Tofacitinib Is a Mechanism-Based Inactivator of Cytochrome P450 3A4

Chem Res Toxicol. 2019 Sep 16;32(9):1791-1800. doi: 10.1021/acs.chemrestox.9b00141. Epub 2019 Aug 26.

Abstract

Tofacitinib (TFT) is an oral JAK inhibitor which has been approved for the treatment of moderately and severely active rheumatoid arthritis. TFT was found to show concentration-, time-, and NADPH-dependent inhibition of CYP3A4, and irreversibility of the inactivation was also observed. Incubation (40 min, 37 °C) of recombinant CYP3A4 with TFT at 200 μM resulted in >70% loss of CYP3A4 activity. Estimated kinact and KI were 0.037 min-1 and 93.2 μM, respectively. GSH and superoxide dismutase/catalase revealed minor or little protection against the CYP3A4 inactivation. Furthermore, ketoconazole attenuated TFT-mediated CYP3A4 inactivation. Epoxide and α-keto-aldehyde intermediates of TFT were trapped and characterized in microsomal incubations, respectively. The aldehyde intermediate is believed to be the key for the enzyme inactivation. Multiple P450 enzymes, including CYPs2C19, 3A4, 2D6, and 1A2, participated in the metabolism of TFT to the epoxide, while the formation of the aldehyde was mainly catalyzed by CYP3A4. In conclusion, TFT was proven to be a mechanism-based inactivator of CYP3A4.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cytochrome P-450 CYP3A / metabolism*
  • Cytochrome P-450 CYP3A Inhibitors / chemical synthesis
  • Cytochrome P-450 CYP3A Inhibitors / pharmacology*
  • Enzyme Assays
  • Humans
  • Ketoconazole / pharmacology
  • Male
  • Microsomes, Liver / drug effects
  • NADP / metabolism
  • Piperidines / chemical synthesis
  • Piperidines / pharmacology*
  • Pyrimidines / chemical synthesis
  • Pyrimidines / pharmacology*
  • Pyrroles / chemical synthesis
  • Pyrroles / pharmacology*

Substances

  • Cytochrome P-450 CYP3A Inhibitors
  • Piperidines
  • Pyrimidines
  • Pyrroles
  • NADP
  • tofacitinib
  • Cytochrome P-450 CYP3A
  • CYP3A4 protein, human
  • Ketoconazole