A pharmacokinetic drug–drug interaction study between rosuvastatin and emvododstat, a potent anti‐SARS‐CoV‐2 (COVID‐19) DHODH (dihydroorotate dehydrogenase) inhibitor

Abstract A therapeutic agent that targets both viral replication and the hyper‐reactive immune response would offer a highly desirable treatment for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2; COVID‐19) management. Emvododstat (PTC299) was found to be a potent inhibitor of immunomod...

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Main Authors: Terri L. Morton, Oscar L. Laskin, Diksha Kaushik, Lucy Lee, Jiyuan Ma, Allan Kristensen, Kylie O'Keefe, Lee Golden, Matthew Klein, Ronald Kong
Format: Article
Language:English
Published: Wiley 2023-04-01
Series:Pharmacology Research & Perspectives
Subjects:
Online Access:https://doi.org/10.1002/prp2.1076
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author Terri L. Morton
Oscar L. Laskin
Diksha Kaushik
Lucy Lee
Jiyuan Ma
Allan Kristensen
Kylie O'Keefe
Lee Golden
Matthew Klein
Ronald Kong
author_facet Terri L. Morton
Oscar L. Laskin
Diksha Kaushik
Lucy Lee
Jiyuan Ma
Allan Kristensen
Kylie O'Keefe
Lee Golden
Matthew Klein
Ronald Kong
author_sort Terri L. Morton
collection DOAJ
description Abstract A therapeutic agent that targets both viral replication and the hyper‐reactive immune response would offer a highly desirable treatment for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2; COVID‐19) management. Emvododstat (PTC299) was found to be a potent inhibitor of immunomodulatory and inflammation‐related processes by the inhibition of dihydroorotate dehydrogenase (DHODH) to reduce SARS‐CoV‐2 replication. DHODH is the rate‐limiting enzyme of the de novo pyrimidine nucleotide biosynthesis pathway. This drug interaction study was performed to determine whether emvododstat was an inhibitor of breast cancer resistance protein (BCRP) transporters in humans. Potential drug–drug interactions (DDIs) between emvododstat and a BCRP transporter substrate (rosuvastatin) were investigated by measuring plasma rosuvastatin concentrations before and after emvododstat administration. There was no apparent difference in rosuvastatin plasma exposure. The geometric means of maximum plasma rosuvastatin concentrations (Cmax) were 4369 (rosuvastatin) and 5141 pg/mL (rosuvastatin + emvododstat) at 4 h postdose. Geometric mean rosuvastatin area under the concentration–time curve (AUC) from time 0 to the last measurable plasma concentration was 45 616 and 48 975 h·pg/mL when administered alone and after 7 days of b.i.d. emvododstat dosing, respectively. Geometric least squares mean ratios for Cmax and AUC were approximately equal to 1. Overall, administration of multiple doses of 100 mg emvododstat b.i.d. for 7 days in combination with a single dose of rosuvastatin was safe and well tolerated. Emvododstat can be safely administered with other BCRP substrate drugs. Hence, pharmacokinetic DDI mediated via BCRP inhibition is not expected when emvododstat and BCRP substrates are coadministered.
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spelling doaj.art-39ad2230eba34f49a3e6b8a52a05b53b2023-04-11T06:38:37ZengWileyPharmacology Research & Perspectives2052-17072023-04-01112n/an/a10.1002/prp2.1076A pharmacokinetic drug–drug interaction study between rosuvastatin and emvododstat, a potent anti‐SARS‐CoV‐2 (COVID‐19) DHODH (dihydroorotate dehydrogenase) inhibitorTerri L. Morton0Oscar L. Laskin1Diksha Kaushik2Lucy Lee3Jiyuan Ma4Allan Kristensen5Kylie O'Keefe6Lee Golden7Matthew Klein8Ronald Kong9PTC Therapeutics South Plainfield New Jersey USAPTC Therapeutics South Plainfield New Jersey USAPTC Therapeutics South Plainfield New Jersey USAPTC Therapeutics South Plainfield New Jersey USAPTC Therapeutics South Plainfield New Jersey USAPTC Therapeutics South Plainfield New Jersey USAPTC Therapeutics South Plainfield New Jersey USAPTC Therapeutics South Plainfield New Jersey USAPTC Therapeutics South Plainfield New Jersey USAPTC Therapeutics South Plainfield New Jersey USAAbstract A therapeutic agent that targets both viral replication and the hyper‐reactive immune response would offer a highly desirable treatment for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2; COVID‐19) management. Emvododstat (PTC299) was found to be a potent inhibitor of immunomodulatory and inflammation‐related processes by the inhibition of dihydroorotate dehydrogenase (DHODH) to reduce SARS‐CoV‐2 replication. DHODH is the rate‐limiting enzyme of the de novo pyrimidine nucleotide biosynthesis pathway. This drug interaction study was performed to determine whether emvododstat was an inhibitor of breast cancer resistance protein (BCRP) transporters in humans. Potential drug–drug interactions (DDIs) between emvododstat and a BCRP transporter substrate (rosuvastatin) were investigated by measuring plasma rosuvastatin concentrations before and after emvododstat administration. There was no apparent difference in rosuvastatin plasma exposure. The geometric means of maximum plasma rosuvastatin concentrations (Cmax) were 4369 (rosuvastatin) and 5141 pg/mL (rosuvastatin + emvododstat) at 4 h postdose. Geometric mean rosuvastatin area under the concentration–time curve (AUC) from time 0 to the last measurable plasma concentration was 45 616 and 48 975 h·pg/mL when administered alone and after 7 days of b.i.d. emvododstat dosing, respectively. Geometric least squares mean ratios for Cmax and AUC were approximately equal to 1. Overall, administration of multiple doses of 100 mg emvododstat b.i.d. for 7 days in combination with a single dose of rosuvastatin was safe and well tolerated. Emvododstat can be safely administered with other BCRP substrate drugs. Hence, pharmacokinetic DDI mediated via BCRP inhibition is not expected when emvododstat and BCRP substrates are coadministered.https://doi.org/10.1002/prp2.1076BCRPcoronavirusCOVID‐19DHODHpharmacokineticsPTC299
spellingShingle Terri L. Morton
Oscar L. Laskin
Diksha Kaushik
Lucy Lee
Jiyuan Ma
Allan Kristensen
Kylie O'Keefe
Lee Golden
Matthew Klein
Ronald Kong
A pharmacokinetic drug–drug interaction study between rosuvastatin and emvododstat, a potent anti‐SARS‐CoV‐2 (COVID‐19) DHODH (dihydroorotate dehydrogenase) inhibitor
Pharmacology Research & Perspectives
BCRP
coronavirus
COVID‐19
DHODH
pharmacokinetics
PTC299
title A pharmacokinetic drug–drug interaction study between rosuvastatin and emvododstat, a potent anti‐SARS‐CoV‐2 (COVID‐19) DHODH (dihydroorotate dehydrogenase) inhibitor
title_full A pharmacokinetic drug–drug interaction study between rosuvastatin and emvododstat, a potent anti‐SARS‐CoV‐2 (COVID‐19) DHODH (dihydroorotate dehydrogenase) inhibitor
title_fullStr A pharmacokinetic drug–drug interaction study between rosuvastatin and emvododstat, a potent anti‐SARS‐CoV‐2 (COVID‐19) DHODH (dihydroorotate dehydrogenase) inhibitor
title_full_unstemmed A pharmacokinetic drug–drug interaction study between rosuvastatin and emvododstat, a potent anti‐SARS‐CoV‐2 (COVID‐19) DHODH (dihydroorotate dehydrogenase) inhibitor
title_short A pharmacokinetic drug–drug interaction study between rosuvastatin and emvododstat, a potent anti‐SARS‐CoV‐2 (COVID‐19) DHODH (dihydroorotate dehydrogenase) inhibitor
title_sort pharmacokinetic drug drug interaction study between rosuvastatin and emvododstat a potent anti sars cov 2 covid 19 dhodh dihydroorotate dehydrogenase inhibitor
topic BCRP
coronavirus
COVID‐19
DHODH
pharmacokinetics
PTC299
url https://doi.org/10.1002/prp2.1076
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