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Peyronneau MA, Kuhnast B, Nguyen DL, Jego B, Sayet G, Caillé F, Lavisse S, Gervais P, Stankoff B, Sarazin M, Remy P, Bouilleret V, Leroy C, Bottlaender M. [ 18F]DPA-714: Effect of co-medications, age, sex, BMI and TSPO polymorphism on the human plasma input function. Eur J Nucl Med Mol Imaging 2023; 50:3251-3264. [PMID: 37291448 DOI: 10.1007/s00259-023-06286-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 05/16/2023] [Indexed: 06/10/2023]
Abstract
PURPOSE We aimed to assess the effect of concomitant medication, age, sex, body mass index and 18-kDa translocator protein (TSPO) binding affinity status on the metabolism and plasma pharmacokinetics of [18F]DPA-714 and their influence on the plasma input function in a large cohort of 201 subjects who underwent brain and whole-body PET imaging to investigate the role of neuroinflammation in neurological diseases. METHODS The non-metabolized fraction of [18F]DPA-714 was estimated in venous plasma of 138 patients and 63 healthy controls (HCs; including additional arterial sampling in 16 subjects) during the 90 min brain PET acquisition using a direct solid-phase extraction method. The mean fraction between 70 and 90 min post-injection ([18F]DPA-71470-90) and corresponding normalized plasma concentration (SUV70-90) were correlated with all factors using a multiple linear regression model. Differences between groups (arterial vs venous measurements; HCs vs patients; high- (HAB), mixed- (MAB) and low-affinity binders (LAB); subjects with vs without co-medications, females vs males were also assessed using the non-parametric Mann-Whitney or Kruskal-Wallis ANOVA tests. Finally, the impact of co-medications on the brain uptake of [18F]DPA-714 at equilibrium was investigated. RESULTS As no significant differences were observed between arterial and venous [18F]DPA-71470-90 and SUV70-90, venous plasma was used for correlations. [18F]DPA-71470-90 was not significantly different between patients and HCS (59.7 ± 12.3% vs 60.2 ± 12.9%) despite high interindividual variability. However, 47 subjects exhibiting a huge increase or decrease of [18F]DPA-71470-90 (up to 88% or down to 23%) and SUV70-90 values (2-threefold) were found to receive co-medications identified as inhibitors or inducers of CYP3A4, known to catalyse [18F]DPA-714 metabolism. Comparison between cortex-to-plasma ratios using individual input function (VTIND) or population-based input function derived from untreated HCs (VTPBIF) indicated that non-considering the individual metabolism rate led to a bias of about 30% in VT values. Multiple linear regression model analysis of subjects free of these co-medications suggested significant correlations between [18F]DPA-71470-90 and age, BMI and sex while TSPO polymorphism did not influence the metabolism of the radiotracer. [18F]DPA-714 metabolism fell with age and BMI and was significantly faster in females than in males. Whole-body PET/CT exhibited a high uptake of the tracer in TSPO-rich organs (heart wall, spleen, kidneys…) and those involved in metabolism and excretion pathways (liver, gallbladder) in HAB and MAB with a strong decrease in LAB (-89% and -85%) resulting in tracer accumulation in plasma (4.5 and 3.3-fold increase). CONCLUSION Any co-medication that inhibits or induces CYP3A4 as well as TSPO genetic status, age, BMI and sex mostly contribute to interindividual variations of the radiotracer metabolism and/or concentration that may affect the input function of [18F]DPA-714 and consequently its human brain and peripheral uptake. TRIAL REGISTRATION INFLAPARK, NCT02319382, registered December 18, 2014, retrospectively registered; IMABIO 3, NCT01775696, registered January 25, 2013, retrospectively registered; INFLASEP, NCT02305264, registered December 2, 2014, retrospectively registered; EPI-TEP, EudraCT 2017-003381-27, registered September 24, 2018.
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Affiliation(s)
- M A Peyronneau
- Université Paris Saclay, INSERM, CNRS, CEA, Laboratoire d'Imagerie Biomedicale Multimodale (BioMaps), Service Hospitalier Frédéric Joliot, 4 Place du Général Leclerc, F-91401, ORSAY, France.
| | - B Kuhnast
- Université Paris Saclay, INSERM, CNRS, CEA, Laboratoire d'Imagerie Biomedicale Multimodale (BioMaps), Service Hospitalier Frédéric Joliot, 4 Place du Général Leclerc, F-91401, ORSAY, France
| | - D-L Nguyen
- Université Paris Saclay, INSERM, CNRS, CEA, Laboratoire d'Imagerie Biomedicale Multimodale (BioMaps), Service Hospitalier Frédéric Joliot, 4 Place du Général Leclerc, F-91401, ORSAY, France
| | - B Jego
- Université Paris Saclay, INSERM, CNRS, CEA, Laboratoire d'Imagerie Biomedicale Multimodale (BioMaps), Service Hospitalier Frédéric Joliot, 4 Place du Général Leclerc, F-91401, ORSAY, France
| | - G Sayet
- Université Paris Saclay, INSERM, CNRS, CEA, Laboratoire d'Imagerie Biomedicale Multimodale (BioMaps), Service Hospitalier Frédéric Joliot, 4 Place du Général Leclerc, F-91401, ORSAY, France
| | - F Caillé
- Université Paris Saclay, INSERM, CNRS, CEA, Laboratoire d'Imagerie Biomedicale Multimodale (BioMaps), Service Hospitalier Frédéric Joliot, 4 Place du Général Leclerc, F-91401, ORSAY, France
| | - S Lavisse
- Laboratoire Des Maladies Neurodégénératives, Université Paris-Saclay, CEA, CNRS, MIRCen, F-92265, Fontenay-Aux-Roses, France
| | - P Gervais
- Université Paris Saclay, INSERM, CNRS, CEA, Laboratoire d'Imagerie Biomedicale Multimodale (BioMaps), Service Hospitalier Frédéric Joliot, 4 Place du Général Leclerc, F-91401, ORSAY, France
| | - B Stankoff
- Sorbonne Université, UPMC Paris 06, Institut du Cerveau et de La Moelle Epinière, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, Paris, France
| | - M Sarazin
- Université Paris Saclay, INSERM, CNRS, CEA, Laboratoire d'Imagerie Biomedicale Multimodale (BioMaps), Service Hospitalier Frédéric Joliot, 4 Place du Général Leclerc, F-91401, ORSAY, France
- Service de Neurologie de La Mémoire Et du Langage, GHU Paris Psychiatrie & Neurosciences, Hôpital Sainte Anne, F-75014, Paris, France
| | - P Remy
- Laboratoire Des Maladies Neurodégénératives, Université Paris-Saclay, CEA, CNRS, MIRCen, F-92265, Fontenay-Aux-Roses, France
- Centre Expert Parkinson, Neurologie, Hôpital Henri Mondor, AP-HP, F-94010, Créteil, France
- Université Paris-Est Créteil, INSERM U955, Institut Mondor de Recherche Biomédicale, Equipe NeuroPsychologie Interventionnelle, F-94010, Créteil, France
- Département d'Etudes Cognitives, École Normale Supérieure, Université PSL, F-75005, Paris, France
| | - V Bouilleret
- Université Paris Saclay, INSERM, CNRS, CEA, Laboratoire d'Imagerie Biomedicale Multimodale (BioMaps), Service Hospitalier Frédéric Joliot, 4 Place du Général Leclerc, F-91401, ORSAY, France
- Service de Neurophysiologie Clinique et d'Epileptologie, Hôpital Bicêtre, AP-HP, Université Paris Saclay, F-94270, Le Kremlin-Bicêtre, France
| | - C Leroy
- Université Paris Saclay, INSERM, CNRS, CEA, Laboratoire d'Imagerie Biomedicale Multimodale (BioMaps), Service Hospitalier Frédéric Joliot, 4 Place du Général Leclerc, F-91401, ORSAY, France
| | - M Bottlaender
- Université Paris Saclay, INSERM, CNRS, CEA, Laboratoire d'Imagerie Biomedicale Multimodale (BioMaps), Service Hospitalier Frédéric Joliot, 4 Place du Général Leclerc, F-91401, ORSAY, France
- Université Paris Saclay, UNIACT, Neurospin, CEA, Gif-Sur-Yvette, F-91190, France
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Kreutzwiser D, Tseng A. Drug interactions between antiretrovirals and drugs used to treat benign prostatic hyperplasia/lower urinary tract symptoms. Expert Opin Drug Metab Toxicol 2016; 12:1211-24. [PMID: 27376653 DOI: 10.1080/17425255.2016.1209483] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Significant advances in antiretroviral (ARV) therapy have transformed HIV into a chronic manageable disease. Co-morbidities associated with aging, such as benign prostatic hyperplasia (BPH), are becoming increasingly prevalent in the HIV-infected population. The pharmacological treatment of BPH involves medications mainly metabolized by CYP 450 enzymes, while many ARVs have inducing or inhibiting effects on the CYP 450 system. Consequently, there is potential for significant pharmacokinetic (PK) interactions between these two classes of medications. AREAS COVERED This article reviews the pharmacology and metabolism of selected BPH drug therapies and ARVs, in addition to highlighting potential interactions between these two drug categories. The authors also present PK evidence of interactions from available clinical trials, product monographs and international conference abstracts. Potentially significant drug interactions are summarized and strategies for management are discussed. EXPERT OPINION Drugs most likely to interact with BPH medications include protease inhibitors, the non-nucleoside reverse transcriptase inhibitors efavirenz, nevirapine, etravirine, and the cobicistat-boosted integrase inhibitor elvitegravir. Clinically significant PK interactions with BPH medications and dolutegravir, raltegravir, rilpivirine, or the investigational agent doravirine do not appear to exist. Clinicians working with HIV-infected individuals need to recognize the potential for interactions involving BPH and ARV treatments to ensure effective and safe drug therapy use.
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Affiliation(s)
- Denise Kreutzwiser
- a Leslie Dan Faculty of Pharmacy, University of Toronto , Toronto , Ontario , Canada.,b Chronic Viral Illness Service, McGill University Health Centre , Montreal , Quebec , Canada.,c Immunodeficiency Clinic, Toronto General Hospital , University Health Network , Toronto , Ontario , Canada
| | - Alice Tseng
- a Leslie Dan Faculty of Pharmacy, University of Toronto , Toronto , Ontario , Canada.,c Immunodeficiency Clinic, Toronto General Hospital , University Health Network , Toronto , Ontario , Canada
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