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

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-concentrat...

Full description

Saved in:
Bibliographic Details
Published in:Drug metabolism and disposition 2015-04, Vol.43 (4), p.620-630
Main Authors: Yu, Hongbin, Balani, Suresh K, Chen, Weichao, Cui, Donghui, He, Ling, Humphreys, W Griffith, Mao, Jialin, Lai, W George, Lee, Anthony J, Lim, Heng-Keang, MacLauchlin, Christopher, Prakash, Chandra, Surapaneni, Sekhar, Tse, Susanna, Upthagrove, Alana, Walsky, Robert L, Wen, Bo, Zeng, Zhaopie
Format: Article
Language:English
Subjects:
Area Under Curve
Cytochrome P-450 Enzyme Inhibitors - metabolism
Cytochrome P-450 Enzyme Inhibitors - pharmacokinetics
Cytochrome P-450 Enzyme Inhibitors - pharmacology
Cytochrome P-450 Enzyme System - metabolism
Drug Industry - legislation & jurisprudence
Drug Interactions
Europe
Fellowships and Scholarships
Government Regulation
Guidelines as Topic
Humans
Prescription Drugs - metabolism
Prescription Drugs - pharmacokinetics
Prescription Drugs - pharmacology
Risk Assessment - economics
Risk Assessment - legislation & jurisprudence
Risk Assessment - methods
United States
United States Food and Drug Administration
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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 R(met) strategy) to predict P450 inhibition-based DDIs caused by metabolites in the clinic.
ISSN:0090-9556
1521-009X
DOI:10.1124/dmd.114.059345