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Comprehensive PBPK model to predict drug interaction potential of Zanubrutinib as a victim or perpetrator

A physiologically based pharmacokinetic (PBPK) model was developed to evaluate and predict (1) the effect of concomitant cytochrome P450 3A (CYP3A) inhibitors or inducers on the exposures of zanubrutinib, (2) the effect of zanubrutinib on the exposures of CYP3A4, CYP2C8, and CYP2B6 substrates, and (...

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Autores principales: Wang, Kun, Yao, Xueting, Zhang, Miao, Liu, Dongyang, Gao, Yuying, Sahasranaman, Srikumar, Ou, Ying C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8129716/
https://www.ncbi.nlm.nih.gov/pubmed/33687157
http://dx.doi.org/10.1002/psp4.12605
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author Wang, Kun
Yao, Xueting
Zhang, Miao
Liu, Dongyang
Gao, Yuying
Sahasranaman, Srikumar
Ou, Ying C.
author_facet Wang, Kun
Yao, Xueting
Zhang, Miao
Liu, Dongyang
Gao, Yuying
Sahasranaman, Srikumar
Ou, Ying C.
author_sort Wang, Kun
collection PubMed
description A physiologically based pharmacokinetic (PBPK) model was developed to evaluate and predict (1) the effect of concomitant cytochrome P450 3A (CYP3A) inhibitors or inducers on the exposures of zanubrutinib, (2) the effect of zanubrutinib on the exposures of CYP3A4, CYP2C8, and CYP2B6 substrates, and (3) the impact of gastric pH changes on the pharmacokinetics of zanubrutinib. The model was developed based on physicochemical and in vitro parameters, as well as clinical data, including pharmacokinetic data in patients with B‐cell malignancies and in healthy volunteers from two clinical drug‐drug interaction (DDI) studies of zanubrutinib as a victim of CYP modulators (itraconazole, rifampicin) or a perpetrator (midazolam). This PBPK model was successfully validated to describe the observed plasma concentrations and clinical DDIs of zanubrutinib. Model predictions were generally within 1.5‐fold of the observed clinical data. The PBPK model was used to predict untested clinical scenarios; these simulations indicated that strong, moderate, and mild CYP3A inhibitors may increase zanubrutinib exposures by approximately four‐fold, two‐ to three‐fold, and <1.5‐fold, respectively. Strong and moderate CYP3A inducers may decrease zanubrutinib exposures by two‐ to three‐fold or greater. The PBPK simulations showed that clinically relevant concentrations of zanubrutinib, as a DDI perpetrator, would have no or limited impact on the enzyme activity of CYP2B6 and CYP2C8. Simulations indicated that zanubrutinib exposures are not impacted by acid‐reducing agents. Development of a PBPK model for zanubrutinib as a DDI victim and perpetrator in parallel can increase confidence in PBPK models supporting zanubrutinib label dose recommendations.
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spelling pubmed-81297162021-05-21 Comprehensive PBPK model to predict drug interaction potential of Zanubrutinib as a victim or perpetrator Wang, Kun Yao, Xueting Zhang, Miao Liu, Dongyang Gao, Yuying Sahasranaman, Srikumar Ou, Ying C. CPT Pharmacometrics Syst Pharmacol Research A physiologically based pharmacokinetic (PBPK) model was developed to evaluate and predict (1) the effect of concomitant cytochrome P450 3A (CYP3A) inhibitors or inducers on the exposures of zanubrutinib, (2) the effect of zanubrutinib on the exposures of CYP3A4, CYP2C8, and CYP2B6 substrates, and (3) the impact of gastric pH changes on the pharmacokinetics of zanubrutinib. The model was developed based on physicochemical and in vitro parameters, as well as clinical data, including pharmacokinetic data in patients with B‐cell malignancies and in healthy volunteers from two clinical drug‐drug interaction (DDI) studies of zanubrutinib as a victim of CYP modulators (itraconazole, rifampicin) or a perpetrator (midazolam). This PBPK model was successfully validated to describe the observed plasma concentrations and clinical DDIs of zanubrutinib. Model predictions were generally within 1.5‐fold of the observed clinical data. The PBPK model was used to predict untested clinical scenarios; these simulations indicated that strong, moderate, and mild CYP3A inhibitors may increase zanubrutinib exposures by approximately four‐fold, two‐ to three‐fold, and <1.5‐fold, respectively. Strong and moderate CYP3A inducers may decrease zanubrutinib exposures by two‐ to three‐fold or greater. The PBPK simulations showed that clinically relevant concentrations of zanubrutinib, as a DDI perpetrator, would have no or limited impact on the enzyme activity of CYP2B6 and CYP2C8. Simulations indicated that zanubrutinib exposures are not impacted by acid‐reducing agents. Development of a PBPK model for zanubrutinib as a DDI victim and perpetrator in parallel can increase confidence in PBPK models supporting zanubrutinib label dose recommendations. John Wiley and Sons Inc. 2021-05-02 2021-05 /pmc/articles/PMC8129716/ /pubmed/33687157 http://dx.doi.org/10.1002/psp4.12605 Text en © 2021 Beigene. CPT: Pharmacometrics & Systems Pharmacology published by Wiley Periodicals LLC on behalf of American Society for Clinical Pharmacology and Therapeutics https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Research
Wang, Kun
Yao, Xueting
Zhang, Miao
Liu, Dongyang
Gao, Yuying
Sahasranaman, Srikumar
Ou, Ying C.
Comprehensive PBPK model to predict drug interaction potential of Zanubrutinib as a victim or perpetrator
title Comprehensive PBPK model to predict drug interaction potential of Zanubrutinib as a victim or perpetrator
title_full Comprehensive PBPK model to predict drug interaction potential of Zanubrutinib as a victim or perpetrator
title_fullStr Comprehensive PBPK model to predict drug interaction potential of Zanubrutinib as a victim or perpetrator
title_full_unstemmed Comprehensive PBPK model to predict drug interaction potential of Zanubrutinib as a victim or perpetrator
title_short Comprehensive PBPK model to predict drug interaction potential of Zanubrutinib as a victim or perpetrator
title_sort comprehensive pbpk model to predict drug interaction potential of zanubrutinib as a victim or perpetrator
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8129716/
https://www.ncbi.nlm.nih.gov/pubmed/33687157
http://dx.doi.org/10.1002/psp4.12605
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