Comprehensive PBPK model to predict drug interaction potential of Zanubrutinib as a victim or perpetrator

Abstract A physiologically based pharmacokinetic (PBPK) model was developed to evaluate and predict (1) the effect of concomitant cytochrome P450 3A (CYP3A) inhibitors or inducers on the exposures of zanubrutinib, (2) the effect of zanubrutinib on the exposures of CYP3A4, CYP2C8, and CYP2B6 substrat...

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Main Authors: Kun Wang, Xueting Yao, Miao Zhang, Dongyang Liu, Yuying Gao, Srikumar Sahasranaman, Ying C. Ou
Format: Article
Language:English
Published: Wiley 2021-05-01
Series:CPT: Pharmacometrics & Systems Pharmacology
Online Access:https://doi.org/10.1002/psp4.12605
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author Kun Wang
Xueting Yao
Miao Zhang
Dongyang Liu
Yuying Gao
Srikumar Sahasranaman
Ying C. Ou
author_facet Kun Wang
Xueting Yao
Miao Zhang
Dongyang Liu
Yuying Gao
Srikumar Sahasranaman
Ying C. Ou
author_sort Kun Wang
collection DOAJ
description Abstract A physiologically based pharmacokinetic (PBPK) model was developed to evaluate and predict (1) the effect of concomitant cytochrome P450 3A (CYP3A) inhibitors or inducers on the exposures of zanubrutinib, (2) the effect of zanubrutinib on the exposures of CYP3A4, CYP2C8, and CYP2B6 substrates, and (3) the impact of gastric pH changes on the pharmacokinetics of zanubrutinib. The model was developed based on physicochemical and in vitro parameters, as well as clinical data, including pharmacokinetic data in patients with B‐cell malignancies and in healthy volunteers from two clinical drug‐drug interaction (DDI) studies of zanubrutinib as a victim of CYP modulators (itraconazole, rifampicin) or a perpetrator (midazolam). This PBPK model was successfully validated to describe the observed plasma concentrations and clinical DDIs of zanubrutinib. Model predictions were generally within 1.5‐fold of the observed clinical data. The PBPK model was used to predict untested clinical scenarios; these simulations indicated that strong, moderate, and mild CYP3A inhibitors may increase zanubrutinib exposures by approximately four‐fold, two‐ to three‐fold, and <1.5‐fold, respectively. Strong and moderate CYP3A inducers may decrease zanubrutinib exposures by two‐ to three‐fold or greater. The PBPK simulations showed that clinically relevant concentrations of zanubrutinib, as a DDI perpetrator, would have no or limited impact on the enzyme activity of CYP2B6 and CYP2C8. Simulations indicated that zanubrutinib exposures are not impacted by acid‐reducing agents. Development of a PBPK model for zanubrutinib as a DDI victim and perpetrator in parallel can increase confidence in PBPK models supporting zanubrutinib label dose recommendations.
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spelling doaj.art-c6ef1cbd2e704a50ba2bf248d270e4042022-12-21T19:06:52ZengWileyCPT: Pharmacometrics & Systems Pharmacology2163-83062021-05-0110544145410.1002/psp4.12605Comprehensive PBPK model to predict drug interaction potential of Zanubrutinib as a victim or perpetratorKun Wang0Xueting Yao1Miao Zhang2Dongyang Liu3Yuying Gao4Srikumar Sahasranaman5Ying C. Ou6Shanghai Qiangshi Information Technology Co., Ltd Shanghai ChinaDrug Clinical Trial Center Peking University Third Hospital Beijing ChinaDrug Clinical Trial Center Peking University Third Hospital Beijing ChinaDrug Clinical Trial Center Peking University Third Hospital Beijing ChinaShanghai Qiangshi Information Technology Co., Ltd Shanghai ChinaBeiGene USA, Inc San Mateo CA USABeiGene USA, Inc San Mateo CA USAAbstract A physiologically based pharmacokinetic (PBPK) model was developed to evaluate and predict (1) the effect of concomitant cytochrome P450 3A (CYP3A) inhibitors or inducers on the exposures of zanubrutinib, (2) the effect of zanubrutinib on the exposures of CYP3A4, CYP2C8, and CYP2B6 substrates, and (3) the impact of gastric pH changes on the pharmacokinetics of zanubrutinib. The model was developed based on physicochemical and in vitro parameters, as well as clinical data, including pharmacokinetic data in patients with B‐cell malignancies and in healthy volunteers from two clinical drug‐drug interaction (DDI) studies of zanubrutinib as a victim of CYP modulators (itraconazole, rifampicin) or a perpetrator (midazolam). This PBPK model was successfully validated to describe the observed plasma concentrations and clinical DDIs of zanubrutinib. Model predictions were generally within 1.5‐fold of the observed clinical data. The PBPK model was used to predict untested clinical scenarios; these simulations indicated that strong, moderate, and mild CYP3A inhibitors may increase zanubrutinib exposures by approximately four‐fold, two‐ to three‐fold, and <1.5‐fold, respectively. Strong and moderate CYP3A inducers may decrease zanubrutinib exposures by two‐ to three‐fold or greater. The PBPK simulations showed that clinically relevant concentrations of zanubrutinib, as a DDI perpetrator, would have no or limited impact on the enzyme activity of CYP2B6 and CYP2C8. Simulations indicated that zanubrutinib exposures are not impacted by acid‐reducing agents. Development of a PBPK model for zanubrutinib as a DDI victim and perpetrator in parallel can increase confidence in PBPK models supporting zanubrutinib label dose recommendations.https://doi.org/10.1002/psp4.12605
spellingShingle Kun Wang
Xueting Yao
Miao Zhang
Dongyang Liu
Yuying Gao
Srikumar Sahasranaman
Ying C. Ou
Comprehensive PBPK model to predict drug interaction potential of Zanubrutinib as a victim or perpetrator
CPT: Pharmacometrics & Systems Pharmacology
title Comprehensive PBPK model to predict drug interaction potential of Zanubrutinib as a victim or perpetrator
title_full Comprehensive PBPK model to predict drug interaction potential of Zanubrutinib as a victim or perpetrator
title_fullStr Comprehensive PBPK model to predict drug interaction potential of Zanubrutinib as a victim or perpetrator
title_full_unstemmed Comprehensive PBPK model to predict drug interaction potential of Zanubrutinib as a victim or perpetrator
title_short Comprehensive PBPK model to predict drug interaction potential of Zanubrutinib as a victim or perpetrator
title_sort comprehensive pbpk model to predict drug interaction potential of zanubrutinib as a victim or perpetrator
url https://doi.org/10.1002/psp4.12605
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