Heli Parviainen, Helsinki

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Presentation transcript:

International Transporter Consortium Commentary on Clinically Important Transporter Polymorphisms Heli Parviainen, Helsinki Giacomini KM, Balimane PV, Cho SK, Eadon M, Edeki T, Hillgren KM, Huang S-M, Sugiyama Y, Weitz D, Wen Y, Xia CQ, Yee SW, Zimdahl H, Niemi M, on behalf of the International Transporter Consortium Clinical Pharmacology & Therapeutics 94(1), 23-26 2013

Objectives What are transporter polymorphisms? Why should they be considered in drug development? Recommendations on how polymorphisms can be taken into account in drug development Benefits of pharmacogenomic studies Heli Parviainen, Helsinki 25.10.2017

Transporter polymorphisms Genetic mutations SNP = Single Nucleotide Polymorphism Nonsynonymous polymorphism changes the amino acid sequence Missense: amino acid exchange Nonsense: premature stop codon Can affect transporter activity Heli Parviainen, Helsinki 25.10.2017

Transporter polymorphisms in pharmakokinetics One of the main reasons for variation in drug exposure and response Effect depends on precise genotype, phenotype and transporter specificity This should be taken into accound in drug development Preclinical and clinical studies Heli Parviainen, Helsinki 25.10.2017

Preclinical studies Objective is to identify transporters involved in the pharmacokinetics of the new drug In silico In vitro Genetically engineered animals Relative contribution of different transporters Heli Parviainen, Helsinki 25.10.2017

Clinical studies: DDI study An inhibitor of the transporter is used Inhibitors are usually not fully specific Provides information on the maximum possible effect of a polymorphism Interpretation of the data? Nonspecificity Relative to therapeutic window Heli Parviainen, Helsinki 25.10.2017

Clinical studies: Pharmacogenomic studies Separate studies or part of phase I – III studies Testing strategy guided by data obtained in preclinical studies and DDI studies Preselecting test subjects by genetic profile can be concidered Heli Parviainen, Helsinki 25.10.2017

Advantages of concidering polymorphisms in drug development Information on the safe use of the new molecule Information on the relative importance of particular transporters in the pharmacokinetcs of a new drug Information on the pharmacokinetic and pharmacodynamic mechanisms of the new drug Heli Parviainen, Helsinki 25.10.2017

Take home messages Transporter polymorphisms can have a large effect on the pharmacokinetics of a drug Pharmacogenomic data can provide new insights on the pharmacokinetic and pharmacodynamic properties of a new drug Pharmacogenomics can guide the safe use of a new drug Heli Parviainen, Helsinki 25.10.2017

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