Evaluating the drug-drug interactions of SHR4640 on repaglinide and midazolam in healthy subjects

• Published in: Expert opinion on drug metabolism & toxicology Vol. 21; no. 2; p. 217
• Main Authors: Cheng, Yuanzhi, Hu, Xiaotong, Pei, Zejun, Zhang, Zhe, Lin, Hongda, Feng, Sheng, Gao, Zhenyan, Ma, Yanlin, Cao, Zhihai, Zhang, Qian, Zheng, Liang, Zhang, Wei, Shen, Kai, Hu, Wei
• Format: Journal Article
• Language: English
• Published: England 01.02.2025
• Subjects: Administration, Oral; Adult; Area Under Curve; Carbamates - administration & dosage; Carbamates - pharmacokinetics; Cyclobutanes; Cytochrome P-450 CYP2C8 - metabolism; Cytochrome P-450 CYP2C8 Inhibitors - administration & dosage; Cytochrome P-450 CYP2C8 Inhibitors - pharmacology; Cytochrome P-450 CYP3A - drug effects; Cytochrome P-450 CYP3A - metabolism; Cytochrome P-450 CYP3A Inhibitors - administration & dosage; Double-Blind Method; Drug Interactions; Female; Healthy Volunteers; Humans; Hypoglycemic Agents - administration & dosage; Hypoglycemic Agents - pharmacokinetics; Male; Midazolam - administration & dosage; Midazolam - pharmacokinetics; Middle Aged; Piperidines - administration & dosage; Piperidines - pharmacokinetics; Pyrroles; Quinolines; Sulfones; Young Adult; repaglinide; pharmacokinetics; SHR4640; midazolam; safety
• ISSN: 1744-7607
• DOI: 10.1080/17425255.2024.2428367

SHR4640, a highly selective URAT1 inhibitor, was evaluated to investigate its inhibitory effects on CYP2C8 and CYP3A4 in vivo clinical trial. This study assessed the pharmacokinetic (PK) impact of SHR4640 when co-administered with the CYP2C8 probe substrate repaglinide and the CYP3A4 probe substrate midazolam. In this single-center, randomized, double-blind, placebo-controlled study, participants were randomly allocated in a 1:1:1 ratio to SHR4640 Group A, SHR4640 Group B, and placebo group and received oral repaglinide, midazolam, SHR4640 or placebo at specific times. The primary endpoints included the main PK parameters of repaglinide and midazolam, both alone and in combination with SHR4640 (AUC , AUC , and C ). The increase in the area under the concentration-time curve (AUC) for repaglinide, when co-administered with SHR4640, was less than 1.25-fold, while the AUC for midazolam exhibited a slight increase of 46%. SHR4640 exerts a weak inhibitory effect on the AUC of CYP enzyme probe substrates and has minimal potential for drug-drug interactions and presents a favorable safety profile. www.clinicaltrials.gov identifier is NCT06196580 (Name: PK Effects of SHR4640 on Repaglinide and Midazolam, and the Impact of SHR4640 on QT Interval).