Physiologically based pharmacokinetic modeling for assessing the clinical drug-drug interaction of alisporivir

Eur J Pharm Sci. 2014 Oct 15:63:103-12. doi: 10.1016/j.ejps.2014.06.021. Epub 2014 Jul 4.

Abstract

Alisporivir is a novel cyclophilin-binding molecule with potent anti-hepatitis C virus (HCV) activity. In vitro data from human liver microsomes suggest that alisporivir is a substrate and a time-dependent inhibitor (TDI) of CYP3A4. The aim of the current work was to develop a novel physiologically based pharmacokinetic (PBPK) model to quantitatively assess the magnitude of CYP3A4 mediated drug-drug interactions with alisporivir as the substrate or victim drug. Towards that, a Simcyp PBPK model was developed by integrating in vitro data with in vivo clinical findings to characterize the clinical pharmacokinetics of alisporivir and further assess the magnitude of drug-drug interactions. Incorporated with absorption, distribution, elimination, and TDI data, the model accurately predicted AUC, Cmax, and tmax values after single or multiple doses of alisporivir with a prediction deviation within ± 32%. The model predicted an alisporivir AUC increase by 9.4-fold and a decrease by 86% when alisporivir was co-administrated with ketoconazole (CYP3A4 inhibitor) or rifampin (CYP3A4 inducer), respectively. Predictions were within ± 20% of the observed changes. In conclusion, the PBPK model successfully predicted the alisporivir PK and the magnitude of drug-drug interactions.

Keywords: Alisporivir; CL; CYP3A4; Drug–drug interaction; Physiologically-based pharmacokinetic (PBPK) model; Time-dependent inhibition; clearance.

MeSH terms

  • Administration, Oral
  • Caco-2 Cells
  • Cyclosporine / administration & dosage
  • Cyclosporine / metabolism
  • Cyclosporine / pharmacokinetics*
  • Cytochrome P-450 CYP3A / metabolism*
  • Dose-Response Relationship, Drug
  • Drug Interactions
  • Humans
  • Ketoconazole / chemistry
  • Ketoconazole / pharmacology*
  • Models, Biological*
  • Rifampin / chemistry
  • Rifampin / pharmacology*

Substances

  • Cyclosporine
  • Cytochrome P-450 CYP3A
  • Ketoconazole
  • alisporivir
  • Rifampin