The pharmacokinetics, metabolism, and clearance mechanisms of tofacitinib, a janus kinase inhibitor, in humans

Drug Metab Dispos. 2014 Apr;42(4):759-73. doi: 10.1124/dmd.113.054940. Epub 2014 Jan 24.

Abstract

Tofacitinib is a novel, oral Janus kinase inhibitor. The objectives of this study were to summarize the pharmacokinetics and metabolism of tofacitinib in humans, including clearance mechanisms. Following administration of a single 50-mg (14)C-labeled tofacitinib dose to healthy male subjects, the mean (standard deviation) total percentage of administered radioactive dose recovered was 93.9% (±3.6), with 80.1% (±3.6) in the urine (28.8% parent), and 13.8% (±1.9) in feces (0.9% parent). Tofacitinib was rapidly absorbed, with plasma concentrations and total radioactivity peaking at around 1 hour after oral administration. The mean terminal phase half-life was approximately 3.2 hours for both parent drug and total radioactivity. Most (69.4%) circulating radioactivity in plasma was parent drug, with all metabolites representing less than 10% each of total circulating radioactivity. Hepatic clearance made up around 70% of total clearance, while renal clearance made up the remaining 30%. The predominant metabolic pathways of tofacitinib included oxidation of the pyrrolopyrimidine and piperidine rings, oxidation of the piperidine ring side-chain, N-demethylation and glucuronidation. Cytochrome P450 (P450) profiling indicated that tofacitinib was mainly metabolized by CYP3A4, with a smaller contribution from CYP2C19. This pharmacokinetic characterization of tofacitinib has been consistent with its clinical experience in drug-drug interaction studies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aryl Hydrocarbon Hydroxylases / metabolism*
  • Biotransformation
  • Chromatography, High Pressure Liquid
  • Cytochrome P-450 CYP2C19
  • Cytochrome P-450 CYP3A / metabolism*
  • Feces / chemistry
  • Female
  • Humans
  • Janus Kinases / antagonists & inhibitors*
  • Liver / enzymology
  • Liver / metabolism*
  • Magnetic Resonance Spectroscopy
  • Male
  • Metabolic Clearance Rate
  • Microsomes, Liver / enzymology
  • Microsomes, Liver / metabolism
  • Piperidines / blood
  • Piperidines / metabolism
  • Piperidines / pharmacokinetics*
  • Piperidines / urine
  • Protein Kinase Inhibitors / blood
  • Protein Kinase Inhibitors / metabolism
  • Protein Kinase Inhibitors / pharmacokinetics*
  • Protein Kinase Inhibitors / urine
  • Pyrimidines / blood
  • Pyrimidines / metabolism
  • Pyrimidines / pharmacokinetics*
  • Pyrimidines / urine
  • Pyrroles / blood
  • Pyrroles / metabolism
  • Pyrroles / pharmacokinetics*
  • Pyrroles / urine
  • Tandem Mass Spectrometry

Substances

  • Piperidines
  • Protein Kinase Inhibitors
  • Pyrimidines
  • Pyrroles
  • tofacitinib
  • Aryl Hydrocarbon Hydroxylases
  • CYP2C19 protein, human
  • Cytochrome P-450 CYP2C19
  • Cytochrome P-450 CYP3A
  • CYP3A4 protein, human
  • Janus Kinases