Houston A C, Stevens L A, Cour V
Quintiles (UK) Ltd, Bracknell.
Br J Clin Pharmacol. 1999 Mar;47(3):279-84. doi: 10.1046/j.1365-2125.1999.00888.x.
The aim of this open, randomised, crossover, parallel-group study was to compare the pharmacokinetics and neutrophil responses of lenograstim when administered subcutaneously (s.c.) and intravenously (i.v.).
A total of 27 healthy male volunteers was recruited. Lenograstim doses (0.5, 2, 5, or 10 microg kg(-1)) were administered s.c. or i.v. once-daily for 5 days, and then, after a 10-day washout period, vice versa for a further 5 days. Lenograstim concentrations and absolute neutrophil counts (ANCs) were measured predosing and postdosing on days 1 and 5.
Maximum serum concentrations of lenograstim were higher following i.v. dosing (mean 5.2-185.5 vs 0.7-30.0 ng ml(-1) after s.c. dosing on day 1) and attained sooner (median 0.5-0.8 vs 4.7-8.7 h on day 1). However, apparent elimination half-lives of lenograstim were longer following s.c. dosing (mean 2.3-3.3 vs 0.8-1.2 h after i.v. dosing on days 1 and 5). ANCs increased in a dose-dependent manner with both routes of lenograstim, but more prolonged rises and higher ANC peaks were attained following s.c. doses. ANCs peaked on day 6 following 5 microg kg(-1) s.c. doses (mean peak=26.3x10(9) cells l(-1)), but on day 2 after 5 microg kg(-1) i.v. doses (mean peak = 12.4 x 10(9) cells l(-1)). Irrespective of route, the most common adverse events were headaches and back/spine pain; at doses of up to 5 microg kg(-1) these were mild and generally well tolerated.
While supporting the use of both s.c. and i.v. administered lenograstim to treat neutropenia, these results demonstrate that neutrophil responses are more sustained and prolonged with the s.c. route.
本开放性、随机、交叉、平行组研究旨在比较皮下注射(s.c.)和静脉注射(i.v.)来格司亭的药代动力学及中性粒细胞反应。
共招募了27名健康男性志愿者。来格司亭剂量(0.5、2、5或10μg kg⁻¹)经皮下或静脉注射,每日1次,共5天,然后经过10天的洗脱期后,换用另一种给药方式再持续5天。在第1天和第5天给药前及给药后测量来格司亭浓度和绝对中性粒细胞计数(ANCs)。
静脉注射给药后,来格司亭的最大血清浓度更高(第1天皮下注射后平均为5.2 - 185.5 ng ml⁻¹,静脉注射后为0.7 - 30.0 ng ml⁻¹)且达到峰值的时间更快(第1天皮下注射的中位数为4.7 - 8.7小时,静脉注射为0.5 - 0.8小时)。然而,皮下注射后来格司亭的表观消除半衰期更长(第1天和第5天静脉注射后平均为0.8 - 1.2小时,皮下注射后为2.3 - 3.3小时)。两种给药途径的来格司亭均使ANCs呈剂量依赖性增加,但皮下注射剂量后ANCs升高持续时间更长且峰值更高。皮下注射5μg kg⁻¹剂量后,ANCs在第6天达到峰值(平均峰值 = 26.3×10⁹细胞/升),而静脉注射5μg kg⁻¹剂量后在第2天达到峰值(平均峰值 = 12.4×10⁹细胞/升)。无论给药途径如何,最常见的不良事件是头痛和背部/脊柱疼痛;在剂量高达5μg kg⁻¹时,这些症状较轻且一般耐受性良好。
虽然支持皮下注射和静脉注射来格司亭治疗中性粒细胞减少症,但这些结果表明皮下注射途径的中性粒细胞反应更持久。