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Inhibition of human UDP-glucuronosyltransferase enzymes by midostaurin and ruxolitinib: implications for drug-drug interactions.

Abstract
Cancer therapy with tyrosine kinase inhibitors (TKIs) is a rapidly developing field, and several TKIs have been reported to have an impact on the activities of UDP-glucosyltransferases (UGTs), implying a potential risk for drug-drug interaction (DDI). Herein, we investigated the inhibitory effects of two commonly used TKIs, midostaurin and ruxolitinib, on human UGTs and quantitatively evaluated their DDI potential via UGT inhibition. It was found that midostaurin was a potent inhibitor of the majority of human UGTs, including UGT1A3, 1A4, 1A7, 1A8, 1A9, 1A10, 2B7, 2B15, and 2B17, with IC50 values lower than 4 μM (IC50 0.0128-3.85 μM), while ruxolitinib exhibited weak inhibition towards the activity of almost all the tested UGT isoforms. Furthermore, based on reversible inhibition, the co-administration of midostaurin at the clinical available dose was predicted to increase the plasma exposure to sensitive UGT1A3, 1A7, and 1A8 substrates by at least 61.4%, 25.6%, and 651%, respectively. In summary, our data identify that midostaurin is a potent inhibitor of the majority of human UGTs and may bring a potential risk of DDI via inhibition against UGT1A3, 1A7, and 1A8, while ruxolitinib cannot trigger UGT-mediated DDI due to its weak inhibition towards UGTs.
AuthorsZhe Wang, Xiaoyu Wang, Yaqin Jia, Hang Yin, Yuyi Feng, Lili Jiang, Jun Cao, Yong Liu
JournalBiopharmaceutics & drug disposition (Biopharm Drug Dispos) Vol. 41 Issue 6 Pg. 231-238 (Jun 2020) ISSN: 1099-081X [Electronic] England
PMID32436276 (Publication Type: Journal Article)
Copyright© 2020 John Wiley & Sons, Ltd.
Chemical References
  • Antineoplastic Agents
  • Isoenzymes
  • Nitriles
  • Protein Kinase Inhibitors
  • Pyrazoles
  • Pyrimidines
  • Recombinant Proteins
  • ruxolitinib
  • Glucuronosyltransferase
  • Staurosporine
  • midostaurin
Topics
  • Antineoplastic Agents (pharmacology)
  • Drug Interactions
  • Glucuronosyltransferase (antagonists & inhibitors)
  • Humans
  • Isoenzymes (antagonists & inhibitors)
  • Nitriles
  • Protein Kinase Inhibitors (pharmacology)
  • Pyrazoles (pharmacology)
  • Pyrimidines
  • Recombinant Proteins
  • Staurosporine (analogs & derivatives, pharmacology)

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