Population Pharmacokinetics of Tenofovir Alafenamide Fumarate and Its Metabolite Tenofovir in Healthy Chinese Volunteers

Abstract Tenofovir alafenamide fumarate (TAF) is a first‐line drug for treating hepatitis B virus infection. This study aimed to establish the prodrug–metabolite population pharmacokinetic (PK) model for TAF and its metabolite tenofovir (TFV) in healthy Chinese volunteers and evaluate the factors affecting the PK. Using 1043 TAF and 1198 TFV plasma sample concentrations collected from 67 healthy volunteers, a population PK model was developed using the nonlinear mixed‐effects model. The 1‐compartment model containing 4 transit compartments and the 2‐compartment model accurately described the PK of TAF and TFV, respectively. Covariates such as meal state and sex were found to be statistically significant and potentially clinically relevant. Both internal and external validations demonstrated good stability and predictive performance of the connected model. This study elucidated the PK process by which TAF was absorbed, converted, and finally metabolized and eliminated as TFV, and explored the sources of interindividual variability between TAF and TFV.