Wei Zhuodu, Jeong Hyeon-Cheol, Kim Min-Gul, Shin Kwang-Hee
College of Pharmacy, Research Institute of Pharmaceutical Sciences, Kyungpook National University, 80, Daehak-ro, Buk-gu, Daegu 41566, Republic of Korea.
Department of Pharmacology, Medical School, Jeonbuk National University, Jeonju 54907, Republic of Korea.
Pharmaceuticals (Basel). 2023 Feb 26;16(3):360. doi: 10.3390/ph16030360.
Tegoprazan is a novel potassium-competitive acid blocker. This study investigated the effect of drug-drug interaction on the pharmacokinetics and pharmacodynamics of tegoprazan co-administered with amoxicillin and clarithromycin, the first-line therapy for the eradication of , using physiologically based pharmacokinetic and pharmacodynamic (PBPK/PD) modeling. The previously reported tegoprazan PBPK/PD model was modified and applied. The clarithromycin PBPK model was developed based on the model provided by the SimCYP compound library. The amoxicillin model was constructed using the middle-out approach. All of the observed concentration-time profiles were covered well by the predicted profiles with the 5th and 95th percentiles. The mean ratios of predicted to observed PK parameters, including the area under the curve (AUC), maximum plasma drug concentration (C), and clearance, were within the 30% intervals for the developed models. Two-fold ratios of predicted fold-changes of C and AUC from time 0 to 24 h to observed data were satisfied. The predicted PD endpoints, including median intragastric pH and percentage holding rate at pH above 4 or 6 on day 1 and day 7, were close to the corresponding observed data. This investigation allows evaluation of the effects of CYP3A4 perpetrators on tegoprazan PK and PD changes, thus providing clinicians with the rationale for co-administration dosing adjustment.
替戈拉赞是一种新型钾离子竞争性酸阻滞剂。本研究使用基于生理的药代动力学和药效学(PBPK/PD)模型,调查了药物相互作用对替戈拉赞与阿莫西林和克拉霉素联合使用时药代动力学和药效学的影响,阿莫西林和克拉霉素是根除幽门螺杆菌的一线治疗方案。对先前报道的替戈拉赞PBPK/PD模型进行了修改并应用。克拉霉素PBPK模型是基于SimCYP化合物库提供的模型开发的。阿莫西林模型采用由中至外的方法构建。预测曲线很好地覆盖了所有观察到的浓度-时间曲线,第5和第95百分位数均在范围内。对于所开发的模型,预测的与观察到的药代动力学参数的平均比值,包括曲线下面积(AUC)、最大血浆药物浓度(Cmax)和清除率,均在30%的区间内。从0至24小时,Cmax和AUC预测的变化倍数与观察数据的两倍比值得到满足。预测的药效学终点,包括第1天和第7天胃内pH中位数以及pH高于4或6时的保持率百分比,均与相应的观察数据接近。本研究有助于评估CYP3A4诱导剂对替戈拉赞药代动力学和药效学变化的影响,从而为临床医生提供联合给药剂量调整的理论依据。