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Pharmacokinetics of voclosporin in renal impairment and hepatic impairment
Author(s) -
Ling S.Y.,
Huizinga R.B.,
Mayo P.R.,
Freitag D.G.,
Aspeslet L.J.,
Foster R.T.
Publication year - 2013
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1002/jcph.166
Subject(s) - cmax , medicine , renal function , pharmacokinetics , confidence interval , urology , creatinine , transplantation , gastroenterology
Voclosporin is a novel calcineurin inhibitor intended for prevention of organ graft rejection and treatment of lupus nephritis. These studies evaluated the effect of renal or hepatic impairment on pharmacokinetics of voclosporin. Thirty‐three subjects were enrolled into 1 of 4 groups based on renal function as defined by creatinine clearance and 18 subjects were enrolled into 1 of 3 groups based on hepatic function defined by Child‐Pugh classes. Voclosporin 0.4 mg/kg was administered orally. Geometric mean ratios (renal/hepatic impairment‐to‐normal) and 90% confidence intervals for C max and AUC were calculated. A default no‐effect interval of 80–125% was set. Although 90% confidence intervals exceeded the no‐effect intervals for both parameters, individual C max and AUC plots indicate almost complete overlapping range of values for mild and moderate renal impairment and normal subjects. Severe renal impairment resulted in a 1.5‐fold increase in AUC without an increase in C max . Mild to moderate hepatic impairment resulted in a 1.5‐ to 2‐fold increase in voclosporin exposure. Voclosporin can be administered safely to patients with mild to moderate renal impairment without dose modification. Appropriate safety monitoring with concentration‐based adjustments in transplantation are recommended for patients with severe renal impairment, and for patients with hepatic impairment.