Drug interaction profile for GSK2248761, a next generation non-nucleoside reverse transcriptase inhibitor

Br J Clin Pharmacol. 2012 Aug;74(2):336-45. doi: 10.1111/j.1365-2125.2012.04194.x.

Abstract

Aim: To evaluate potential drug interactions with antiretroviral therapies or supportive therapies for use in conjunction with the once daily, next generation non-nucleoside reverse transcriptase inhibitor GSK2248761 in patients with HIV-1 infection.

Methods: A series of phase I drug interaction studies was conducted.

Results: GSK2248761 was shown to be a weak CYP3A4 and CYP2D6 inhibitor in a clinical study with a probe cocktail. Mean plasma concentration-time profiles for atazanavir, tenofovir disoproxil fumarate/emtricitabine (TDF/FTC), darunavir (DRV, administered with ritonavir [RTV]), and drospirenone/ethinylestradiol were similar following co-administration of GSK2248761. Plasma raltegravir AUC(0,τ) and C(max) increased by 18% with no change in Cτ when raltegravir was co-administered with GSK2248761. Lopinavir (LPV) plasma AUC(0,τ), C(max) and Cτ decreased by 23%, 14% and 40%, respectively, following administration of lopinavir/ritonavir with GSK2248761. Atorvastatin, rosuvastatin and simvastatin AUC(0,∞) and C(max) increased following co-administration with GSK2248761, with the largest changes observed for simvastatin (3.7-fold and 4.3-fold). Changes in maximum and extent of GSK2248761 exposure were marginal after co-administration with atazanavir, TDF/FTC and raltegravir compared with GSK2248761 administered alone. Co-administration of GSK2248761 with DRV/RTV and LPV/RTV increased plasma GSK2248761 exposures by 1.25- to ≤2-fold compared with GSK2248761 administered alone, and increases in GSK2248761 exposure were higher following single dose co-administration of DRV/RTV or LPV/RTV compared with multiple doses. There were few drug-related AEs, and no treatment-related trends in blood chemistry, haematology, urinalysis, vital signs or ECG findings.

Conclusions: These studies indicate that GSK2248761 was safe and well tolerated in healthy adults treated in these studies at the doses and duration of therapy evaluated.

Trial registration: ClinicalTrials.gov NCT00920088 NCT01101893 NCT01138072 NCT01195974.

Publication types

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

MeSH terms

  • Adenine / administration & dosage
  • Adenine / analogs & derivatives
  • Adenine / pharmacokinetics
  • Androstenes / administration & dosage
  • Androstenes / pharmacokinetics
  • Anti-HIV Agents / administration & dosage
  • Anti-HIV Agents / pharmacokinetics*
  • Atazanavir Sulfate
  • Atorvastatin
  • Contraceptives, Oral / administration & dosage
  • Contraceptives, Oral / pharmacokinetics
  • Cross-Over Studies
  • Cytochrome P-450 CYP2D6 / metabolism
  • Cytochrome P-450 CYP2D6 Inhibitors
  • Cytochrome P-450 CYP3A / metabolism
  • Cytochrome P-450 CYP3A Inhibitors
  • Darunavir
  • Deoxycytidine / administration & dosage
  • Deoxycytidine / analogs & derivatives
  • Deoxycytidine / pharmacokinetics
  • Double-Blind Method
  • Drug Combinations
  • Drug Interactions
  • Emtricitabine
  • Ethinyl Estradiol / administration & dosage
  • Ethinyl Estradiol / pharmacokinetics
  • Female
  • Fluorobenzenes / administration & dosage
  • Fluorobenzenes / pharmacokinetics
  • Heptanoic Acids / administration & dosage
  • Heptanoic Acids / pharmacokinetics
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / pharmacokinetics
  • Indoles / administration & dosage
  • Indoles / pharmacokinetics*
  • Least-Squares Analysis
  • Linear Models
  • Lopinavir / administration & dosage
  • Lopinavir / pharmacokinetics
  • Male
  • Oligopeptides / administration & dosage
  • Oligopeptides / pharmacokinetics
  • Organophosphonates / administration & dosage
  • Organophosphonates / pharmacokinetics
  • Patient Safety
  • Phosphinic Acids / administration & dosage
  • Phosphinic Acids / pharmacokinetics*
  • Pyridines / administration & dosage
  • Pyridines / pharmacokinetics
  • Pyrimidines / administration & dosage
  • Pyrimidines / pharmacokinetics
  • Pyrroles / administration & dosage
  • Pyrroles / pharmacokinetics
  • Pyrrolidinones / administration & dosage
  • Pyrrolidinones / pharmacokinetics
  • Raltegravir Potassium
  • Reverse Transcriptase Inhibitors / administration & dosage
  • Reverse Transcriptase Inhibitors / pharmacokinetics*
  • Risk Assessment
  • Ritonavir / administration & dosage
  • Ritonavir / pharmacokinetics
  • Rosuvastatin Calcium
  • Simvastatin / administration & dosage
  • Simvastatin / pharmacokinetics
  • Sulfonamides / administration & dosage
  • Sulfonamides / pharmacokinetics
  • Tenofovir

Substances

  • Androstenes
  • Anti-HIV Agents
  • Contraceptives, Oral
  • Cytochrome P-450 CYP2D6 Inhibitors
  • Cytochrome P-450 CYP3A Inhibitors
  • Drug Combinations
  • Fluorobenzenes
  • Heptanoic Acids
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • IDX 899
  • Indoles
  • Oligopeptides
  • Organophosphonates
  • Phosphinic Acids
  • Pyridines
  • Pyrimidines
  • Pyrroles
  • Pyrrolidinones
  • Reverse Transcriptase Inhibitors
  • Sulfonamides
  • drospirenone and ethinyl estradiol combination
  • lopinavir-ritonavir drug combination
  • Deoxycytidine
  • Lopinavir
  • Ethinyl Estradiol
  • Raltegravir Potassium
  • Atazanavir Sulfate
  • Rosuvastatin Calcium
  • Tenofovir
  • Atorvastatin
  • Simvastatin
  • Cytochrome P-450 CYP2D6
  • Cytochrome P-450 CYP3A
  • CYP3A4 protein, human
  • Emtricitabine
  • Adenine
  • Ritonavir
  • Darunavir

Associated data

  • ClinicalTrials.gov/NCT00920088
  • ClinicalTrials.gov/NCT01101893
  • ClinicalTrials.gov/NCT01138072
  • ClinicalTrials.gov/NCT01195974