Assessment of Drug-Drug Interaction Potential Between Atorvastatin and LCZ696, A Novel Angiotensin Receptor Neprilysin Inhibitor, in Healthy Chinese Male Subjects

作者：Ayalasomayajula, Surya^*; Pan, Wei; Han, Yi; Yang, Fan; Langenickel, Thomas; Pal, Parasar; Zhou, Wei; Yuan, Yaozong; Rajman, Iris; Sunkara, Gangadhar

来源：European Journal of Drug Metabolism and Pharmacokinetics, 2017, 42(2): 309-318.

DOI：10.1007/s13318-016-0349-y

• PHARMACOKINETIC INTERACTION
• TRANSPORTER
• VALSARTAN
• DISPOSITION
• MANAGEMENT
• ENALAPRIL
• RISK

Background and Objective LCZ696 (sacubitril/valsartan), a novel angiotensin receptor neprilysin inhibitor has been recently approved for the treatment of patients with heart failure (HF) and reduced ejection fraction. As several HF patients are likely to use statins as co-medications, the potential for a pharmacokinetic drug-drug interaction between atorvastatin and LCZ696 was evaluated. @@@ Methods This was an open-label, three-period, single-sequence study in 28 healthy Chinese male subjects wherein LCZ696 200 mg was administered twice daily for 5 days in period 1. Following a washout period, atorvastatin 80 mg was administered once daily for 4 days (period 2) and subsequently co-administered with LCZ696 200 mg for 5 days (period 3). Serial plasma samples were collected to determine pharmacokinetic parameters of LCZ696 analytes (sacubitril, LBQ657, and valsartan) and atorvastatin and its metabolites. @@@ Results Atorvastatin co-administration had no effect on the pharmacokinetics of LBQ657, while the AUC(tau),(ss) and C-max,(ss) of sacubitril increased by 30 and 19 %, respectively, and the corresponding values for valsartan decreased by 19 and 9 %, respectively. Co-administration with LCZ696 increased Cmax, ss of atorvastatin, o-hydrox-yatorvastatin, and p- hydroxyatorvastatin by 74, 68, and 108 %, respectively, and the AUC(tau),(ss) of corresponding analytes increased by 34, 22, and 26 %, respectively. @@@ Conclusions While atorvastatin had no significant impact on the pharmacokinetics of LCZ696 analytes upon co-administration, the C-max of atorvastatin and its metabolites increased twofold, with a marginal increase in AUC (< 1.3-fold). Multiple-dose administration of LCZ696 200 mg twice daily and atorvastatin 80 mg once daily either alone or in combination was generally safe and well tolerated in healthy subjects.

• 出版日期2017-4
• 单位上海市闵行区中心医院; 上海交通大学