Pd. Worboys et Dj. Carlile, Implications and consequences of enzyme induction on preclinical and clinical drug development, XENOBIOTICA, 31(8-9), 2001, pp. 539-556
1. Enzyme induction has traditionally been studied during drug development
to assess the potential of drug entities to interact with concomitant medic
ations and alter their pharmacological effects, and clearly it is an unwant
ed phenomenon. However, another hurdle caused by induction occurs during pr
eclinical development via the attainment of safety data, obtained by dosing
high quantities of compound to species used in toxicology assessment. This
review considers the techniques that can now be utilized in drug discovery
, their relevance, the pharmacokinetic aspects of this phenomenon, and it d
iscusses the consequences and implications of induction during preclinical
and clinical development.
2. It is becoming increasingly routine to employ hepatocyte cultures and no
vel techniques such as quantitative real-time reverse transcriptase PCR to
identify enzyme inducers in vitro. The major challenge is to utilize these
in vitro data to predict the consequences of induction in vivo. From an und
erstanding of pharmacokinetic principles and low clinical doses relative to
preclinical studies, there is limited potential for induction by a develop
ment candidate to significantly alter the pharmacological efficacy of a coa
dministered drug.
3. The most comprehensive approach when considering induction involves inte
grating quantitative in vitro data, information on the pharmacokinetic beha
viour of the compound and the PK/PD relationship in order to predict its co
nsequences. The generation of this holistic strategy would enable more deta
iled and informed decisionmaking about both the suitability of molecules fo
r development and the development strategy itself.