title: Effect of brivaracetam on CYP3A activity, measured by oral midazolam.
abstract: Brivaracetam is a synaptic vesicle protein 2A ligand in phase III development for epilepsy. A phase I, open-label, randomized study was conducted in 42 healthy male participants to assess the effect of brivaracetam on CYP3A activity using midazolam as a probe. Participants were randomized to oral brivaracetam 5, 50, or 150 mg/day from Day 8 to Day 14. A single oral dose (7.5 mg) of midazolam was administered on Days 1, 13, and 20, and full pharmacokinetic profiles were obtained. For all brivaracetam doses, the areas under the plasma concentration-time curves from 0 to infinity (AUCinf ) for midazolam and 1'-hydroxymidazolam were similar on Days 13 and 20 compared with Day 1. Following brivaracetam 150 mg/day, the Day 13/Day 1 AUCinf ratio (90% confidence interval) was 1.09 (0.97, 1.21) and 1.04 (0.93, 1.17) for midazolam and 1'-hydroxymidazolam, respectively. For the Day 20/Day 1 comparison, the corresponding AUCinf ratios were 1.10 (0.98, 1.23) and 1.07 (0.97, 1.18). Maximum midazolam plasma concentration was increased on both Day 13 and Day 20 vs. Day 1 but the relevance of this finding was unclear. This study indicates that brivaracetam up to 150 mg/day has no significant inducing or inhibiting effect on CYP3A activity.
authors.affiliation: UCB Pharma, Clinical Pharmacology, Braine-l'Alleud, Belgium.
authors.forename: Armel
authors.initials: A
authors.lastname: Stockis
authors.forename: Shikiko
authors.initials: S
authors.lastname: Watanabe
authors.forename: André J
authors.initials: AJ
authors.lastname: Scheen
mesh_terms: D000293:Adolescent; D000328:Adult; D019540:Area Under Curve; D018592:Cross-Over Studies; D051544:Cytochrome P-450 CYP3A / Q000378:metabolism*; D004305:Dose-Response Relationship, Drug; D004347:Drug Interactions; D006801:Humans; D008297:Male; D008874:Midazolam / Q000031:analogs & derivatives / Q000378:metabolism / Q000493:pharmacokinetics*; D008875:Middle Aged; D011760:Pyrrolidinones / Q000494:pharmacology*; D055815:Young Adult
chemical_list: D011760:Pyrrolidinones; C040081:1-hydroxymethylmidazolam; D051544:Cytochrome P-450 CYP3A; D008874:Midazolam; C482793:brivaracetam
keywords: CYP3A; brivaracetam; interaction; midazolam; pharmacokinetics