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Reimagining the Framework Supporting the Static Analysis of Transporter Drug Interaction Risk; Integrated Use of Biomarkers to Generate Pan-Transporter Inhibition Signatures
Clinical Pharmacology & Therapeutics ( IF 6.7 ) Pub Date : 2022-07-23 , DOI: 10.1002/cpt.2713
A D Rodrigues 1
Affiliation  

Solute carrier (SLC) transporters present as the loci of important drug–drug interactions (DDIs). Therefore, sponsors generate in vitro half-maximal inhibitory concentration (IC50) data and apply regulatory agency-guided “static” methods to assess DDI risk and the need for a formal clinical DDI study. Because such methods are conservative and high false-positive rates are likely (e.g., DDI study triggered when liver SLC R value ≥ 1.04 and renal SLC maximal unbound plasma (Cmax,u)/IC50 ratio ≥ 0.02), investigators have attempted to deploy plasma- and urine-based SLC biomarkers in phase I studies to de-risk DDI and obviate the need for drug probe-based studies. In this regard, it was possible to generate in-house in vitro SLC IC50 data for various clinically (biomarker)-qualified perpetrator drugs, under standard assay conditions, and then estimate “% inhibition” for each SLC and relate it empirically to published clinical biomarker data (area under the plasma concentration vs. time curve (AUC) ratio (AUCR, AUCinhibitor/AUCreference) and % decrease in renal clearance (ΔCLrenal)). After such a “calibration” exercise, it was determined that only compounds with high R values (> 1.5) and Cmax,u/IC50 ratios (> 0.5) are likely to significantly modulate liver (AUCR > 1.25) and renal (ΔCLrenal > 25%) biomarkers and evoke DDI risk. The % inhibition approach supports integration of liver and renal SLC data and allows one to generate pan-SLC inhibition signatures for different test perpetrators (e.g., SLC % inhibition ranking). In turn, such signatures can guide the selection of the most appropriate individual (or combinations of) biomarkers for testing in phase I studies.

中文翻译:

重新构想支持转运蛋白药物相互作用风险静态分析的框架;综合使用生物标志物生成泛转运蛋白抑制特征

溶质载体 (SLC) 转运蛋白作为重要药物-药物相互作用 (DDI) 的位点存在。因此,发起人生成体外半数最大抑制浓度 (IC 50 ) 数据并应用监管机构指导的“静态”方法来评估 DDI 风险和正式临床 DDI 研究的必要性。因为这些方法是保守的并且可能存在高假阳性率(例如,当肝脏 SLC R值 ≥ 1.04 和肾脏 SLC 最大未结合血浆 ( C max,u )/IC 50时触发 DDI 研究比率 ≥ 0.02),研究人员已尝试在 I 期研究中部署基于血浆和尿液的 SLC 生物标志物,以降低 DDI 风险并避免进行基于药物探针的研究。在这方面,可以在标准测定条件下为各种临床(生物标志物)合格的犯罪药物生成内部体外SLC IC 50数据,然后估计每个 SLC 的“抑制百分比”并将其与已发表的经验相关联临床生物标志物数据(血浆浓度与时间曲线下面积(AUC)比率(AUCR,AUC抑制剂/AUC参考值)和肾清除率下降百分比(ΔCL))。经过这样的“校准”练习后,确定只有具有高R 的化合物值 (> 1.5) 和C max,u /IC 50比率 (> 0.5) 可能会显着调节肝脏 (AUCR > 1.25) 和肾脏 (ΔCL肾脏 > 25%) 生物标志物并引起 DDI 风险。抑制百分比方法支持肝脏和肾脏 SLC 数据的整合,并允许为不同的测试实施者生成泛 SLC 抑制特征(例如,SLC 抑制百分比排名)。反过来,这些特征可以指导选择最合适的个体(或组合)生物标志物用于 I 期研究的测试。
更新日期:2022-07-23
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