Modeling and Experimental Studies of Obeticholic Acid Exposure and the Impact of Cirrhosis Stage

• Published in: Clinical and translational science Vol. 9; no. 6; pp. 328 - 336
• Main Authors: Edwards, JE, LaCerte, C, Peyret, T, Gosselin, NH, Marier, JF, Hofmann, AF, Shapiro, D
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.12.2016; John Wiley and Sons Inc
• Subjects: Acids; Adult; Area Under Curve; Bile; Bile acids; Chenodeoxycholic Acid - analogs & derivatives; Chenodeoxycholic Acid - blood; Chenodeoxycholic Acid - pharmacokinetics; Chenodeoxycholic Acid - therapeutic use; Cirrhosis; Computer Simulation; Drug dosages; Excretion; Female; Healthy Volunteers; Humans; Hypertension; Intestine; Liver; Liver cirrhosis; Liver Cirrhosis - blood; Liver Cirrhosis - drug therapy; Liver Cirrhosis - pathology; Liver diseases; Male; Metabolism; Models, Biological; Pharmaceuticals; Plasma levels; Reproducibility of Results; Studies
• ISSN: 1752-8054; 1752-8062; 1752-8062
• DOI: 10.1111/cts.12421

Obeticholic acid (OCA), a semisynthetic bile acid, is a selective and potent farnesoid X receptor (FXR) agonist in development for the treatment of chronic nonviral liver diseases. Physiologic pharmacokinetic models have been previously used to describe the absorption, distribution, metabolism, and excretion (ADME) of bile acids. OCA plasma levels were measured in healthy volunteers and cirrhotic subjects. A physiologic pharmacokinetic model was developed to quantitatively describe the ADME of OCA in patients with and without hepatic impairment. There was good agreement between predicted and observed increases in systemic OCA exposure in subjects with mild, moderate, and severe hepatic impairment, which were 1.4‐, 8‐, and 13‐fold relative to healthy volunteers. Predicted liver exposure for subjects with mild, moderate, and severe hepatic impairment were increased only 1.1‐, 1.5‐, and 1.7‐fold. In subjects with cirrhosis, OCA exposure in the liver, the primary site of pharmacological activity along with the intestine, is increased marginally (∼2‐fold).