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Research ArticlePerspective

Managing the Risk of CYP3A Induction in Drug Development: A Strategic Approach

Barry C. Jones, Helen Rollison, Susanne Johansson, Kajsa P. Kanebratt, Craig Lambert, Karthick Vishwanathan and Tommy B. Andersson
Drug Metabolism and Disposition January 2017, 45 (1) 35-41; DOI: https://doi.org/10.1124/dmd.116.072025
Barry C. Jones
Oncology Innovative Medicines and Early Development Biotech Unit (B.C.J.) and Drug Safety and Metabolism (H.R.), AstraZeneca, Cambridge, United Kingdom; Quantitative Clinical Pharmacology (S.J.), and Cardiovascular and Metabolic Diseases, Innovative Medicines and Early Development Biotech Unit (K.P.K., T.B.A.), AstraZeneca, Mölndal, Sweden; Quantitative Clinical Pharmacology, AstraZeneca, Hertfordshire, United Kingdom (C.L.); Quantitative Clinical Pharmacology, AstraZeneca, Waltham, Massachusetts (K.V.); and Section of Pharmacogenetics, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden (T.B.A.).
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Helen Rollison
Oncology Innovative Medicines and Early Development Biotech Unit (B.C.J.) and Drug Safety and Metabolism (H.R.), AstraZeneca, Cambridge, United Kingdom; Quantitative Clinical Pharmacology (S.J.), and Cardiovascular and Metabolic Diseases, Innovative Medicines and Early Development Biotech Unit (K.P.K., T.B.A.), AstraZeneca, Mölndal, Sweden; Quantitative Clinical Pharmacology, AstraZeneca, Hertfordshire, United Kingdom (C.L.); Quantitative Clinical Pharmacology, AstraZeneca, Waltham, Massachusetts (K.V.); and Section of Pharmacogenetics, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden (T.B.A.).
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Susanne Johansson
Oncology Innovative Medicines and Early Development Biotech Unit (B.C.J.) and Drug Safety and Metabolism (H.R.), AstraZeneca, Cambridge, United Kingdom; Quantitative Clinical Pharmacology (S.J.), and Cardiovascular and Metabolic Diseases, Innovative Medicines and Early Development Biotech Unit (K.P.K., T.B.A.), AstraZeneca, Mölndal, Sweden; Quantitative Clinical Pharmacology, AstraZeneca, Hertfordshire, United Kingdom (C.L.); Quantitative Clinical Pharmacology, AstraZeneca, Waltham, Massachusetts (K.V.); and Section of Pharmacogenetics, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden (T.B.A.).
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Kajsa P. Kanebratt
Oncology Innovative Medicines and Early Development Biotech Unit (B.C.J.) and Drug Safety and Metabolism (H.R.), AstraZeneca, Cambridge, United Kingdom; Quantitative Clinical Pharmacology (S.J.), and Cardiovascular and Metabolic Diseases, Innovative Medicines and Early Development Biotech Unit (K.P.K., T.B.A.), AstraZeneca, Mölndal, Sweden; Quantitative Clinical Pharmacology, AstraZeneca, Hertfordshire, United Kingdom (C.L.); Quantitative Clinical Pharmacology, AstraZeneca, Waltham, Massachusetts (K.V.); and Section of Pharmacogenetics, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden (T.B.A.).
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Craig Lambert
Oncology Innovative Medicines and Early Development Biotech Unit (B.C.J.) and Drug Safety and Metabolism (H.R.), AstraZeneca, Cambridge, United Kingdom; Quantitative Clinical Pharmacology (S.J.), and Cardiovascular and Metabolic Diseases, Innovative Medicines and Early Development Biotech Unit (K.P.K., T.B.A.), AstraZeneca, Mölndal, Sweden; Quantitative Clinical Pharmacology, AstraZeneca, Hertfordshire, United Kingdom (C.L.); Quantitative Clinical Pharmacology, AstraZeneca, Waltham, Massachusetts (K.V.); and Section of Pharmacogenetics, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden (T.B.A.).
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Karthick Vishwanathan
Oncology Innovative Medicines and Early Development Biotech Unit (B.C.J.) and Drug Safety and Metabolism (H.R.), AstraZeneca, Cambridge, United Kingdom; Quantitative Clinical Pharmacology (S.J.), and Cardiovascular and Metabolic Diseases, Innovative Medicines and Early Development Biotech Unit (K.P.K., T.B.A.), AstraZeneca, Mölndal, Sweden; Quantitative Clinical Pharmacology, AstraZeneca, Hertfordshire, United Kingdom (C.L.); Quantitative Clinical Pharmacology, AstraZeneca, Waltham, Massachusetts (K.V.); and Section of Pharmacogenetics, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden (T.B.A.).
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Tommy B. Andersson
Oncology Innovative Medicines and Early Development Biotech Unit (B.C.J.) and Drug Safety and Metabolism (H.R.), AstraZeneca, Cambridge, United Kingdom; Quantitative Clinical Pharmacology (S.J.), and Cardiovascular and Metabolic Diseases, Innovative Medicines and Early Development Biotech Unit (K.P.K., T.B.A.), AstraZeneca, Mölndal, Sweden; Quantitative Clinical Pharmacology, AstraZeneca, Hertfordshire, United Kingdom (C.L.); Quantitative Clinical Pharmacology, AstraZeneca, Waltham, Massachusetts (K.V.); and Section of Pharmacogenetics, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden (T.B.A.).
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Figures

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  • Fig. 1.
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    Fig. 1.

    Schematic detailing AZ induction strategy from preclinical to clinical assessment.

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    Fig. 2.

    Plasma concentrations of 4β-hydroxycholesterol before and after 2 weeks of treatment with daily doses of 20, 100, and 500 mg rifampicin (Kanebratt et al., 2008, figure published with permission from the publisher).

  • Fig. 3.
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    Fig. 3.

    Structure of AZD1208.

  • Fig. 4.
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    Fig. 4.

    Plasma concentrations of 4β-hydroxycholesterol before and after 2 weeks of treatment with daily doses of 700 or 800 mg AZD1208.

Tables

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    TABLE 1

    Effect of AZD1208 on CYP3A4 mRNA in HepaRG and human hepatocytes

    Cell TypeMaximum Concentration TestedCYP3A4 mRNACYP3A4 Activity
    Observed Fold InductionaPercentage Rifampicin InductionbObserved Fold InductionPercentage Rifampicin Induction
    μM
    HepaRG303.35.4Not testedNot tested
    Hepatocyte lot 321302.42.5Concentration-dependent decrease
    Hepatocyte lot 349303.41.6Concentration-dependent decrease
    Hepatocyte lot 295103.4<1.01.1Not calculated
    • ↵a Observed fold induction data are the mean from triplicate wells at the concentration stated.

    • ↵b Induction as percentage of positive control data are the mean of triplicate wells in each group.

Additional Files

  • Figures
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  • Data Supplement

    Files in this Data Supplement:

    • Supplemental Data -

      Supplemental Figure 1 - demonstrate the concordance CYP3A mRNA Emax and EC50 and efficiency ratios (Emax/EC50)...

      Methods

      Supplemental Table 1 - Effect of AZD1208 on CYP3A4 mRNA and CYP3A4/5 mediated testosterone 6-beta-hydroxylase activity in human hepatocytes

      References

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Drug Metabolism and Disposition: 45 (1)
Drug Metabolism and Disposition
Vol. 45, Issue 1
1 Jan 2017
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Research ArticlePerspective

Managing the Risk of CYP3A Induction in Drug Development

Barry C. Jones, Helen Rollison, Susanne Johansson, Kajsa P. Kanebratt, Craig Lambert, Karthick Vishwanathan and Tommy B. Andersson
Drug Metabolism and Disposition January 1, 2017, 45 (1) 35-41; DOI: https://doi.org/10.1124/dmd.116.072025

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Research ArticlePerspective

Managing the Risk of CYP3A Induction in Drug Development

Barry C. Jones, Helen Rollison, Susanne Johansson, Kajsa P. Kanebratt, Craig Lambert, Karthick Vishwanathan and Tommy B. Andersson
Drug Metabolism and Disposition January 1, 2017, 45 (1) 35-41; DOI: https://doi.org/10.1124/dmd.116.072025
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  • Article
    • Abstract
    • Introduction
    • Nuclear Receptor Assays
    • HepaRG Induction Assay
    • Human Hepatocytes Induction Analysis
    • 4β-Hydroxycholesterol Clinical Biomarker Assessment
    • Clinical Midazolam Induction Study
    • Case Study: AZD1208
    • Discussion
    • Authorship Contributions
    • Footnotes
    • Abbreviations
    • References
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