Abstract
The effect of food on pharmacokinetic properties of drugs is a commonly observed occurrence affecting about 40% of orally administered drugs. Within the pharmaceutical industry, significant resources are invested to predict and characterize a clinically relevant food effect. Here, the predictive performance of physiologically based pharmacokinetic (PBPK) food effect models was assessed via de novo mechanistic absorption models for 30 compounds using controlled, pre-defined in vitro, and modeling methodology. Compounds for which absorption was known to be limited by intestinal transporters were excluded in this analysis. A decision tree for model verification and optimization was followed, leading to high, moderate, or low food effect prediction confidence. High (within 0.8- to 1.25-fold) to moderate confidence (within 0.5- to 2-fold) was achieved for most of the compounds (15 and 8, respectively). While for 7 compounds, prediction confidence was found to be low (> 2-fold). There was no clear difference in prediction success for positive or negative food effects and no clear relationship to the BCS category of tested drug molecules. However, an association could be demonstrated when the food effect was mainly related to changes in the gastrointestinal luminal fluids or physiology, including fluid volume, motility, pH, micellar entrapment, and bile salts. Considering these findings, it is recommended that appropriately verified mechanistic PBPK modeling can be leveraged with high to moderate confidence as a key approach to predicting potential food effect, especially related to mechanisms highlighted here.
Highlights
IntroductionThe consumption of food at the time of drug administration can alter absorption [1]
For orally administered drugs, the consumption of food at the time of drug administration can alter absorption [1]
There was no clear correlation between the prediction confidence and BCS category and/or food effect type
Summary
The consumption of food at the time of drug administration can alter absorption [1]. Over 40% of the orally administered drugs approved by the FDA or EMA in the last 10 years were reported to have altered pharmacokinetics (PK) by food [2]. Health authorities expect sponsors to characterize food or meal effects prior to approval [3,4]. In the case of a clinically meaningful PK effect, a specific recommendation will be made for drug administration; for example, a drug can only be given under fasted conditions or taken with a meal to maximize drug absorption
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