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European Journal of Clinical Pharmacology
Article . 2024 . Peer-reviewed
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Understanding adefovir pharmacokinetics as a component of a transporter phenotyping cocktail

Authors: Dong, Qian; Chen, Chunli; Taubert, Max; Bilal, Muhammad; Kinzig, Martina; Sörgel, Fritz; Scherf-Clavel, Oliver; +2 Authors

Understanding adefovir pharmacokinetics as a component of a transporter phenotyping cocktail

Abstract

Abstract Purpose Adefovir (as dipivoxil) was selected as a probe drug in a previous transporter cocktail phenotyping study to assess renal organic anion transporter 1 (OAT1), with renal clearance (CLR) as the primary parameter describing renal elimination. An approximately 20% higher systemic exposure of adefovir was observed when combined with other cocktail components (metformin, sitagliptin, pitavastatin, and digoxin) compared to sole administration. The present evaluation applied a population pharmacokinetic (popPK) modeling approach to describe adefovir pharmacokinetics as a cocktail component in more detail. Methods Data from 24 healthy subjects were reanalyzed. After establishing a base model, covariate effects, including the impact of co-administered drugs, were assessed using forward inclusion then backward elimination. Results A one-compartment model with first-order absorption (including lag time) and a combination of nonlinear renal and linear nonrenal elimination best described the data. A significantly higher apparent bioavailability (73.6% vs. 59.0%) and a lower apparent absorption rate constant (2.29 h−1 vs. 5.18 h−1) were identified in the combined period compared to the sole administration period, while no difference was seen in renal elimination. The population estimate for the Michaelis-Menten constant (Km) of the nonlinear renal elimination was 170 nmol/L, exceeding the observed range of adefovir plasma maximum concentration, while the maximum rate (Vmax) of nonlinear renal elimination was 2.40 µmol/h at the median absolute estimated glomerular filtration rate of 105 mL/min. Conclusion The popPK modeling approach indicated that the co-administration primarily affected the apparent absorption and/or prodrug conversion of adefovir dipivoxil, resulting in the minor drug-drug interaction observed for adefovir as a victim. However, renal elimination remained unaffected. The high Km value suggests that assessing renal OAT1 activity by CLR has no relevant misspecification error with the cocktail doses used.

Keywords

Male, Adult, Digoxin, Metformin/administration ; Digoxin/pharmacokinetics [MeSH] ; Models, Biological [MeSH] ; OAT1-mediated drug-drug interactions ; Male [MeSH] ; Organophosphonates/administration ; Nonlinear renal elimination ; Drug Interactions [MeSH] ; Organophosphonates/pharmacokinetics [MeSH] ; Phenotype [MeSH] ; Sitagliptin Phosphate/pharmacokinetics [MeSH] ; Adefovir ; Adenine/analogs ; Female [MeSH] ; Metformin/pharmacokinetics [MeSH] ; Adult [MeSH] ; Humans [MeSH] ; Middle Aged [MeSH] ; Adenine/pharmacokinetics [MeSH] ; Metformin/blood [MeSH] ; Organic Anion Transport Protein 1/metabolism [MeSH] ; Adenine/administration ; Population pharmacokinetics ; Digoxin/blood [MeSH] ; Research ; Young Adult [MeSH] ; Digoxin/administration ; Biological Availability [MeSH] ; Organic Anion Transport Protein 1/genetics [MeSH] ; Organophosphonates/blood [MeSH], Research, Adenine, Sitagliptin Phosphate, Organophosphonates, Biological Availability, Middle Aged, Models, Biological, Metformin, Young Adult, Organic Anion Transport Protein 1, Phenotype, Humans, Female, Drug Interactions

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
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