A Drug-Drug Interaction Study to Evaluate the Effect of TAS-303 on CYP3A Activity in the Small Intestine and Liver

J Clin Pharmacol. 2020 Jun;60(6):702-710. doi: 10.1002/jcph.1583. Epub 2020 Feb 5.

Abstract

TAS-303 (4-piperidinyl 2,2-diphenyl-2-[propoxy-1,1,2,2,3,3,3-d7 ] acetate hydrochloride) is a novel selective noradrenaline reuptake inhibitor being developed for the treatment of stress urinary incontinence. An in vitro study and a physiologically based pharmacokinetic model simulation showed that TAS-303 had inhibitory potential against cytochrome P450 (CYP) 3A. This open-label, single-group study investigated the effect of TAS-303 on CYP3A activity by evaluating the pharmacokinetics (PK) of single-dose oral simvastatin 5 mg or intravenous midazolam 1 mg after repeated oral administration of TAS-303 3 mg in 12 healthy participants. TAS-303 plus simvastatin resulted in a 1.326-fold and a 1.420-fold increase of simvastatin in peak plasma concentration and area under the plasma concentration-time curve from time zero to time t, where t is the final time of detection (AUC0-t ), respectively. The addition of midazolam resulted in a 1.090-fold increase in the midazolam AUC0-t . TAS-303 had a weak PK interaction with simvastatin but no apparent interaction with midazolam. TAS-303 at 3 mg/day is a weak inhibitor of intestinal but not hepatic CYP3A activity. No clinically important safety concerns related to TAS-303 were raised.

Keywords: PBPK; clinical pharmacology; clinical trials (CTRs); drug-drug interactions; model & simulation; pharmaceutical R & D (PRD).

Publication types

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

MeSH terms

  • Administration, Intravenous
  • Administration, Oral
  • Adrenergic Uptake Inhibitors / administration & dosage
  • Adrenergic Uptake Inhibitors / pharmacokinetics*
  • Adult
  • Anesthetics, Intravenous / administration & dosage
  • Anesthetics, Intravenous / blood
  • Anesthetics, Intravenous / pharmacokinetics
  • Anticholesteremic Agents / administration & dosage
  • Anticholesteremic Agents / blood
  • Anticholesteremic Agents / pharmacokinetics
  • Area Under Curve
  • Computer Simulation
  • Cytochrome P-450 CYP3A / drug effects
  • Cytochrome P-450 CYP3A / metabolism*
  • Cytochrome P-450 CYP3A Inhibitors / administration & dosage
  • Cytochrome P-450 CYP3A Inhibitors / adverse effects*
  • Cytochrome P-450 CYP3A Inhibitors / pharmacology*
  • Drug Interactions
  • Healthy Volunteers
  • Humans
  • Intestine, Small / metabolism
  • Liver / metabolism
  • Male
  • Midazolam / administration & dosage
  • Midazolam / blood
  • Midazolam / pharmacokinetics
  • Models, Biological
  • Simvastatin / administration & dosage
  • Simvastatin / blood
  • Simvastatin / pharmacokinetics
  • Young Adult

Substances

  • Adrenergic Uptake Inhibitors
  • Anesthetics, Intravenous
  • Anticholesteremic Agents
  • Cytochrome P-450 CYP3A Inhibitors
  • Simvastatin
  • Cytochrome P-450 CYP3A
  • Midazolam