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常见的 UGT1A9 多态性对 2 型糖尿病患者达格列净的表观口服清除率无临床意义的影响。

Common UGT1A9 polymorphisms do not have a clinically meaningful impact on the apparent oral clearance of dapagliflozin in type 2 diabetes mellitus.

机构信息

Swarthmore College, Swarthmore, PA, USA.

Emory University, Atlanta, GA, USA.

出版信息

Br J Clin Pharmacol. 2022 Feb;88(4):1942-1946. doi: 10.1111/bcp.15117. Epub 2022 Jan 23.

Abstract

Dapagliflozin is an inhibitor of human renal sodium-glucose cotransporter 2 (SGLT2), first approved for the treatment of type 2 diabetes mellitus (T2DM). Dapagliflozin is primarily metabolized by uridine diphosphate glucuronosyltransferase 1A9 (UGT1A9). The effect of UGT1A9 polymorphisms on dapagliflozin apparent oral clearance (CL/F) was studied with dapagliflozin population pharmacokinetic data and UGT1A9 genotype data (I.399C>T, rs2011404, rs6759892, rs7577677, rs4148323, UGT1A92 and UGT1A93) from a Phase 2 study conducted in subjects with T2DM (n = 187). An analysis of covariance (ANCOVA) model accounting for known covariates influencing dapagliflozin CL/F was applied to these data to quantify the impact of each UGT1A9 polymorphism relative to the wildtype UGT1A9 genotype. The analysis showed that the geometric mean ratios of dapagliflozin CL/F for all of the UGT1A9 polymorphisms studied were within the range of wildtype UGT1A9 CL/F values. Consequently, the polymorphisms of UGT1A9 studied had no clinically meaningful impact on the CL/F of dapagliflozin.

摘要

达格列净是一种人肾脏钠-葡萄糖协同转运蛋白 2(SGLT2)抑制剂,最初被批准用于治疗 2 型糖尿病(T2DM)。达格列净主要通过尿苷二磷酸葡萄糖醛酸基转移酶 1A9(UGT1A9)代谢。通过达格列净群体药代动力学数据和 UGT1A9 基因型数据(I.399C>T、rs2011404、rs6759892、rs7577677、rs4148323、UGT1A92 和 UGT1A93),对 UGT1A9 多态性对达格列净表观口服清除率(CL/F)的影响进行了研究,该研究在 T2DM 受试者中进行(n=187)。应用协方差分析(ANCOVA)模型对这些数据进行分析,以考虑影响达格列净 CL/F 的已知混杂因素,从而定量评估每种 UGT1A9 多态性相对于野生型 UGT1A9 基因型的影响。分析表明,所研究的所有 UGT1A9 多态性的达格列净 CL/F 几何均数比值均在野生型 UGT1A9 CL/F 值范围内。因此,所研究的 UGT1A9 多态性对达格列净 CL/F 无临床意义的影响。

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