| Autor: |
Reddy MB; Early Clinical Development, Department of Clinical Pharmacology Oncology, Pfizer, Boulder, CO 80301, USA., Bolger MB; Simulations Plus Inc., Lancaster, CA 93534, USA., Fraczkiewicz G; Simulations Plus Inc., Lancaster, CA 93534, USA., Del Frari L; PKPD Department, Pierre Fabre Laboratories, 31100 Toulouse, France., Luo L; Material & Analytical Sciences, Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT 06877, USA., Lukacova V; Simulations Plus Inc., Lancaster, CA 93534, USA., Mitra A; Clinical Pharmacology and Pharmacometrics, Janssen Research & Development, Springhouse, PA 19477, USA., Macwan JS; Simulations Plus Inc., Lancaster, CA 93534, USA., Mullin JM; Simulations Plus Inc., Lancaster, CA 93534, USA., Parrott N; Pharmaceutical Sciences, Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche, 4070 Basel, Switzerland., Heikkinen AT; Admescope Ltd., Fi-90620 Oulu, Finland. |
| Abstrakt: |
Uridine 5'-diphospho-glucuronosyltransferases (UGTs) are expressed in the small intestines, but prediction of first-pass extraction from the related metabolism is not well studied. This work assesses physiologically based pharmacokinetic (PBPK) modeling as a tool for predicting intestinal metabolism due to UGTs in the human gastrointestinal tract. Available data for intestinal UGT expression levels and in vitro approaches that can be used to predict intestinal metabolism of UGT substrates are reviewed. Human PBPK models for UGT substrates with varying extents of UGT-mediated intestinal metabolism (lorazepam, oxazepam, naloxone, zidovudine, cabotegravir, raltegravir, and dolutegravir) have demonstrated utility for predicting the extent of intestinal metabolism. Drug-drug interactions (DDIs) of UGT1A1 substrates dolutegravir and raltegravir with UGT1A1 inhibitor atazanavir have been simulated, and the role of intestinal metabolism in these clinical DDIs examined. Utility of an in silico tool for predicting substrate specificity for UGTs is discussed. Improved in vitro tools to study metabolism for UGT compounds, such as coculture models for low clearance compounds and better understanding of optimal conditions for in vitro studies, may provide an opportunity for improved in vitro-in vivo extrapolation (IVIVE) and prospective predictions. PBPK modeling shows promise as a useful tool for predicting intestinal metabolism for UGT substrates. |
