Polymorphism of Drug Transporters, Rather Than Metabolizing Enzymes, Conditions the Pharmacokinetics of Rasagiline

oleh: Pablo Zubiaur, Miriam Matas, Samuel Martín-Vílchez, Paula Soria-Chacartegui, Gonzalo Villapalos-García, Laura Figueiredo-Tor, Sofía Calleja, Marcos Navares-Gómez, Alejandro de Miguel, Jesús Novalbos, Gina Mejía-Abril, Sergio Luquero-Bueno, Manuel Román, Dolores Ochoa, Francisco Abad-Santos

Format: Article
Diterbitkan: MDPI AG 2022-09-01

Deskripsi

Rasagiline is a selective and irreversible inhibitor of monoamine oxidase type B with neuroprotective effect, indicated for the management of Parkinson’s disease. The aim of this work was to evaluate the impact of seven <i>CYP1A2</i> alleles and of 120 additional variants located in other CYP enzymes (e.g., <i>CYP2C19</i>), UGT enzymes (e.g., <i>UGT1A1</i>) or other enzymes (e.g., <i>NAT2</i>), and transporters (e.g., <i>SLCO1B1</i>) on the pharmacokinetic variability and safety of rasagiline. A total of 118 healthy volunteers enrolled in four bioequivalence clinical trials consented to participate in this pharmacogenetic study. <i>CYP1A2</i> alleles were not associated with the pharmacokinetic variability of rasagiline. Patients with <i>ABCB1</i> rs1045642 G/A+A/A genotypes presented higher area under the curve adjusted by dose per weight (AUC<sub>0-∞</sub>/DW) than those with the G/G genotype (<i>p</i> = 0.012) and lower volume of distribution (V<sub>d</sub>/F) and clearance (Cl/F) (<i>p</i> = 0.001 and <i>p</i> = 0.012, respectively). Subjects with the <i>ABCC2</i> rs2273697 A/A genotype presented lower t<sub>max</sub> (i.e., the time to reach the maximum concentration, C<sub>max</sub>) compared to those with G/G+G/A genotypes (<i>p</i> = 0.001). Volunteers with the <i>SLC22A1</i> *1/*5 genotype exhibited lower C<sub>max</sub>/DW and higher t<sub>max</sub> (<i>p</i> = 0.003 and <i>p</i> = 0.018, respectively) than subjects with the *1/*1 diplotype. Only one adverse drug reaction was reported: headache. Our results suggest the genetic polymorphism of drug transporters, rather than metabolizing enzymes, conditions the pharmacokinetics of rasagiline.