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Jang JH, Jeong SH, Lee YB. Population Pharmacokinetic Modeling of Zaltoprofen in Healthy Adults: Exploring the Dosage Regimen. Pharmaceuticals (Basel) 2023; 16:161. [PMID: 37259312 PMCID: PMC9962663 DOI: 10.3390/ph16020161] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/15/2023] [Accepted: 01/17/2023] [Indexed: 12/20/2023] Open
Abstract
Zaltoprofen is a drug used for various pain and inflammatory diseases. Scientific and quantitative dosage regimen studies regarding its clinical application are scarce. This study aimed to discover effective covariates related to interindividual pharmacokinetic variability through population pharmacokinetic modeling for zaltoprofen and to explore dosage regimens. The bioequivalence results of healthy Korean males, biochemical analysis, and CYP2C9 genotyping information were utilized in modeling. The established model has been sufficiently verified through a bootstrap, goodness-of-fit, visual predictive check, and normalized prediction distribution error. External data sets derived from the literature were used for further model validation. The final model could be used to verify the dosage regimen through multiple exposure simulations according to the numerical change of the selected covariates. Zaltoprofen pharmacokinetics could be explained by a two-compartment with a first-order absorption model. Creatinine clearance (CrCL) and albumin were identified as effective covariates related to interindividual zaltoprofen pharmacokinetic variability, and they had positive and negative correlations with clearance (CL/F), respectively. The differences in pharmacokinetics between individuals according to CYP2C9 genetic polymorphisms (*1/*1 and *1/*3) were not significant or valid covariates. The model simulation confirmed that zaltoprofen pharmacokinetics could significantly differ as the CrCL and albumin levels changed within the normal range. Steady-state plasma exposure to zaltoprofen was significantly reduced in the group with CrCL and albumin levels of 130 mL/min and 3.5 g/dL, respectively, suggesting that dose adjustment may be necessary. This study is useful to guide precision medicine of zaltoprofen and provides scientific quantitative judgment data for its clinical applications.
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Affiliation(s)
- Ji-Hun Jang
- College of Pharmacy, Chonnam National University, 77 Yongbong-ro, Buk-gu, Gwangju 61186, Republic of Korea
| | - Seung-Hyun Jeong
- College of Pharmacy, Sunchon National University, 255 Jungang-ro, Suncheon-si 57922, Republic of Korea
| | - Yong-Bok Lee
- College of Pharmacy, Chonnam National University, 77 Yongbong-ro, Buk-gu, Gwangju 61186, Republic of Korea
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Alvarado AT, Saravia M, Losno R, Pariona R, Muñoz AM, Ybañez-Julca RO, Loja B, Bendezú MR, García JA, Surco-Laos F, Laos-Anchante D, Chávez H, Aguilar P, Pineda M. CYP2D6 and CYP2C19 Genes Associated with Tricontinental and Latin American Ancestry of Pe-ruvians. DRUG METABOLISM AND BIOANALYSIS LETTERS 2022; 16:DMBL-EPUB-128245. [PMID: 36518034 PMCID: PMC10436705 DOI: 10.2174/1872312815666221213151140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/30/2022] [Accepted: 10/14/2022] [Indexed: 06/17/2023]
Abstract
Precision medicine seeks to individualize the dose from the beginning of phar-macological therapy based on the characteristics of each patient, genes involved in the metabolic phenotype, ethnicity or miscegenation, with the purpose to minimize adverse effects and optimize drug efficacy. The objective was to re-view studies that describe the association of the CYP2D6 and CYP2C19 genes with the tricontinental and Latin American ancestry of Peruvians. A biblio-graphic search was carried out in PubMed/Medline and SciELO, with various descriptors in Spanish and English. The results of this review confirm that the ethnic origin of Peruvians is triconti-nental due to European (mainly Spanish), African and Asian migration, in addi-tion to Latin American migration, being 60.2% mixed, 25.8% Amerindian, 5.9% white, 3.6% African descent, 1.2% Chinese and Japanese descent, and 3.3% unspecified. Studies on CYP2C19*3, CYP2D6*2, *3 and *6 have been reported in Peruvians, and the frequency is similar to that studied in Ecuadori-ans and Colombians. The CYP2C19*3, CYP2D6*3, and CYP2D6*6 alleles found in Peruvians are common in Europeans, Africans, and Asians; while CYP2D6*4 in Africans and CYP2D6*2 related to Asians. In some studies, the ethnic/gene association has not been demonstrated; while others have shown a significant association, which is why further investigation is warranted. It is concluded that the studies on CYP2D6 and CYP2C19 genes associated with the tricontinental and Latin American ancestry of Peruvians are little, and ac-cording to what has been investigated, the CYP2C19*3, CYP2D6*2, *3, *4 and *6 alleles have more related to their ancestry.
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Affiliation(s)
- Angel T. Alvarado
- International Research Network in Pharmacology and Precision Medicine, Human Medicine School, San Ignacio de Loyola University, USIL, Lima, 15024, Peru
- Latin American Network for the Implementation and Validation of Clinical Pharmacogenomics Guidelines (RELIVAF-CYTED), Madrid, 28001, Spain
| | - María Saravia
- International Research Network in Pharmacology and Precision Medicine, Human Medicine School, San Ignacio de Loyola University, USIL, Lima, 15024, Peru
| | - Ricardo Losno
- International Research Network in Pharmacology and Precision Medicine, Human Medicine School, San Ignacio de Loyola University, USIL, Lima, 15024, Peru
| | - Ricardo Pariona
- International Research Network in Pharmacology and Precision Medicine, Human Medicine School, San Ignacio de Loyola University, USIL, Lima, 15024, Peru
| | - Ana María Muñoz
- Institute of Food Science and Nutrition, ICAN, San Ignacio de Loyola University, USIL, Lima, 15024, Peru
| | - Roberto O. Ybañez-Julca
- Faculty of Pharmacy and Biochemistry, National University of Trujillo, Trujillo, 13001, Peru
| | - Berta Loja
- International Research Network in Pharmacology and Precision Medicine, Human Medicine School, San Ignacio de Loyola University, USIL, Lima, 15024, Peru
| | - María R. Bendezú
- Faculty of Pharmacy and Biochemistry, San Luis Gonzaga National University of Ica, Ica, 11001, Peru
| | - Jorge A. García
- Faculty of Pharmacy and Biochemistry, San Luis Gonzaga National University of Ica, Ica, 11001, Peru
| | - Felipe Surco-Laos
- Faculty of Pharmacy and Biochemistry, San Luis Gonzaga National University of Ica, Ica, 11001, Peru
| | - Doris Laos-Anchante
- Faculty of Pharmacy and Biochemistry, San Luis Gonzaga National University of Ica, Ica, 11001, Peru
| | - Haydee Chávez
- Faculty of Pharmacy and Biochemistry, San Luis Gonzaga National University of Ica, Ica, 11001, Peru
| | | | - Mario Pineda
- Pharmacy and Biochemistry, FCS, Scientific of the South University, UCSUR, Lima, 15067, Peru
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Jeong SH, Jang JH, Cho HY, Lee YB. Population Pharmacokinetic (Pop-PK) Analysis of Torsemide in Healthy Korean Males Considering CYP2C9 and OATP1B1 Genetic Polymorphisms. Pharmaceutics 2022; 14:pharmaceutics14040771. [PMID: 35456605 PMCID: PMC9028991 DOI: 10.3390/pharmaceutics14040771] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 02/04/2023] Open
Abstract
Torsemide is a diuretic drug used for several cardiovascular and chronic diseases. With regard to the clinical application of torsemide, studies on individualized pharmacotherapy and modeling that take variability in pharmacokinetics (PKs) within a population into account have been rarely reported. Thus, the objective of this study was to perform population pharmacokinetic (Pop-PK) modeling and to identify effective covariates that could explain the inter-individual variability (IIV) of torsemide PK. Pop-PK modeling for torsemide was performed based on serum concentration data obtained from 112 healthy Korean males and analysis of various genetic and physicochemical parameters. Modeling was performed with nonlinear mixed-effects (NLME) using Phoenix NLME. The finally developed model was fully verified. The model was also reconfirmed using NONMEM software. As a basic model, the PKs of torsemide within the population were well described by a two-compartment model reflecting the lag-time on oral absorption. According to the genetic polymorphisms of OATP1B1 and CYP2C9, significant associations were found in the V/F, CL/F, and CL2/F of torsemide. These were reflected as effective covariates in the final Pop-PK model of torsemide, resulting in an approximately 5–10% improvement in the model parameter IIV values. Considering that torsemide is a substrate for CYP2C9 and OATP1B1, it was important to search for genetic polymorphisms in CYP2C9 and OATP1B1 as covariates to explain the PK diversity of torsemide between individuals. The differences in CL/F and CL2/F between the phenotypes of CYP2C9 were approximately 36.5–51%. The difference in V/F between the phenotypes of OATP1B1 was approximately 41–64.6%. These results suggested that the phenotypes of CYP2C9 and OATP1B1 produced significant differences in torsemide PKs. Considering that CYP2C9 and OATP1B1 phenotypes as covariates affected different PK parameters of torsemide, it could be inferred that torsemide’s cell membrane permeation process by OATP1B1 and the metabolic process by CYP2C9 could independently affect each other in vivo without interplay. There was no significant difference in the parameter estimates between modeling software (Phoenix NLME vs. NONMEM). In this study, the torsemide PK variability between individuals was largely explained. In the future, individualized effective drug therapy of torsemide taking individual patient’s genotypes into account might become possible.
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Affiliation(s)
- Seung-Hyun Jeong
- College of Pharmacy, Chonnam National University, 77 Yongbong-ro, Buk-gu, Gwangju 61186, Korea; (S.-H.J.); (J.-H.J.)
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, State University of New York at Buffalo, Buffalo, NY 14214, USA
| | - Ji-Hun Jang
- College of Pharmacy, Chonnam National University, 77 Yongbong-ro, Buk-gu, Gwangju 61186, Korea; (S.-H.J.); (J.-H.J.)
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, State University of New York at Buffalo, Buffalo, NY 14214, USA
| | - Hea-Young Cho
- College of Pharmacy, CHA University, 335 Pangyo-ro, Bundang-gu, Seongnam-si 13488, Gyeonggi-Do, Korea
- Correspondence: (H.-Y.C.); (Y.-B.L.); Tel.: +82-31-881-7167 (H.-Y.C.); +82-62-530-2931 (Y.-B.L.)
| | - Yong-Bok Lee
- College of Pharmacy, Chonnam National University, 77 Yongbong-ro, Buk-gu, Gwangju 61186, Korea; (S.-H.J.); (J.-H.J.)
- Correspondence: (H.-Y.C.); (Y.-B.L.); Tel.: +82-31-881-7167 (H.-Y.C.); +82-62-530-2931 (Y.-B.L.)
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Dorji PW, Wangchuk S, Boonprasert K, Tarasuk M, Na-Bangchang K. Pharmacogenetic relevant polymorphisms of CYP2C9, CYP2C19, CYP2D6, and CYP3A5 in Bhutanese population. Drug Metab Pers Ther 2019; 34:/j/dmdi.2019.34.issue-4/dmpt-2019-0020/dmpt-2019-0020.xml. [PMID: 32004143 DOI: 10.1515/dmpt-2019-0020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 12/05/2019] [Indexed: 06/10/2023]
Abstract
Background Marked differences among genotype frequencies (Caucasians, Asians, and Africans) have been observed in cytochrome P450 (CYP) genes. Data on the frequency of pharmacogenetic relevant polymorphisms in Bhutanese population is absent. This study aimed to investigate the frequencies of pharmacogenetic relevant polymorphisms of CYP2C9 (*2 and *3), CYP2C19 (*2 and *3), CYP2D6 (*10), and CYP3A5 (*3) in Bhutanese population. Methods Genotyping was performed in 443 DNA samples using polymerase chain reaction-restriction fragment length polymorphism. Results For CYP2C9, allele frequencies of *2 and *3 variants were 0.339% and 0%, respectively. For CYP2C19, frequencies of *2 and *3 variants were 30.135% and 15.689%, respectively. Allele frequencies of CYP2D6*10 and CYP3A5*3 were 21.332% and 77.314%, respectively. Allele frequencies of CYP2C9*2 are similar to most Asians while CYP2C9*3 was absent. CYP2C19*2 showed a close resemblance to Japanese and Burmese, while CYP2C19*3 is near to Japanese and Korean. CYP2D6*10 is noticeably lower than other Asians. CYP3A5*3 is similar to East Asians (Chinese, Japanese, and Korean). Conclusions The Bhutanese population is polymorphic for these CYP genes, except for CYP2C9*3. Similar to other populations, genetic testing for these genes may, therefore, be helpful to obtain the benefit from pharmacological treatments and prevent adverse drug reactions.
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Affiliation(s)
- Palden Wangyel Dorji
- Graduate Studies, Chulabhorn International College of Medicine, Thammasat University, Thailand; Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
| | - Sonam Wangchuk
- Royal Centre of Disease Control, Ministry of Health, Thimphu, Bhutan
| | - Kanyarat Boonprasert
- Center of Excellence in Pharmacology and Molecular Biology of Malaria and Cholangiocarcinoma, Thammasat University, Thailand
| | - Mayuri Tarasuk
- Center of Excellence in Pharmacology and Molecular Biology of Malaria and Cholangiocarcinoma, Thammasat University, Thailand
| | - Kesara Na-Bangchang
- Center of Excellence in Pharmacology and Molecular Biology of Malaria and Cholangiocarcinoma, Thammasat University, Thailand
- Drug Discovery and Development Center, Office of Advanced Science and Technology, Thammasat University, Thailand
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