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Certara Investor Day Presentation Deck

2021 novel drug approval using Simcyp Simulator Multi-discipline Review for voclosporin Center for Drug Evaluation and Research All simulations were performed using the PK/PD Profiles mode in the Simcyp® Simulator (Version 17 Certara, Sheffield, UK). A scheme of the PBPK simulation strategy is shown in Figure 21, which summarizes the studies used for model development and verification, and model applications in DDI predictions. Simcyp library files of ketoconazole, diltiazem, verapamil and nor- verapamil, fluconazole, fluvoxamine, cimetidine, rifampin MD, efavirenz, rosuvastatin and pravastatin were used for DDI simulations without any modification except that a P-gp Ki of 0.059 M was incorporated into the sim-ketoconazole 400 mg QD file and ketoconazole CL/F was reduced to 3.7 L/h (see comments in the Results section). Simulated concentration-time profiles of voclosporin following difference dosing scenarios in the absence or presence of moderate CYP3A4 inhibitor fluconazole 0.25 mg/kg BID Compared to the Control Blood Concentration (ng/mL) 140 120 100 80 60 40 20 50 Label for drug-drug interaction informed by Simcyp -DRUG INTERACTIONS- . Moderate CYP3A4 inhibitors: Reduce LUPKYNIS daily dosage to 15.8 mg in the morning and 7.9 mg in the evening. (2.5, 7.1, 12.3) . Strong and moderate CYP3A4 inducers: Avoid co-administration. (7.1, 12.3) + Certain P-gp substrates: Reduce dosage of certain P-gp substrates with a narrow therapeutic window when co-administered with LUPKYNIS. (7.2, 12.3) https://www.accessdata.fda.gov/drugsatfda_docs/nda/2021/213716Orig1s000MultidisciplineR.pdf 100 Time (h) 150 38 200 CERTARA
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