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Assessment of Drug–Drug Interactions between Taspoglutide, a Glucagon-Like Peptide-1 Agonist, and Drugs Commonly Used in Type 2 Diabetes Mellitus: Results of Five Phase I Trials

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Abstract

Background and Objective

Taspoglutide, a glucagon-like peptide-1 agonist, like native glucagon-like peptide-1, delays gastric emptying time and prolongs intestinal transit time, which may alter the pharmacokinetics of concomitantly administered oral drugs. The effect of taspoglutide on the pharmacokinetics of five oral drugs commonly used in patients with type 2 diabetes mellitus was assessed in healthy subjects.

Methods

Five clinical pharmacology studies evaluated the potential drug–drug interaction between multiple subcutaneous taspoglutide doses and a single dose of lisinopril, warfarin, and simvastatin and multiple doses of digoxin and an oral contraceptive containing ethinylestradiol and levonorgestrel. The extent of interaction was quantified using geometric mean ratios and 90% confidence intervals for the maximum plasma concentration and area under the plasma concentration–time curve. In addition to pharmacokinetics, pharmacodynamic effects were assessed for warfarin and the oral contraceptive.

Results

Among the tested drugs, the effect of taspoglutide on the pharmacokinetics of simvastatin was most pronounced, on the day of taspoglutide administration, the average exposure to simvastatin was decreased by − 26% and − 58% for the area under the plasma concentration–time curve and maximum plasma concentration, respectively, accompanied by an increase in average exposure to its active metabolite, simvastatin β-hydroxy acid (+ 74% and + 23% for area under the plasma concentration–time curve and maximum plasma concentration, respectively). Although statistically significant changes in exposure were observed for other test drugs, the 90% confidence intervals for the geometric mean ratio for maximum plasma concentration and area under the plasma concentration–time curve were within the 0.7–1.3 interval. No clinically relevant changes on coagulation (for warfarin) and ovulation-suppressing activity (for the oral contraceptive) were apparent.

Conclusion

Overall, multiple doses of taspoglutide did not result in changes in the pharmacokinetics of digoxin, an oral contraceptive containing ethinylestradiol and levonorgestrel, lisinopril, warfarin, and simvastatin that would be considered of clinical relevance. Therefore, no dose adjustments are warranted upon co-administration.

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Acknowledgements

The authors thank Elke Zwanziger, Katja Heinig, Jon Talbot, Christelle Vistuer, and Nathalie Lambert for providing scientific review, operational, and technical support.

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Author notes

  1. Bernhard Mangold

    Present address: , Mühlstrasse 23 A, Walluf, 65396, Germany

Authors and Affiliations

  1. Department of Clinical Pharmacology, Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche AG, Grenzacherstrasse 124, Basel, CH-4070, Switzerland

    Katrijn Bogman, Carsten Hofmann, Mylène Giraudon, Carolina Sturm-Pellanda, Stefan Sturm, Bernhard Mangold & Christophe Schmitt

  2. Department of Biostatistics, Genentech, South San Francisco, CA, USA

    Jochen Brumm

  3. Department of Biostatistics, Pharma Development, F. Hoffmann-La Roche AG, Basel, Switzerland

    Markus Niggli & Annette Sauter

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Correspondence to Katrijn Bogman.

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Funding

This study was funded by F. Hoffmann-La Roche Ltd.

Conflict of interest

Katrijn Bogman, Jochen Brumm, Carsten Hofmann, Mylène Giraudon, Markus Niggli, Carolina Sturm-Pellanda, Annette Sauter, Stefan Sturm, and Christophe Schmitt are employees of F. Hoffmann-La Roche Ltd. Katrijn Bogman, Carsten Hofmann, Carolina Sturm-Pellanda, Annette Sauter, Stefan Sturm, Christophe Schmitt, and Bernhard Mangold are shareholders of F. Hoffmann-La Roche Ltd. Bernhard Mangold was an employee of F. Hoffmann-La Roche Ltd. at the time the studies were conducted and reported.

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Bogman, K., Brumm, J., Hofmann, C. et al. Assessment of Drug–Drug Interactions between Taspoglutide, a Glucagon-Like Peptide-1 Agonist, and Drugs Commonly Used in Type 2 Diabetes Mellitus: Results of Five Phase I Trials. Clin Pharmacokinet 58, 1205–1214 (2019). https://doi.org/10.1007/s40262-019-00757-1

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