1College of Pharmacy, CHA University, 335 Pangyo-ro, Bundang-gu, Seongnam-si 13488, Gyeonggi-do, Republic of Korea.
Pharmaceutics
|March 27, 2025
概括
囊性纤维化转膜导电调节器 (CFTR) 和他类药物之间的药物相互作用可能会增加他类药物的水平. 阿托瓦斯塔丁显示出最高的风险,而罗斯瓦斯塔丁的相互作用较弱,需要对某些他类药物进行剂量调整.
科学领域:
- 药理学 药理学是指药理学的学科.
- 药理动力学 药理动力学
- 药物相互作用 药物相互作用
背景情况:
- 在囊性纤维化 (CF) 患者中增加了他类药物的使用.
- 在他类药物和CFTR调节剂 (elexacaftor,tezacaftor,ivacaftor - ETI) 之间潜在的药物相互作用 (DDI).
- ETI可能会抑制CYP酶,OATP和BCRP,可能会增加他类药物水平和肌肉病症风险.
研究的目的:
- 预测他类药物和ETI之间的潜在DDI.
- 使用基于生理学的药理动力学 (PBPK) 建模方法.
主要方法:
- 在体外测试以确定ETI对OATP和CYP2C9.9的抑制功效.
- 将体外数据纳入PBPK模型.
- 包括已发表的BCRP和CYP3A4.4的抑制参数.
主要成果:
- 对于不同的他类药物,PBPK模拟预测了不同的AUC比率.
- 阿托瓦斯塔丁显示出预测最高的AUC比率 (3.27).
- 普拉瓦斯塔丁 (2.27),皮塔瓦斯塔丁 (2.24) 和罗斯瓦斯塔丁 (1.83) 的预测比率较低.
结论:
- 罗斯瓦斯塔丁与ETI的相互作用很弱.
- 其他他类药物 (阿托瓦斯塔丁,普拉瓦斯塔丁,皮塔瓦斯塔丁) 显示中度相互作用.
- 临床显著DDI的潜力需要减少一些他类药物的剂量,并进一步临床验证.
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