Pharmacokinetic interaction between etravirine or rilpivirine and telaprevir in healthy volunteers: A randomized, two-way crossover trial.

Abstract

Coinfection with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) may require treatment with an HIV non-nucleoside reverse transcriptase inhibitor (NNRTI), for example, rilpivirine or etravirine, and an HCV direct-acting antiviral drug such as telaprevir. In a two-panel, two-way, crossover study, healthy volunteers were randomized to receive etravirine 200 mg twice daily ± telaprevir 750 mg every 8 hours or rilpivirine 25 mg once daily ± telaprevir 750 mg every 8 hours. Pharmacokinetic assessments were conducted for each drug at steady-state when given alone and when coadministered; statistical analyses were least-square means with 90% confidence intervals. Telaprevir minimum plasma concentration (Cmin), maximum plasma concentration (Cmax), and area under the concentration-time curve (AUC) decreased 25%, 10%, and 16%, respectively, when coadministered with etravirine and 11%, 3%, and 5%, respectively, when coadministered with rilpivirine. Telaprevir did not affect etravirine pharmacokinetics, but increased rilpivirine Cmin, Cmax, and AUC by 93%, 49%, and 78%, respectively. Both combinations were generally well tolerated. The small decrease in telaprevir exposure when coadministered with etravirine is unlikely to be clinically relevant. The interaction between telaprevir and rilpivirine is not likely to be clinically relevant under most circumstances. No dose adjustments are deemed necessary when they are coadministered.

• Authors: Thomas N Kakuda, Lorant Leopold, Steven Nijs, Ann Vandevoorde, Herta M Crauwels, Kirk M Bertelsen, Marita Stevens, James Witek, Yvon van Delft, Frank Tomaka, Richard M W Hoetelmans
• Journal: Journal of clinical pharmacology (J Clin Pharmacol) Vol. 54 Issue 5 Pg. 563-73 (May 2014) ISSN: 1552-4604 [Electronic] England
• PMID: 25975423 (Publication Type: Clinical Trial, Phase I, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: © 2013, The American College of Clinical Pharmacology.

Chemical References

• Anti-HIV Agents
• Nitriles
• Oligopeptides
• Pyridazines
• Pyrimidines
• Reverse Transcriptase Inhibitors
• etravirine
• telaprevir
• Rilpivirine

Topics

• Adolescent
• Adult
• Anti-HIV Agents (adverse effects, blood, pharmacokinetics, pharmacology)
• Cross-Over Studies
• Drug Interactions
• Female
• Healthy Volunteers
• Humans
• Male
• Middle Aged
• Nitriles (adverse effects, blood, pharmacokinetics, pharmacology)
• Oligopeptides (adverse effects, blood, pharmacokinetics, pharmacology)
• Pyridazines (adverse effects, blood, pharmacokinetics, pharmacology)
• Pyrimidines (adverse effects, blood, pharmacokinetics, pharmacology)
• Reverse Transcriptase Inhibitors (adverse effects, blood, pharmacokinetics, pharmacology)
• Rilpivirine
• Young Adult