Ursodeoxycholic acid, an inhibitor of hepatocyte nuclear factor 1 alpha, does not increase the systemic exposure of pitavastatin

Abstract

Objective: Pitavastatin, a highly potent inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A reductase, is a known substrate of OATP1B1. Ursodeoxycholic acid (UDCA) inhibits OATP1B1 expression by repressing hepatocyte nuclear factor 1 alpha (HNF1 alpha). Thus, the effects of UDCA on the pharmacokinetics of pitavastatin were investigated in healthy subjects. Methods: An open-label, 2-phase, parallel study was conducted with 13 healthy volunteers. In the control phase, after an overnight fast, each subject received a single dose of 2 mg pitavastatin. After a 1-week washout period, in the UDCA phase, subjects received a daily oral dose of 600 mg of UDCA (300 mg b.i.d.) for 14 days. On day 15, 2 mg of pitavastatin was administered as described previously for the control phase. Results: In the UDCA phase, the maximum plasma concentration (C-max) of pitavastatin was slightly higher than in the control phase (48.6 +/- 22.9 ng/mL vs. 42.4 +/- 16.1 ng/mL). However, the overall pharmacokinetic parameters of pitavastatin and pitavastatin lactone during the two study phases were not significantly different. Conclusions: UDCA had no significant effect on the pharmacokinetics of pitavastatin. These results do not support the notion that UDCA increases the systemic exposure of OATP1B1 substrate by inhibiting HNF1 alpha and decreasing OATP1B1 transporter expression.