Assessment of the CYP3A-mediated drug interaction potential of anacetrapib, a potent cholesteryl ester transfer protein (CETP) inhibitor, in healthy volunteers

J Clin Pharmacol. 2009 Jan;49(1):80-7. doi: 10.1177/0091270008326718. Epub 2008 Nov 11.

Abstract

In this study, midazolam was used as a probe-sensitive CYP3A substrate to investigate the effect of anacetrapib on CYP3A activity, and ketoconazole was used as a probe-inhibitor to investigate the effect of potent CYP3A inhibition on the pharmacokinetics of anacetrapib, a novel cholesteryl ester transfer protein inhibitor in development for the treatment of dyslipidemia. Two partially blinded, randomized, 2-period, fixed-sequence studies were performed. Safety, tolerability, and midazolam and anacetrapib plasma concentrations were assessed. All treatments were generally well tolerated. The geometric mean ratios (90% confidence interval) of midazolam with anacetrapib/midazolam alone for AUC0-infinity and Cmax were 1.04 (0.94, 1.14) and 1.15 (0.97, 1.37), respectively. Exposure to anacetrapib was increased by ketoconazole--specifically, the geometric mean ratios (90% confidence interval) of anacetrapib with ketoconazole/anacetrapib alone for AUC0-infinity and Cmax were 4.58 (3.68, 5.71) and 2.37 (2.02, 2.78), respectively. The study showed that anacetrapib does not inhibit or induce CYP3A activity. Furthermore, anacetrapib appears to be a moderately sensitive substrate of CYP3A.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cholesterol Ester Transfer Proteins / antagonists & inhibitors*
  • Cytochrome P-450 CYP3A
  • Cytochrome P-450 Enzyme Inhibitors
  • Cytochrome P-450 Enzyme System / physiology*
  • Drug Interactions
  • Hepatocytes / drug effects
  • Hepatocytes / metabolism
  • Humans
  • In Vitro Techniques
  • Ketoconazole / pharmacology
  • Microsomes, Liver / drug effects
  • Microsomes, Liver / metabolism
  • Midazolam / pharmacology
  • Middle Aged
  • Oxazolidinones / adverse effects
  • Oxazolidinones / pharmacology*
  • Young Adult

Substances

  • Cholesterol Ester Transfer Proteins
  • Cytochrome P-450 Enzyme Inhibitors
  • Oxazolidinones
  • Cytochrome P-450 Enzyme System
  • CYP3A protein, human
  • Cytochrome P-450 CYP3A
  • anacetrapib
  • Midazolam
  • Ketoconazole