Effect of faldaprevir on raltegravir pharmacokinetics in healthy volunteers

J Clin Pharmacol. 2015 Apr;55(4):384-91. doi: 10.1002/jcph.418. Epub 2014 Dec 8.

Abstract

Faldaprevir is a potent hepatitis C virus (HCV) NS3/4A protease inhibitor and an inhibitor of UDP-glucuronosyltransferase-1A1 (UGT1A1), which is involved in raltegravir clearance. Raltegravir, an HIV integrase inhibitor, may be used in combination with HCV treatment in HCV/HIV co-infected patients. In this open-label, 2-period, fixed-sequence study, 24 healthy volunteers (12 males) received faldaprevir 240 mg and raltegravir 400 mg in 2 treatment schedules (A and B) separated by a washout phase of ≥7 days: (A) twice-daily raltegravir (Days 1-3), once-daily raltegravir (Day 4); (B) twice-daily raltegravir and twice-daily faldaprevir (loading dose, Day 1), twice-daily raltegravir and once-daily faldaprevir (Days 2-5), once-daily raltegravir and once-daily faldaprevir (Day 6). Pharmacokinetics and safety were assessed over 132 hours post-dosing. Compared with raltegravir alone, co-administration with faldaprevir led to 2.7-fold and 2.5-fold increases in raltegravir geometric mean AUC(τ,ss) and C(max,ss), respectively, and a similar increase in raltegravir glucuronide metabolite exposure. No serious adverse events (AEs) were reported and no subject discontinued due to AEs. Faldaprevir and raltegravir co-administration was well tolerated and resulted in a moderate increase in raltegravir exposure.

Keywords: HIV/AIDS; clinical trials; drug interactions; infectious diseases; pharmacokinetics and drug metabolism; virology.

Publication types

  • Clinical Trial, Phase I
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aminoisobutyric Acids
  • Drug Administration Schedule
  • Drug Interactions / genetics
  • Female
  • Genotype
  • Glucuronosyltransferase / genetics
  • HIV Integrase Inhibitors / administration & dosage
  • HIV Integrase Inhibitors / adverse effects
  • HIV Integrase Inhibitors / pharmacokinetics*
  • Healthy Volunteers
  • Humans
  • Leucine / analogs & derivatives
  • Male
  • Oligopeptides / administration & dosage
  • Oligopeptides / adverse effects
  • Oligopeptides / pharmacology*
  • Proline / analogs & derivatives
  • Protease Inhibitors / administration & dosage
  • Protease Inhibitors / adverse effects
  • Protease Inhibitors / pharmacology*
  • Quinolines
  • Raltegravir Potassium / administration & dosage
  • Raltegravir Potassium / adverse effects
  • Raltegravir Potassium / pharmacokinetics*
  • Thiazoles / administration & dosage
  • Thiazoles / adverse effects
  • Thiazoles / pharmacology*
  • Young Adult

Substances

  • Aminoisobutyric Acids
  • HIV Integrase Inhibitors
  • Oligopeptides
  • Protease Inhibitors
  • Quinolines
  • Thiazoles
  • Raltegravir Potassium
  • faldaprevir
  • Proline
  • UGT1A1 enzyme
  • Glucuronosyltransferase
  • Leucine