Whole Body PBPK Modeling of Remdesivir and Its Metabolites to Aid in Estimating Active Metabolite Exposure in the Lung and Liver in Patients With Organ Dysfunction
| Autor: | Vikram Arya, Xinyuan Zhang, Justin C. Earp, Kellie S. Reynolds, Yaning Wang, Manuela Grimstein, Hao Zhu, Yuching Yang, Eliford Kitabi, Jianghong Fan |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Drug Physiologically based pharmacokinetic modelling Multiple Organ Failure media_common.quotation_subject Pharmacology Models Biological Pharmacokinetics Humans Medicine Tissue Distribution Pharmacology (medical) Lung Active metabolite media_common Alanine Nucleoside analogue business.industry Organ dysfunction Prodrug Adenosine Monophosphate medicine.anatomical_structure Liver medicine.symptom business medicine.drug |
| Zdroj: | Clinical Pharmacology & Therapeutics. 111:624-634 |
| ISSN: | 1532-6535 0009-9236 |
| DOI: | 10.1002/cpt.2445 |
| Popis: | Remdesivir (RDV) is the first drug approved by the US Food and Drug Administration (FDA) for the treatment of coronavirus disease 2019 (COVID-19) in certain patients requiring hospitalization. As a nucleoside analogue prodrug, RDV undergoes intracellular multistep activation to form its pharmacologically active species, GS-443902, which is not detectable in the plasma. A question arises that whether the observed plasma exposure of RDV and its metabolites would correlate with or be informative about the exposure of GS-443902 in tissues. A whole body physiologically-based pharmacokinetic (PBPK) modeling and simulation approach was utilized to elucidate the disposition mechanism of RDV and its metabolites in the lungs and liver and explore the relationship between plasma and tissue pharmacokinetics (PK) of RDV and its metabolites in healthy subjects. In addition, the potential alteration of plasma and tissue PK of RDV and its metabolites in patients with organ dysfunction was explored. Our simulation results indicated that intracellular exposure of GS-443902 was decreased in the liver and increased in the lungs in subjects with hepatic impairment relative to the subjects with normal liver function. In subjects with severe renal impairment, the exposure of GS-443902 in the liver was slightly increased, whereas the lung exposure of GS-443902 was not impacted. These predictions along with the organ impairment study results may be used to support decision making regarding the RDV dosage adjustment in these patient subgroups. The modeling exercise illustrated the potential of whole body PBPK modeling to aid in decision making for nucleotide analogue prodrugs, particularly when the active metabolite exposure in the target tissues is not available. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text