A pharmacokinetic drug-drug interaction study between selexipag and midazolam, a CYP3A4 substrate, in healthy male subjects.

Purpose: In vitro data showed that selexipag and its active metabolite (ACT-333679) have an inductive effect on CYP3A4, CYP2B6, and CYP2C9 at concentrations approximately 100-fold higher than the maximum plasma concentration ( C ) measured under steady-state conditions. In order to confirm in vivo t...

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Published in:European Journal of Clinical Pharmacology Vol. 73; no. 9; pp. 1121 - 1129
Main Authors: Juif, Pierre-Eric, Boehler, Margaux, Donazzolo, Yves, Bruderer, Shirin, Dingemanse, Jasper
Format: research tables/charts randomized controlled trial Journal Article
Published: Springer Nature Sep2017
Online Access:View this record in EBSCOhost
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      dt: Sep2017
      vid: 73
      iid: 9
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00228-017-2282-7
        124504645
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        atl: A pharmacokinetic drug-drug interaction study between selexipag and midazolam, a CYP3A4 substrate, in healthy male subjects.
      aug:
        au:
          Juif, Pierre-Eric
          Boehler, Margaux
          Donazzolo, Yves
          Bruderer, Shirin
          Dingemanse, Jasper
        affil: Department of Clinical Pharmacology , Actelion Pharmaceuticals Ltd. , Gewerbestrasse 16 4123 Allschwil Switzerland
      sug:
        subj:
          Midazolam Pharmacokinetics
          Drug Interactions
          Prostaglandins I
          Cytochrome P-450 Enzyme System
          Human
          Male
          Health
          Data Collection
          Randomized Controlled Trials
          Receptors, Cell Surface
          Patient Safety
          Data Analysis Software
          Drug Therapy, Combination
          Funding Source
          Male
      ab: Purpose: In vitro data showed that selexipag and its active metabolite (ACT-333679) have an inductive effect on CYP3A4, CYP2B6, and CYP2C9 at concentrations approximately 100-fold higher than the maximum plasma concentration ( C ) measured under steady-state conditions. In order to confirm in vivo the lack of induction at the enterocyte level, we assessed the effect of selexipag on midazolam, a substrate of hepatic and intestinal CYP3A4. Methods: This study was conducted according to an open-label, randomized, two-way crossover design. A total of 20 subjects received a single oral dose of 7.5 mg midazolam alone (treatment A) or on top of steady-state selexipag (treatment B). Selexipag was administered twice daily using an up-titration scheme consisting of three steps: 400, 600, 1000, and 1600 μg with increments every fourth day. A 24-h pharmacokinetic profile was performed following midazolam administration, and bioequivalence criteria were investigated on an exploratory basis. Results: The C of midazolam and 1-hydroxymidazolam was decreased by approximately 20 and 14%, respectively, following treatment B compared to A. The time to reach C for midazolam and 1-hydroxymidazolam was similar between treatments. The terminal half-life was reduced in treatment B compared to A for both midazolam (16%) and 1-hydroxymidazolam (20%). Exposure (area under the curve) to midazolam and 1-hydroxymidazolam was similar between treatments, and the 90% confidence intervals of geometric mean ratios were within the bioequivalence interval. Treatment with midazolam, selexipag, and the combination was safe and well tolerated. Conclusion: Exposure to midazolam and 1-hydroxymidazolam was not affected by treatment with selexipag.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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