Tofacitinib and Baricitinib Are Taken up by Different Uptake Mechanisms Determining the Efficacy of Both Drugs in RA

Int J Mol Sci. 2020 Sep 10;21(18):6632. doi: 10.3390/ijms21186632.

Abstract

Background: Rheumatoid arthritis (RA) is a systemic autoimmune disease in which synovial fibroblasts (SF) play a key role. Baricitinib and Tofacitinib both act intracellularly, blocking the ATP-binding side of JAK proteins and thereby the downstream signalling pathway via STAT-3. Therefore, we investigated the role of organic cation transporters (OCTs) in Baricitinib and Tofacitinib cellular transport.

Methods: OCT expression was analysed in SF isolated from RA and osteoarthritis (OA) patients, as well as peripheral blood mononuclear cells. The interaction of Baricitinib and Tofacitinib with OCTs was investigated using quenching experiments. The intracellular accumulation of both drugs was quantified using LC/MS. Target inhibition for both drugs was tested using Western blot for phosphorylated JAK1 and STAT3 upon stimulation with IL-6.

Results: MATE-1 expression increased in OASF compared to RASF. The other OCTs were not differentially expressed. The transport of Baricitinib was not OCT dependent. Tofacitinib; however, was exported from RASF in a MATE-1 dependent way. Tofacitinib and Baricitinib showed comparable inhibition of downstream signalling pathways.

Conclusion: We observed different cellular uptake strategies for Baricitinib and Tofacitinib. Tofacitinib was exported out of healthy cells due to the increased expression of MATE1. This might make Tofacitinib the favourable drug.

Keywords: Baricitinib; MATE1; RA; Tofacitinib; organic cation transporter.

MeSH terms

  • Antirheumatic Agents / pharmacokinetics*
  • Antirheumatic Agents / therapeutic use
  • Arthritis, Rheumatoid / drug therapy*
  • Arthritis, Rheumatoid / metabolism
  • Azetidines / pharmacokinetics*
  • Azetidines / therapeutic use
  • Drug Evaluation, Preclinical
  • Fibroblasts / metabolism
  • HEK293 Cells
  • Humans
  • Janus Kinase 1 / antagonists & inhibitors
  • Organic Cation Transport Proteins / metabolism
  • Phosphorylation / drug effects
  • Piperidines / pharmacokinetics*
  • Piperidines / therapeutic use
  • Primary Cell Culture
  • Purines / pharmacokinetics*
  • Purines / therapeutic use
  • Pyrazoles / pharmacokinetics*
  • Pyrazoles / therapeutic use
  • Pyrimidines / pharmacokinetics*
  • Pyrimidines / therapeutic use
  • STAT3 Transcription Factor / metabolism
  • Sulfonamides / pharmacokinetics*
  • Sulfonamides / therapeutic use

Substances

  • Antirheumatic Agents
  • Azetidines
  • Organic Cation Transport Proteins
  • Piperidines
  • Purines
  • Pyrazoles
  • Pyrimidines
  • SLC47A1 protein, human
  • STAT3 Transcription Factor
  • STAT3 protein, human
  • Sulfonamides
  • tofacitinib
  • Janus Kinase 1
  • baricitinib