Effect of aprepitant, a moderate CYP3A4 inhibitor, on bosutinib exposure in healthy subjects.

Purpose: Bosutinib is an oral, dual Src and Abl tyrosine kinase inhibitor (TKI) approved for the treatment of Philadelphia chromosome-positive chronic myeloid leukemia resistant or intolerant to prior TKI therapy. Bosutinib is primarily metabolized by cytochrome P450 (CYP) 3A4, suggesting drug inter...

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Published in:European Journal of Clinical Pharmacology Vol. 73; no. 1; pp. 49 - 57
Main Authors: Hsyu, Poe-Hirr, Pignataro, Daniela, Matschke, Kyle
Format: research tables/charts Journal Article
Published: Springer Nature Jan2017
Online Access:View this record in EBSCOhost
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      dt: Jan2017
      vid: 73
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00228-016-2108-z
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        atl: Effect of aprepitant, a moderate CYP3A4 inhibitor, on bosutinib exposure in healthy subjects.
      aug:
        au:
          Hsyu, Poe-Hirr
          Pignataro, Daniela
          Matschke, Kyle
        affil: Pfizer Inc , 10646 Science Center Drive La Jolla 92121 USA
      sug:
        subj:
          Tyrosine Kinase Inhibitors
          Leukemia, Myeloid Drug Therapy
          Pharmacokinetics Evaluation
          Human
          Adult
          Male
          Female
          Drug Interactions
          Cytochrome P-450 Enzyme System
          Adult: 19-44 years
          Male
          Female
      ab: Purpose: Bosutinib is an oral, dual Src and Abl tyrosine kinase inhibitor (TKI) approved for the treatment of Philadelphia chromosome-positive chronic myeloid leukemia resistant or intolerant to prior TKI therapy. Bosutinib is primarily metabolized by cytochrome P450 (CYP) 3A4, suggesting drug interaction potential with other CYP3A4 modulators. This open-label, randomized, 2-sequence, 2-period crossover study assessed the effect of single-dose aprepitant, a moderate CYP3A4 inhibitor, on the single-dose pharmacokinetic profile of oral bosutinib 500 mg. Methods: Nineteen healthy, fed adults received bosutinib (100 mg × 5) alone or coadministered with aprepitant (125 mg × 1) in each treatment period (with a ≥14-day washout); serial blood samples were analyzed. Safety was evaluated. Results: Following coadministration of aprepitant with bosutinib, the area under the concentration-time curve from time zero extrapolated to infinity (AUC) and maximum plasma concentration ( C ) were higher than in bosutinib alone (AUC, 4719 and 2268 ng•h/mL; C , 146.0 and 94.94 ng/mL). For bosutinib with aprepitant versus bosutinib alone, mean terminal elimination half-life was similar (25.99 vs 27.79 h), time to C was longer (6.02 vs 4.15 h), and apparent oral clearance (CL/F) was decreased (105.9 vs 220.4 L/h). The ratio of adjusted geometric means of AUC and C for bosutinib with aprepitant relative to bosutinib alone were 199 % (90 % confidence interval, 167-237 %) and 153 % (127-184 %), respectively. Both treatments were well tolerated. Conclusion: In healthy volunteers, administering a single dose of aprepitant increased the AUC and C following a single dose of bosutinib by 99 and 53 %, respectively. These results are consistent with a moderate CYP3A4 inhibitor effect of aprepitant on bosutinib (Trial Registration: NCT02058277).
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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