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2016 ; 36
(6
): 443-52
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In Vitro and In Vivo Interaction Studies Between Lesinurad, a Selective Urate
Reabsorption Inhibitor, and Major Liver or Kidney Transporters
#MMPMID26951201
Shen Z
; Yeh LT
; Wallach K
; Zhu N
; Kerr B
; Gillen M
Clin Drug Investig
2016[Jun]; 36
(6
): 443-52
PMID26951201
show ga
BACKGROUND AND OBJECTIVES: Lesinurad is a selective uric acid reabsorption
inhibitor (SURI) under investigation for the treatment of gout. This study
elucidated the interaction of lesinurad with major liver and kidney transporters
in vitro and evaluated the drug-drug interactions (DDIs) of lesinurad and
atorvastatin, metformin, and furosemide in clinical studies. METHODS: Lesinurad
interaction with membrane transporters was evaluated in validated
transporter-expressing cell systems and analyzed by liquid scintillation
counting. Healthy male subjects (ages 18-65 years; body mass index 18-32 kg/m(2))
received atorvastatin (40 mg; n = 28) with or without lesinurad 200 or 400 mg, or
received metformin (850 mg; n = 12) or furosemide (40 mg; n = 11) with or without
lesinurad 400 mg. Plasma concentrations of each concomitant drug were determined
by validated liquid chromatography with tandem mass spectrometry methods.
RESULTS: Lesinurad interacted in vitro with OATP1B1, OCT1, and OAT1/3
transporters. Co-administration of lesinurad 200 mg did not significantly alter
plasma exposure (maximum concentration [C max] and area under the
concentration-time curve [AUC]) of total atorvastatin
(atorvastatin + hydroxyl-metabolites) or atorvastatin, while co-administration of
lesinurad 400 mg increased the C max of total atorvastatin and atorvastatin by
17-26 %, but had no effect on AUC. Co-administration of lesinurad 400 mg had no
effect on the plasma exposure of metformin. Furosemide plasma AUC was reduced by
31 % in the presence of lesinurad 400 mg, but furosemide renal clearance and
diuretic activity were unchanged. CONCLUSIONS: No clinically relevant DDIs were
observed between lesinurad and substrates of major liver or kidney transporters.