Evidence map›Paper›PMID 22108774›Full record

Trial reportEuropean journal of clinical pharmacology2012

Fluconazole but not the CYP3A4 inhibitor, itraconazole, increases zafirlukast plasma concentrations.

Tiina Karonen, Jouko Laitila, Mikko Niemi, Pertti J Neuvonen, Janne T Backman

Abstract readComparative StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in European journal of clinical pharmacology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.8field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 13 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
  4. Genetic and Epigenetic Components of Aspirin-Exacerbated Respiratory Disease.Immunology and allergy clinics of North America · 2016
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Tiina KaronenDepartment of Clinical Pharmacology, University of Helsinki and HUSLAB, Helsinki University Central Hospital, PO Box 705, FI-00029 Helsinki, Finland.
Jouko Laitila
Mikko Niemi
Pertti J Neuvonen
Janne T Backman
Helsinki University Hospital · FIUniversity of Helsinki · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeZafirlukast is a substrate of cytochrome P450 2C9 (CYP2C9) and cytochrome P450 3A4 (CYP3A4) in vitro, but the role of these enzymes in its metabolism in vivo is unknown. To investigate the contribution of CYP2C9 and CYP3A4 to zafirlukast metabolism, we studied the effects of fluconazole and itraconazole on its pharmacokinetics (PK).

methodsIn a randomized crossover study, 12 healthy volunteers ingested fluconazole 200 mg (first dose 400 mg) once daily, itraconazole 100 mg (first dose 200 mg) twice daily, or placebo twice daily for 5 days, and on day 3, 20 mg zafirlukast. Plasma concentrations of zafirlukast and the antimycotics were measured up to 72 h.

resultsFluconazole increased the total area under the plasma concentration-time curve (AUC) of zafirlukast 1.6-fold [95% confidence interval (CI) 1.3-2.0-fold, P < 0.001), and its peak plasma concentration 1.5-fold (95% CI 1.2-2.0-fold, P < 0.05). Fluconazole did not affect the time of peak plasma concentration or elimination half-life of zafirlukast. None of the zafirlukast PK variables differed significantly from the control in the itraconazole phase; e.g., the ratio to control of the total AUC of zafirlukast was 1.0 (95% CI 0.82-1.2) during the itraconazole phase.

conclusionsFluconazole, but not itraconazole, increases zafirlukast plasma concentrations, strongly suggesting that CYP2C9 but not CYP3A4 participates in zafirlukast metabolism in humans.

Indexed as

Cytochrome P-450 CYP3A InhibitorsAdultAnti-Asthmatic AgentsAntifungal AgentsAryl Hydrocarbon HydroxylasesBiotransformationCross-Over StudiesCytochrome P-450 CYP2C19Cytochrome P-450 CYP2C9Cytochrome P-450 CYP3ADrug InteractionsEnzyme InhibitorsFemaleFluconazoleGenetic Association StudiesHalf-LifeAnti-Asthmatic AgentsAntifungal AgentsAryl Hydrocarbon HydroxylasesCYP2C19 protein, humanCYP2C9 protein, humanCYP3A4 protein, humanCytochrome P-450 CYP2C19Cytochrome P-450 CYP2C9Cytochrome P-450 CYP3ACytochrome P-450 CYP3A InhibitorsEnzyme InhibitorsFluconazolehydroxyitraconazoleIndolesItraconazoleLeukotriene AntagonistsPhenylcarbamatesSulfonamidesTosyl Compoundszafirlukast

Identifiers

PMID22108774
OpenAlexW1998224710

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.