Assessment of drug–drug interaction potential with EDP‐305, a farnesoid X receptor agonist, in healthy subjects

• Published in: Clinical and translational science Vol. 15; no. 9; pp. 2146 - 2158
• Main Authors: Ahmad, Alaa, Adda, Nathalie
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.09.2022; John Wiley and Sons Inc; Wiley
• Subjects: Agonists; Caffeine; Comorbidity; CYP1A2 protein; Cytochrome; Cytochrome P-450 CYP3A - metabolism; Cytochrome P450; Drug dosages; Drug interaction; Drug Interactions; Enzymes; Fibrosis; Healthy Volunteers; Humans; Isoenzymes; Liver; Non-alcoholic Fatty Liver Disease; Patients; Pharmaceutical Preparations; Proteins; Steroids
• ISSN: 1752-8054; 1752-8062; 1752-8062
• DOI: 10.1111/cts.13348

EDP‐305 is a farnesoid X receptor (FXR) agonist that selectively activates FXR and is a potential treatment for patients with nonalcoholic steatohepatitis (NASH) with liver fibrosis. Results from preclinical studies indicate that CYP3A4 is the primary enzyme involved in EDP‐305 metabolism and that EDP‐305 has low potential to inhibit or induce cytochrome (CYP) isoenzymes and drug transporters. Four studies were conducted in healthy volunteers to evaluate the drug–drug interaction (DDI) potential of EDP‐305 co‐administered with drugs known to be substrates for drug metabolizing enzymes or transporters, and to assess the effect of inhibitors and inducers of CYP3A4 on EDP‐305. Results suggest caution when substrates of CYP3A4 are administered concomitantly with EDP‐305. A potential for increased exposure is apparent when CYP1A2 substrates with a narrow therapeutic index are administered with EDP‐305. In contrast, substrates of drug transporters can be administered concomitantly with EDP‐305 with a low potential for interactions. Coadministration of EDP‐305 and a combined OC had no relevant effects on plasma concentrations of the combined OC. Co‐administration of EDP‐305 with strong or moderate inhibitors and inducers of CYP3A4 is not recommended. These results indicate low overall likelihood of interaction of EDP‐305 and other substrates through CYP mediated interactions. The interaction potential of EDP‐305 with drug transporters was low and of unlikely clinical significance. The EDP‐305 DDI profile allows for convenient administration in patients with NASH and other patient populations with comorbidities, with minimal dose modification of concomitant medications.