CYP2B6 Genetics and Drug Interactions in Healthy Volunteers
Status:
Completed
Trial end date:
2016-05-31
Target enrollment:
Participant gender:
Summary
The CYP2B6 enzyme metabolizes a growing number of clinically important drugs such as the
anti-HIV drug efavirenz, but its activity in the liver is highly variable, which may lead to
failure of therapy or toxicity and unpredictable drug interactions. Genetic and several
nongenetic factors affect the activity of CYP2B6. The goal of this study is to determine the
impact of simultaneous autoinhibition/autoinduction and CYP2B6 genetics on CYP2B6 activity,
efavirenz exposure and efavirenz-mediated drug interactions. The pharmacokinetics and drug
interactions will be determined on three occasions in a total of 60 healthy volunteers. The
whole study will have 4 phases. A) Phase 1 (baseline control): using selective probe
substrates, the baseline activities of CYP2B6 (bupropion), CYP2C8 (montelukast) and OATP1B1
(rosuvastatin) are determined. B) Phase 2 (inhibition): the metabolism and pharmacokinetics
of a single 600 mg oral dose of efavirenz) and the activities of CYP2B6, CYP2C8 and OATP1B1
(inhibition) are determined. C) Phase 3 (treatment phase): After completing phase 2, subjects
take 600 mg/day efavirenz at home for 17 days. C) Phase 4 (induction and inhibition): At the
end of phase 3, steady state metabolism and pharmacokinetics of efavirenz and the activities
of CYP2B6, CYP2C8 and OATP1B1 will be determined. Efavirenz serves as a model substrate,
inhibitor and inducer of CYP2B6 (and other drug disposition proteins). Bupropion
4-hydroxylation is an alternative in vivo probe of CYP2B6 activity and will be studied here
in addition to the metabolism and pharmacokinetics of efavirenz.
Phase:
Phase 4
Details
Lead Sponsor:
Indiana University
Collaborator:
National Institute of General Medical Sciences (NIGMS)