Pharmacokinetics of Upadacitinib With the Clinical Regimens of the Extended-Release Formulation Utilized in Rheumatoid Arthritis Phase 3 Trials.

Article Details

Citation

Mohamed MF, Zeng J, Marroum PJ, Song IH, Othman AA

Pharmacokinetics of Upadacitinib With the Clinical Regimens of the Extended-Release Formulation Utilized in Rheumatoid Arthritis Phase 3 Trials.

Clin Pharmacol Drug Dev. 2019 Feb;8(2):208-216. doi: 10.1002/cpdd.462. Epub 2018 Apr 24.

PubMed ID
29688617 [ View in PubMed
]
Abstract

Upadacitinib is a Janus kinase 1 inhibitor under development for the treatment of several inflammatory disorders including rheumatoid arthritis (RA). Upadacitinib was administered in the phase 2 RA trials primarily as twice-daily regimens of an immediate-release (IR) formulation. The upadacitinib extended-release (ER) formulation was developed to enable once-daily dosing. In the present study, upadacitinib pharmacokinetics were characterized after the administration of single and multiple once-daily doses of the ER formulation in healthy subjects relative to single and multiple twice-daily doses of the IR formulation. Increase in upadacitinib exposure was dose-proportional over the evaluated 15- to 30-mg ER dose range. Single 15- and 30-mg ER doses provided equivalent AUC0-inf compared with single 12- and 24-mg IR doses, respectively. A high-fat breakfast increased upadacitinib ER Cmax and AUC0-inf by only 20% and 17%, respectively, relative to fasting conditions. The median time to peak plasma concentrations was 2 to 4 hours for the ER formulation, and steady state was achieved by day 4 of once-daily dosing. Doses of 15 and 30 mg once daily using the ER formulation provided equivalent AUC0-24 , comparable Cmax and Cmin , and a fluctuation index over a 24-hour period at steady state similar to 6 and 12 mg twice daily, respectively, using the IR formulation. These results supported the use of upadacitinib 15- and 30-mg doses of the ER formulation in the phase 3 trials in RA.

DrugBank Data that Cites this Article

Drugs
Drug Enzymes
DrugEnzymeKindOrganismPharmacological ActionActions
UpadacitinibCytochrome P450 2D6ProteinHumans
Unknown
Substrate
Details
UpadacitinibCytochrome P450 3A4ProteinHumans
No
Substrate
Details
Drug Interactions
DrugsInteraction
Upadacitinib
Terfenadine
The metabolism of Upadacitinib can be decreased when combined with Terfenadine.
Upadacitinib
Voriconazole
The metabolism of Upadacitinib can be decreased when combined with Voriconazole.
Upadacitinib
Efavirenz
The metabolism of Upadacitinib can be decreased when combined with Efavirenz.
Upadacitinib
Ergotamine
The metabolism of Upadacitinib can be decreased when combined with Ergotamine.
Upadacitinib
Delavirdine
The metabolism of Upadacitinib can be decreased when combined with Delavirdine.