Scientific Publications by FDA Staff

J Clin Pharmacol 2017 Feb;57(2):219-29

Effects of SLC22A1 polymorphisms on metformin-induced reductions in adiposity and metformin pharmacokinetics in obese children with insulin resistance.

Sam WJ, Roza O, Hon YY, Alfaro RM, Calis KA, Reynolds JC, Yanovski JA

Steady state population pharmacokinetics of a non-commercial immediate release metformin (hydrochloride) drug product were characterized in 28 severely obese children with insulin resistance. The concentration-time profiles with double peaks were well described by a one-compartment model with two absorption sites. Mean population apparent clearance (CL/F) was 68.1 L/hr and mean apparent volume of distribution (V/F) was 28.8 L. Body weight was a covariate of CL/F and V/F. Estimated glomerular filtration rate was a significant covariate of CL/F (p<0.001). SLC22A1genotype did not significantly affect metformin pharmacokinetics. The response to 6 months of metformin treatment (HbA1c, HOMA IR, fasting insulin, and glucose changes) was not different between SLC22A1 wild type subjects and carriers of presumably low activity SLC22A1 alleles. However, SLC22A1 variant carriers had smaller reductions in percentage of total trunk fat after metformin therapy, although the percentage reduction in trunk fat was small. The median % change in trunk fat was -2.20 % (-9.00 % - 0.900 %) and -1.20 % (-2.40 % - 7.30 %) for the SLC22A1 wild-type subjects and variant carriers, respectively. Future study is needed to evaluate the effects of SLC22A1 polymorphisms on metformin-mediated weight reduction in obese children.