Modeling of rifampicin-induced CYP3A4 activation dynamics for the prediction of clinical drug-drug interactions from in vitro data

PLoS One. 2013 Sep 24;8(9):e70330. doi: 10.1371/journal.pone.0070330. eCollection 2013.

Abstract

Induction of cytochrome P450 3A4 (CYP3A4) expression is often implicated in clinically relevant drug-drug interactions (DDI), as metabolism catalyzed by this enzyme is the dominant route of elimination for many drugs. Although several DDI models have been proposed, none have comprehensively considered the effects of enzyme transcription/translation dynamics on induction-based DDI. Rifampicin is a well-known CYP3A4 inducer, and is commonly used as a positive control for evaluating the CYP3A4 induction potential of test compounds. Herein, we report the compilation of in vitro induction data for CYP3A4 by rifampicin in human hepatocytes, and the transcription/translation model developed for this enzyme using an extended least squares method that can account for inherent inter-individual variability. We also developed physiologically based pharmacokinetic (PBPK) models for the CYP3A4 inducer and CYP3A4 substrates. Finally, we demonstrated that rifampicin-induced DDI can be predicted with reasonable accuracy, and that a static model can be used to simulate DDI once the blood concentration of the inducer reaches a steady state following repeated dosing. This dynamic PBPK-based DDI model was implemented on a new multi-hierarchical physiology simulation platform named PhysioDesigner.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibiotics, Antitubercular / pharmacology*
  • Cells, Cultured
  • Cytochrome P-450 CYP3A / metabolism*
  • Drug Interactions
  • Enzyme Activation
  • Hepatocytes / drug effects
  • Hepatocytes / enzymology
  • Humans
  • In Vitro Techniques
  • Models, Theoretical
  • Rifampin / pharmacology*

Substances

  • Antibiotics, Antitubercular
  • Cytochrome P-450 CYP3A
  • CYP3A4 protein, human
  • Rifampin

Grant support

This research was supported in part by Grant-in-Aid for Scientific Research on Innovative Areas (23136102) from the Ministry of Education, Culture, Sports, Science and Technology, Japan (http://www.mext.go.jp/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.