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Furthermore, ATSP-7041 inhibited the P-gp and BCRP-mediated efflux of the substrate.134 In addition, a clinically significant DDI was reported in a Phase I study of ALRN-6924, an analog of ATSP-7041 and an inhibitor of OATP1B3.135 A patient co-administered with telmisartan (an OATP1B3 substrate) presented with hypotension, which may have been caused by increased exposure of telmisartan mediated by ATSP-7041.135,136 Based on these findings, CYP- and transporter-mediated DDIs involving peptide drugs are not negligible and should be carefully evaluated

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