Effect of Upadacitinib on the Pharmacokinetics of Rosuvastatin or Atorvastatin in Healthy Subjects

Clin Pharmacol Drug Dev. 2021 Nov;10(11):1335-1344. doi: 10.1002/cpdd.957. Epub 2021 Jun 9.

Abstract

This phase 1, 2-part, 2-period, open-label, drug-drug interaction study evaluated the potential for pharmacokinetic interactions between upadacitinib and rosuvastatin, an organic anion transporting polypeptide (OATP) 1B1 and breast cancer resistance protein substrate, or atorvastatin, a cytochrome P450 3A, OATP1B1, and OATP1B3 substrate, in 36 healthy volunteers. During period 1, a single dose of rosuvastatin (5 mg; part 1) or atorvastatin (10 mg; part 2) was administered on day 1, followed by a washout period of 5 days. During period 2, once-daily doses of upadacitinib extended-release (30 mg) were administered on days 1 to 10, and a single dose of rosuvastatin (5 mg; part 1) or atorvastatin (10 mg; part 2) was administered 1 hour after the upadacitinib dose on day 7. Serial blood samples were collected for assays of drug concentrations. In Part 1, rosuvastatin maximum observed plasma concentration (Cmax ) and area under the plasma concentration-time curve from time 0 to infinity (AUCinf ) were 23% and 33% lower, respectively, when administered with upadacitinib relative to when administered alone. In part 2, atorvastatin Cmax and AUCinf was 11% and 23% lower, respectively, when administered with upadacitinib relative to when administered alone. The Cmax and AUCinf of the active metabolite ortho-hydroxyatorvastatin remained unchanged. Administration of a single 5-mg dose of rosuvastatin or a single 10-mg dose of atorvastatin had no relevant effect on upadacitinib Cmax or area under the plasma concentration-time curve. These results demonstrated that upadacitinib has no clinically relevant effect on the pharmacokinetics of rosuvastatin and atorvastatin or on substrates transported by OATP1B or breast cancer resistance protein.

Keywords: ABT-494; BCRP; OATP1B1; P-gp; atorvastatin; rosuvastatin; upadacitinib.

Publication types

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

MeSH terms

  • ATP Binding Cassette Transporter, Subfamily G, Member 2 / drug effects
  • ATP Binding Cassette Transporter, Subfamily G, Member 2 / metabolism
  • Adult
  • Anticholesteremic Agents / pharmacokinetics*
  • Atorvastatin / pharmacokinetics*
  • Drug Interactions*
  • Female
  • Healthy Volunteers
  • Heterocyclic Compounds, 3-Ring / pharmacology*
  • Humans
  • Janus Kinase Inhibitors / pharmacology*
  • Liver-Specific Organic Anion Transporter 1 / drug effects
  • Liver-Specific Organic Anion Transporter 1 / metabolism
  • Male
  • Middle Aged
  • Neoplasm Proteins / drug effects
  • Neoplasm Proteins / metabolism
  • Rosuvastatin Calcium / pharmacokinetics*
  • Young Adult

Substances

  • ABCG2 protein, human
  • ATP Binding Cassette Transporter, Subfamily G, Member 2
  • Anticholesteremic Agents
  • Heterocyclic Compounds, 3-Ring
  • Janus Kinase Inhibitors
  • Liver-Specific Organic Anion Transporter 1
  • Neoplasm Proteins
  • SLCO1B1 protein, human
  • upadacitinib
  • Rosuvastatin Calcium
  • Atorvastatin