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Fromage Y, Jamal N, Codde C, Monchaud C, Labriffe M, Ponthier L, Marquet P, Faucher JF, Woillard JB. In Silico Pharmacokinetics Evaluation of Forgiveness for Doravirine and Rilpivirine. Ther Drug Monit 2024; 46:391-396. [PMID: 38158596 DOI: 10.1097/ftd.0000000000001169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/29/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND This study aimed to evaluate the concentrations of rilpivirine (RLP) and doravirine (DOR) after 3 days-off using simulations from population pharmacokinetics models. METHODS The authors conducted a series of 500 sets of 10,000 Monte Carlo simulations to examine the steady-state conditions for 2 common dosage levels: 25 mg/d for RLP and 100 mg/d for DOR. These simulations were conducted under 2 scenarios: 1 without drug cessation and another after a 3-day break. The validity of the implementation was established through a comparison of median trough concentrations (C24h) with previously reported data. Subsequently, the proportion of simulated patients with C24h and C72h after 3 days-off (C72h/3do) that exceeded the inhibitory concentration 50 (IC50), 5.2 mcg/L for DOR and 20.5 mcg/L for RLP respectively, was calculated. The inhibitory quotient (IQ) was also computed, which was 6 times IC50 for DOR and 4.5 times IC50 for RLP. Finally, nomograms were constructed to estimate the probability of having C72h/3do > IC50 or > IQ for different ranges of C24h. RESULTS Simulated C24h median ± SD for RLP were 61.8 ± 0.4 mcg/L and for DOR 397 ± 0 mcg/L. For RLP, 99.3 ± 0.1% exceeded IC50 at C24h, 16.4 ± 0.4% at C72h/3do, and none surpassed the IQ threshold. In contrast, DOR had 100% ± 0% above IC50 at C24h, 93.6 ± 0.2% at C72h/3do, and 58.6 ± 0.5% exceeded the IQ. CONCLUSIONS These findings suggest that treatment with DOR may offer a more forgiving therapeutic profile than RLP, given the larger proportion of patients achieving effective drug exposure with DOR. However, it is important to acknowledge a significant limitation of this study, namely, the assumption that drug concentration is a perfect surrogate for drug effectiveness.
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Affiliation(s)
- Yeleen Fromage
- Department of Pharmacology, Toxicology and Pharmacovigilance, CHU de Limoges, Limoges, France
| | - Najwa Jamal
- Department of Pharmacology, Toxicology and Pharmacovigilance, CHU de Limoges, Limoges, France
| | - Cyrielle Codde
- Department of Pharmacology, Toxicology and Pharmacovigilance, CHU de Limoges, Limoges, France
| | - Caroline Monchaud
- Department of Pharmacology, Toxicology and Pharmacovigilance, CHU de Limoges, Limoges, France
| | - Marc Labriffe
- Department of Pharmacology, Toxicology and Pharmacovigilance, CHU de Limoges, Limoges, France
| | | | - Pierre Marquet
- Department of Pharmacology, Toxicology and Pharmacovigilance, CHU de Limoges, Limoges, France
| | | | - Jean-Baptiste Woillard
- Department of Pharmacology, Toxicology and Pharmacovigilance, CHU de Limoges, Limoges, France
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Das A, Maji B. Substrate-controlled divergent remote C-H and N-H polyfluoroarylation of 2-aminopyrimidines with polyfluoroarenes via Pd(II)/Pd(0) catalysis. Chem Commun (Camb) 2024; 60:5630-5633. [PMID: 38716516 DOI: 10.1039/d4cc01518e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2024]
Abstract
Substrate-controlled product divergence in the reaction of 2-aminopyrimidines with polyfluoroarenes under palladium catalysis is demonstrated for the first time. The reaction of secondary N-alkylpyrimidine-2-amines with polyfluoroarenes leads to C5-H polyfluoroarylation via C-H/C-H coupling, while secondary N-aryl substituents yield N-H polyfluoroarylation, forming triarylamines.
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Affiliation(s)
- Animesh Das
- Department of Chemical Sciences, Indian Institute of Science Education and Research Kolkata, Mohanpur, 741246, India.
| | - Biplab Maji
- Department of Chemical Sciences, Indian Institute of Science Education and Research Kolkata, Mohanpur, 741246, India.
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Martínez AL, Brea J, López D, Cosme N, Barro M, Monroy X, Burgueño J, Merlos M, Loza MI. In vitro models for neuropathic pain phenotypic screening in brain therapeutics. Pharmacol Res 2024; 202:107111. [PMID: 38382648 DOI: 10.1016/j.phrs.2024.107111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/02/2024] [Accepted: 02/18/2024] [Indexed: 02/23/2024]
Abstract
The discovery of brain therapeutics faces a significant challenge due to the low translatability of preclinical results into clinical success. To address this gap, several efforts have been made to obtain more translatable neuronal models for phenotypic screening. These models allow the selection of active compounds without predetermined knowledge of drug targets. In this review, we present an overview of various existing models within the field, examining their strengths and limitations, particularly in the context of neuropathic pain research. We illustrate the usefulness of these models through a comparative review in three crucial areas: i) the development of novel phenotypic screening strategies specifically for neuropathic pain, ii) the validation of the models for both primary and secondary screening assays, and iii) the use of the models in target deconvolution processes.
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Affiliation(s)
- A L Martínez
- BioFarma Research Group, Centro Singular de Investigación en Medicina Molecular e Enfermidades Crónicas (CIMUS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Instituto de Investigacións Sanitarias de Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Departamento de Farmacoloxía, Farmacia e Tecnoloxía Farmacéutica, Facultade de Farmacia, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - J Brea
- BioFarma Research Group, Centro Singular de Investigación en Medicina Molecular e Enfermidades Crónicas (CIMUS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Instituto de Investigacións Sanitarias de Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Departamento de Farmacoloxía, Farmacia e Tecnoloxía Farmacéutica, Facultade de Farmacia, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - D López
- BioFarma Research Group, Centro Singular de Investigación en Medicina Molecular e Enfermidades Crónicas (CIMUS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Instituto de Investigacións Sanitarias de Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - N Cosme
- BioFarma Research Group, Centro Singular de Investigación en Medicina Molecular e Enfermidades Crónicas (CIMUS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Instituto de Investigacións Sanitarias de Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - M Barro
- BioFarma Research Group, Centro Singular de Investigación en Medicina Molecular e Enfermidades Crónicas (CIMUS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Instituto de Investigacións Sanitarias de Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - X Monroy
- WeLab Barcelona, Parc Científic de Barcelona, Barcelona, Spain
| | - J Burgueño
- WeLab Barcelona, Parc Científic de Barcelona, Barcelona, Spain
| | - M Merlos
- WeLab Barcelona, Parc Científic de Barcelona, Barcelona, Spain
| | - M I Loza
- BioFarma Research Group, Centro Singular de Investigación en Medicina Molecular e Enfermidades Crónicas (CIMUS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Instituto de Investigacións Sanitarias de Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Departamento de Farmacoloxía, Farmacia e Tecnoloxía Farmacéutica, Facultade de Farmacia, Universidade de Santiago de Compostela, Santiago de Compostela, Spain.
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Atoyebi S, Bunglawala F, Cottura N, Grañana-Castillo S, Montanha MC, Olagunju A, Siccardi M, Waitt C. Physiologically-based pharmacokinetic modelling of long-acting injectable cabotegravir and rilpivirine in pregnancy. Br J Clin Pharmacol 2024. [PMID: 38340019 DOI: 10.1111/bcp.16006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 11/25/2023] [Accepted: 01/06/2024] [Indexed: 02/12/2024] Open
Abstract
AIMS Long-acting cabotegravir and rilpivirine have been approved to manage HIV in adults, but data regarding safe use in pregnancy are limited. Physiologically-based pharmacokinetic (PBPK) modelling was used to simulate the approved dosing regimens in pregnancy and explore if Ctrough was maintained above cabotegravir and rilpivirine target concentrations (664 and 50 ng/mL, respectively). METHODS An adult PBPK model was validated using clinical data of cabotegravir and rilpivirine in nonpregnant adults. This was modified by incorporating pregnancy-induced metabolic and physiological changes. The pregnancy PBPK model was validated with data on oral rilpivirine and raltegravir (UGT1A1 probe substrate) in pregnancy. Twelve weeks' disposition of monthly and bimonthly dosing of long-acting cabotegravir and rilpivirine was simulated at different trimesters and foetal exposure was also estimated. RESULTS Predicted Ctrough at week 12 for monthly long-acting cabotegravir was above 664 ng/mL throughout pregnancy, but below the target in 0.5% of the pregnant population in the third trimester with bimonthly long-acting cabotegravir. Predicted Ctrough at week 12 for monthly and bimonthly long-acting rilpivirine was below 50 ng/mL in at least 40% and over 90% of the pregnant population, respectively, throughout pregnancy. Predicted medians (range) of cord-to-maternal blood ratios were 1.71 (range, 1.55-1.79) for cabotegravir and 0.88 (0.78-0.93) for rilpivirine between weeks 38 and 40. CONCLUSIONS Model predictions suggest that monthly long-acting cabotegravir could maintain antiviral efficacy throughout pregnancy, but that bimonthly administration may require careful clinical evaluation. Both monthly and bimonthly long-acting rilpivirine may not adequately maintain antiviral efficacy in pregnancy.
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Mehta R, Lagishetty CV, Angelis K, Aylott A, Kahl L, Blair L, Matthews J, Wynne B, Crauwels H, Underwood M, Adkison KK. Pharmacokinetic and pharmacokinetic/pharmacodynamic characterization of the dolutegravir/rilpivirine two-drug regimen in SWORD-1/-2 phase 3 studies. Br J Clin Pharmacol 2023; 89:2190-2200. [PMID: 36740580 DOI: 10.1111/bcp.15683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 12/19/2022] [Accepted: 01/14/2023] [Indexed: 02/07/2023] Open
Abstract
AIM SWORD-1 and SWORD-2 phase 3 studies concluded that switching virologically suppressed participants with HIV-1 from their current three- or four-drug antiretroviral regimen (CAR) to the two-drug regimen of once-daily dolutegravir (DTG, 50 mg) and rilpivirine (RPV, 25 mg) was safe, well tolerated and noninferior for maintaining HIV-1 suppression at week 48 and highly efficacious to week 148. A secondary objective was to characterize drug exposure and exposure-efficacy/safety relationships. METHODS Adults with plasma HIV-1 RNA <50 copies/mL were randomized to switch to once-daily DTG + RPV on day 1 or to continue CAR for 52 weeks before switching. Trough plasma concentrations (C0) of DTG and RPV, the proportion of participants with HIV-1 RNA <50 copies/mL and adverse events to week 100 were summarized and subjected to exposure-response analyses in the overall population, in the subset of participants who switched from CAR containing enzyme-inducing drugs and by age category (≥50 and <50 years). The relationship between C0avg (individual average C0 across visits) and efficacy/safety was investigated. RESULTS Although week 2 DTG and RPV C0 were lower in participants switching from enzyme-inducing antiretroviral drugs, C0 and C0avg stayed above in vitro antiviral protein binding-adjusted IC90 and to week 100 with viral suppression >89%. DTG or RPV C0avg showed no relationship with virologic failures or safety. Participants ≥50 years had similar C0avg and safety response to younger participants. CONCLUSION No clinically relevant relationship between DTG or RPV exposures and virologic or safety response was observed, confirming the DTG + RPV switch for participants as a safe and effective treatment.
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Affiliation(s)
| | | | | | | | | | - Libby Blair
- ViiV Healthcare, Durham, North Carolina, USA
| | | | - Brian Wynne
- ViiV Healthcare, Durham, North Carolina, USA
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Grañana-Castillo S, Montanha MC, Bearon R, Khoo S, Siccardi M. Evaluation of drug-drug interaction between rilpivirine and rifapentine using PBPK modelling. Front Pharmacol 2022; 13:1076266. [PMID: 36588698 PMCID: PMC9797969 DOI: 10.3389/fphar.2022.1076266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
Tuberculosis remains the leading cause of death among people living with HIV. Rifapentine is increasingly used to treat active disease or prevent reactivation, in both cases given either as weekly or daily therapy. However, rifapentine is an inducer of CYP3A4, potentially interacting with antiretrovirals like rilpivirine. This in silico study investigates the drug-drug interaction (DDI) magnitude between daily oral rilpivirine 25 mg with either daily 600 mg or weekly 900 mg rifapentine. A physiologically based pharmacokinetic (PBPK) model was built in Simbiology (Matlab R2018a) to simulate the drug-drug interaction. The simulated PK parameters from the PBPK model were verified against reported clinical data for rilpivirine and rifapentine separately, daily rifapentine with midazolam, and weekly rifapentine with doravirine. The simulations of concomitant administration of rifapentine with rilpivirine at steady-state lead to a maximum decrease on AUC0-24 and Ctrough by 83% and 92% on day 5 for the daily rifapentine regimen and 68% and 92% for the weekly regimen on day 3. In the weekly regimen, prior to the following dose, AUC0-24 and Ctrough were still reduced by 47% and 53%. In both simulations, the induction effect ceased 2 weeks after the interruption of rifapentine's treatment. A daily double dose of rilpivirine after initiating rifapentine 900 mg weekly was simulated but failed to compensate the drug-drug interaction. The drug-drug interaction model suggested a significant decrease on rilpivirine exposure which is unlikely to be corrected by dose increment, thus coadministration should be avoided.
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Affiliation(s)
- Sandra Grañana-Castillo
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, United Kingdom,*Correspondence: Sandra Grañana-Castillo,
| | - Maiara Camotti Montanha
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, United Kingdom
| | - Rachel Bearon
- Department of Mathematical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Saye Khoo
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, United Kingdom
| | - Marco Siccardi
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, United Kingdom
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Néant N, Lê MP, Bouazza N, Gattacceca F, Yazdanpanah Y, Dhiver C, Bregigeon S, Mokhtari S, Peytavin G, Tamalet C, Descamps D, Lacarelle B, Solas C. Usefulness of therapeutic drug monitoring of rilpivirine and its relationship with virologic response and resistance in a cohort of naive and pretreated HIV-infected patients. Br J Clin Pharmacol 2020; 86:2404-2413. [PMID: 32374049 PMCID: PMC7688528 DOI: 10.1111/bcp.14344] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 04/07/2020] [Accepted: 04/21/2020] [Indexed: 12/13/2022] Open
Abstract
AIMS The purpose of this study was to assess the antiviral activity of the rilpivirine/emtricitabine/tenofovir disoproxil fumarate combination and to describe the pharmacokinetics of rilpivirine and its association with resistance in clinical routine. METHODS A retrospective multicentre cohort study was performed in both naive and pretreated HIV patients receiving the once-daily rilpivirine/emtricitabine/tenofovir disoproxil fumarate regimen. Immuno-virologic and resistance data, and rilpivirine plasma trough concentrations were collected over the follow-up. Statistical analyses were performed to evaluate the relationship between rilpivirine pharmacokinetics and virological response. Receiver operating characteristic (ROC) curve analysis was performed to determine the best target rilpivirine trough concentration. RESULTS Overall, 379 patients were included. After a median follow-up of 28 months, 26% of patients discontinued mainly due to toxicity and the virological success rate was 65.7%. Virological failure occurred in 5% of patients. A significant proportion of patients with HIV-RNA > 40 copies/mL displayed rilpivirine plasma trough concentrations below the currently used 50 ng/mL efficacy threshold at both M6 (28%) and M12 (31%), in agreement with a significant lower median rilpivirine plasma trough concentration compared with patients virologically suppressed. Half of the patients with virologic failure who acquired rilpivirine resistance mutations had at least one suboptimal rilpivirine trough concentration. The optimal target for rilpivirine trough concentration was 70 ng/mL (sensitivity 75.4%; specificity 61.5%). CONCLUSIONS This study shows the impact of rilpivirine plasma trough concentration on both virological response and the emergence of rilpivirine mutations. Moreover, our results suggest that a higher target of rilpivirine trough concentration could be proposed in clinical practice.
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Affiliation(s)
- Nadège Néant
- Laboratoire de Pharmacocinétique et ToxicologieAix Marseille Univ, APHM, INSERM, CNRS, CRCM SMARTc, Hôpital La TimoneMarseilleF‐13005France
| | - Minh Patrick Lê
- APHP, Hôpital Bichat‐Claude Bernard, Laboratoire de Pharmacologie‐Toxicologie, IAME, UMR 1137, Université Paris Diderot, Sorbonne Paris Cité and INSERMParisF‐75018France
| | - Naïm Bouazza
- Université Paris DescartesEA7323, Sorbonne Paris CitéFrance
- Unité de Recherche Clinique Paris Descartes Necker Cochin, AP‐HPFrance
- CIC‐1419 Inserm, Cochin‐NeckerParisFrance
| | | | - Yazdan Yazdanpanah
- Univ Paris Diderot, APHP, IAME‐UMR 1137, Hôpital Bichat‐Claude Bernard, Service des Maladies Infectieuses et TropicalesParisF‐75018France
| | - Catherine Dhiver
- IHU Méditerranée Infection, Aix Marseille Univ., AP‐HM, URMITE UM 63 CNRS 7278 IRD 198 INSERM 1095MarseilleF‐13005France
| | - Sylvie Bregigeon
- APHM, Hôpital Sainte‐MargueriteService d'Immuno‐hématologie cliniqueMarseilleF‐13009France
| | - Saadia Mokhtari
- IHU Méditerranée Infection, Aix Marseille Univ., AP‐HM, URMITE UM 63 CNRS 7278 IRD 198 INSERM 1095MarseilleF‐13005France
| | - Gilles Peytavin
- APHP, Hôpital Bichat‐Claude Bernard, Laboratoire de Pharmacologie‐Toxicologie, IAME, UMR 1137, Université Paris Diderot, Sorbonne Paris Cité and INSERMParisF‐75018France
| | - Catherine Tamalet
- IHU Méditerranée Infection, Aix Marseille Univ., AP‐HM, URMITE UM 63 CNRS 7278 IRD 198 INSERM 1095MarseilleF‐13005France
| | - Diane Descamps
- APHP, Hôpital Bichat‐Claude Bernard, Laboratoire de Virologie, IAME, UMR 1137, Université Paris Diderot, Sorbonne Paris Cité and INSERMParisF‐75018France
| | - Bruno Lacarelle
- Laboratoire de Pharmacocinétique et ToxicologieAix Marseille Univ, APHM, INSERM, CNRS, CRCM SMARTc, Hôpital La TimoneMarseilleF‐13005France
| | - Caroline Solas
- Aix Marseille Univ, APHM, INSERM 1207, IRD 190, UVE, Hôpital La Timone, Laboratoire de Pharmacocinétique et ToxicologieMarseilleF‐13005France
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