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A multi-compartment single and multiple dose pharmacokinetic comparison of rectally applied tenofovir 1% gel and oral tenofovir disoproxil fumarate

Yang, KH and Hendrix, C and Bumpus, N and Elliott, J and Tanner, K and Mauck, C and Cranston, R and McGowan, I and Richardson-Harman, N and Anton, PA and Kashuba, ADM (2014) A multi-compartment single and multiple dose pharmacokinetic comparison of rectally applied tenofovir 1% gel and oral tenofovir disoproxil fumarate. PLoS ONE, 9 (10).

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Abstract

© 2014 Yang et al. This Phase 1, randomized, two-site (United States), double-blind, placebo-controlled study enrolled 18 sexually abstinent men and women. All received a single 300-mg dose of oral tenofovir disoproxil fumarate (TDF) and were then randomized 2:1 to receive single and then seven daily rectal exposures of vaginally-formulated tenofovir (TFV) 1% gel or a hydroxyethyl cellulose (HEC) placebo gel. Blood, colonic biopsies and rectal and vaginal mucosal fluids were collected after the single oral TDF, the single topical TFV gel dose, and after 7 days of topical TFV gel dosing for extracellular analysis of TFV and intracellular analysis of the active metabolite tenofovir diphosphate (TFVdp) in peripheral blood mononuclear cells (PBMCs) and isolated mucosal mononuclear cells (MMC), including CD4+ and CD4- cell subsets. With a single rectal dose, TFV plasma concentrations were 24-33 fold lower and half-life was 5 h shorter compared to a single oral dose (p = 0.02). TFVdp concentrations were also undetectable in PBMCs with rectal dosing. Rectal tissue exposure to both TFV and TFVdp was 2 to 4-log10 higher after a single rectal dose compared to a single oral dose, and after 7 daily doses, TFVdp accumulated 4.5 fold in tissue. TFVdp in rectal tissue homogenate was predictive (residual standard error, RSE = 0.47) of tissue MMC intracellular TFVdp concentration, with the CD4+ cells having a 2-fold higher TFVdp concentration than CD4- cells. TFV concentrations from rectal sponges was a modest surrogate indicator for both rectal tissue TFV and TFVdp (RSE = 0.67, 0.66, respectively) and plasma TFV (RSE = 0.38). TFV penetrates into the vaginal cavity after oral and rectal dosing, with rectal dosing leading to higher vaginal TFV concentrations (p<0.01).


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Yang, KH
Hendrix, C
Bumpus, N
Elliott, J
Tanner, K
Mauck, C
Cranston, Rrdc27@pitt.eduRDC27
McGowan, Iimcgowan@pitt.eduIMCGOWAN
Richardson-Harman, N
Anton, PA
Kashuba, ADM
Contributors:
ContributionContributors NameEmailPitt UsernameORCID
EditorWinston, AlanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Date: 28 October 2014
Date Type: Publication
Journal or Publication Title: PLoS ONE
Volume: 9
Number: 10
DOI or Unique Handle: 10.1371/journal.pone.0106196
Schools and Programs: School of Medicine > Medicine
Refereed: Yes
Other ID: NLM PMC4211672
PubMed Central ID: PMC4211672
PubMed ID: 25350119
Date Deposited: 12 May 2015 18:27
Last Modified: 02 Feb 2019 16:58
URI: http://d-scholarship.pitt.edu/id/eprint/24038

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