RT Journal Article
SR Electronic
T1 Contribution of Metabolites to P450 Inhibition–Based Drug–Drug Interactions: Scholarship from the Drug Metabolism Leadership Group of the Innovation and Quality Consortium Metabolite Group
JF Drug Metabolism and Disposition
JO Drug Metab Dispos
FD American Society for Pharmacology and Experimental Therapeutics
SP 620
OP 630
DO 10.1124/dmd.114.059345
VO 43
IS 4
A1 Yu, Hongbin
A1 Balani, Suresh K.
A1 Chen, Weichao
A1 Cui, Donghui
A1 He, Ling
A1 Humphreys, W. Griffith
A1 Mao, Jialin
A1 Lai, W. George
A1 Lee, Anthony J.
A1 Lim, Heng-Keang
A1 MacLauchlin, Christopher
A1 Prakash, Chandra
A1 Surapaneni, Sekhar
A1 Tse, Susanna
A1 Upthagrove, Alana
A1 Walsky, Robert L.
A1 Wen, Bo
A1 Zeng, Zhaopie
YR 2015
UL http://dmd.aspetjournals.org/content/43/4/620.abstract
AB Recent European Medicines Agency (final) and US Food and Drug Administration (draft) drug interaction guidances proposed that human circulating metabolites should be investigated in vitro for their drug–drug interaction (DDI) potential if present at ≥25% of the parent area under the time-concentration curve (AUC) (US Food and Drug Administration) or ≥25% of the parent and ≥10% of the total drug-related AUC (European Medicines Agency). To examine the application of these regulatory recommendations, a group of scientists, representing 18 pharmaceutical companies of the Drug Metabolism Leadership Group of the Innovation and Quality Consortium, conducted a scholarship to assess the risk of contributions by metabolites to cytochrome P450 (P450) inhibition–based DDIs. The group assessed the risk of having a metabolite as the sole contributor to DDI based on literature data and analysis of the 137 most frequently prescribed drugs, defined structural alerts associated with P450 inhibition/inactivation by metabolites, and analyzed current approaches to trigger in vitro DDI studies for metabolites. The group concluded that the risk of P450 inhibition caused by a metabolite alone is low. Only metabolites from 5 of 137 drugs were likely the sole contributor to the in vivo P450 inhibition–based DDIs. Two recommendations were provided when assessing the need to conduct in vitro P450 inhibition studies for metabolites: 1) consider structural alerts that suggest P450 inhibition potential, and 2) use multiple approaches (e.g., a metabolite cut-off value of 100% of the parent AUC and the Rmet strategy) to predict P450 inhibition–based DDIs caused by metabolites in the clinic.