The NTCP-inhibitor Myrcludex B: Effects on Bile Acid Disposition and Tenofovir Pharmacokinetics.

Abstract

Myrcludex B acts as a hepatitis B and D virus entry inhibitor blocking the sodium taurocholate cotransporting polypeptide (SLC10A1). We investigated the effects of myrcludex B on plasma bile acid disposition, tenofovir pharmacokinetics, and perpetrator characteristics on cytochrome P450 (CYP) 3A. Twelve healthy volunteers received 300 mg tenofovir disoproxil fumarate orally and 10 mg subcutaneous myrcludex B. Myrcludex B increased total plasma bile acid exposure 19.2-fold without signs of cholestasis. The rise in conjugated bile acids was up to 124-fold (taurocholic acid). Coadministration of tenofovir with myrcludex B revealed no relevant changes in tenofovir pharmacokinetics. CYP3A activity slightly but significantly decreased by 29% during combination therapy. Myrcludex B caused an asymptomatic but distinct rise in plasma bile acid concentrations and had no relevant impact on tenofovir pharmacokinetics. Changes in CYP3A activity might be due to alterations in bile acid signaling. Long-term effects of elevated bile acids will require critical evaluation.

• Authors: A Blank, A Eidam, M Haag, N Hohmann, J Burhenne, M Schwab, Sfj van de Graaf, M R Meyer, H H Maurer, K Meier, J Weiss, T Bruckner, A Alexandrov, S Urban, G Mikus, W E Haefeli
• Journal: Clinical pharmacology and therapeutics (Clin Pharmacol Ther) Vol. 103 Issue 2 Pg. 341-348 (02 2018) ISSN: 1532-6535 [Electronic] United States
• PMID: 28543042 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2017 American Society for Clinical Pharmacology and Therapeutics.

Chemical References

• Antiviral Agents
• Bile Acids and Salts
• Biomarkers
• Lipopeptides
• Organic Anion Transporters, Sodium-Dependent
• Reverse Transcriptase Inhibitors
• Symporters
• myrcludex-B
• sodium-bile acid cotransporter
• Tenofovir
• CYP3A protein, human
• Cytochrome P-450 CYP3A

Topics

• Administration, Oral
• Adult
• Antiviral Agents (administration & dosage, adverse effects, pharmacokinetics)
• Bile Acids and Salts (blood)
• Biomarkers (blood)
• Cytochrome P-450 CYP3A (metabolism)
• Drug Interactions
• Female
• Humans
• Injections, Subcutaneous
• Lipopeptides (administration & dosage, adverse effects, pharmacokinetics)
• Male
• Middle Aged
• Organic Anion Transporters, Sodium-Dependent (antagonists & inhibitors, metabolism)
• Prospective Studies
• Reverse Transcriptase Inhibitors (administration & dosage, adverse effects, pharmacokinetics)
• Risk Assessment
• Symporters (antagonists & inhibitors, metabolism)
• Tenofovir (administration & dosage, adverse effects, pharmacokinetics)
• Up-Regulation
• Young Adult