ABSTRACT:In vitro intrinsic metabolic clearance (CL int ) is used routinely for compound selection in drug discovery; however, in vitro CL int often underpredicts in vivo clearance (CL). Forty-one proprietary compounds and 16 marketed drugs were selected to determine whether permeability and efflux status could influence the predictability of CL from in vitro CL int obtained from liver microsomal and hepatocyte incubations. For many of the proprietary compounds examined, rat CL was significantly underpredicted using the well stirred model incorporating both fraction of unbound drug in blood and fraction of unbound drug in the microsomal or hepatocyte incubation. Further analysis revealed that the accuracy of the prediction was differentiated by permeability and P-glycoprotein-(Pgp) and mouse breast cancer resistance protein (mBcrp)-mediated efflux. For proprietary compounds with passive permeability greater than 5 ؋ 10 ؊6 cm/s and efflux ratios less than 5 in both P-gp-and mBcrp-expressing cells, CL int provided reasonable prediction. The average -fold error (AFE) was 1.8 for rat liver microsomes (RLMs) and 2.3 for rat hepatocytes. In contrast, CL was dramatically underpredicted for compounds with passive permeability less than 5 ؋ 10 ؊6 cm/s; AFEs of 54.4 and 29.2 were observed for RLM and rat hepatocytes, respectively. In vivo CL was also underpredicted for compounds that were good efflux substrates (permeability >5 ؋ 10 ؊6 cm/s). The AFEs were 7.4 and 8.1for RLM and rat hepatocytes, respectively. A similar relationship between permeability, efflux status, and human CL prediction reported in the literature was observed for 16 marketed drugs. These data show that permeability and efflux status are determinants for the predictability of CL from in vitro metabolic CL int .In vitro metabolic clearance (CL int ) derived from liver microsomal incubations is used routinely to aid compound selection in drug discovery. Hepatocytes, which possess intact cellular membranes, complete enzymatic systems, and cofactors, have also become a common option for determination of CL int . Successful prediction of in vivo clearance (CL) from CL int in liver microsomes or hepatocytes has been reported for some compounds. Obach (1999) reported that CL was predicted within a 2-fold error for 16 of 29 compounds from CL int in human liver microsomes using the well stirred model incorporating both fraction of unbound drug in blood (fu b ) and fraction of unbound drug in the microsomal or hepatocyte incubation (fu inc ).Likewise, CL int from human hepatocytes provided prediction within a 2-fold error for 11 of 37 (Brown et al., 2007) or 23 of 56 compounds (Riley et al., 2005). However, a tendency toward underprediction was observed for many drugs (Obach, 1999;Ito and Houston, 2004;Riley et al., 2005;Brown et al., 2007;Stringer et al., 2008). Marked underprediction of CL from in vitro metabolic CL int in humans and/or animals has been reported for compounds such as montelukast, troglitazone, and quinotolast (Naritomi et al., 2001(Naritomi e...