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Physiologically‐Based Pharmacokinetic Modeling of Atorvastatin Incorporating Delayed Gastric Emptying and Acid‐to‐Lactone Conversion

机译:阿托伐他汀结合延迟胃排空和酸-内酯转化的基于生理的药代动力学模型

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摘要

The drug–drug interaction profile of atorvastatin confirms that disposition is determined by cytochrome P450 (CYP) 3A4 and organic anion transporting polypeptides (OATPs). Drugs that affect gastric emptying, including dulaglutide, also affect atorvastatin pharmacokinetics (PK). Atorvastatin is a carboxylic acid that exists in equilibrium with a lactone form in vivo. The purpose of this work was to assess gastric acid–mediated lactone equilibration of atorvastatin and incorporate this into a physiologically‐based PK (PBPK) model to describe atorvastatin acid, lactone, and their major metabolites. In vitro acid‐to‐lactone conversion was assessed in simulated gastric fluid and included in the model. The PBPK model was verified with in vivo data including CYP3A4 and OATP inhibition studies. Altering the gastric acid–lactone equilibrium reproduced the change in atorvastatin PK observed with dulaglutide. The model emphasizes the need to include gastric acid–lactone conversion and all major atorvastatin‐related species for the prediction of atorvastatin PK.
机译:阿托伐他汀的药物相互作用研究证实,其处置取决于细胞色素P450(CYP)3A4和有机阴离子转运多肽(OATP)。影响胃排空的药物(包括度拉鲁肽)也影响阿托伐他汀的药代动力学(PK)。阿托伐他汀是在体内与内酯形式平衡存在的羧酸。这项工作的目的是评估胃酸介导的阿托伐他汀的内酯平衡,并将其纳入基于生理的PK(PBPK)模型中,以描述阿托伐他汀酸,内酯及其主要代谢产物。在模拟胃液中评估了体外酸到内酯的转化,并将其包括在模型中。用体内数据(包括CYP3A4和OATP抑制研究)验证了PBPK模型。改变胃酸-内酯平衡可重现杜拉鲁肽中阿托伐他汀PK的变化。该模型强调需要将胃酸-内酯转化和所有主要的阿托伐他汀相关物种包括在内,以预测阿托伐他汀PK。

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