Stempak Diana, Gammon Janet, Klein Julia, Koren Gideon, Baruchel Sylvain
New Agents and Innovative Therapy Program, Divisions of Hematology/Oncology and Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Toronto, Ontario, Canada.
Clin Pharmacol Ther. 2002 Nov;72(5):490-7. doi: 10.1067/mcp.2002.129322.
Celecoxib is a member of a novel group of agents that selectively inhibit cyclooxygenase 2 (COX-2). COX-2 inhibitors have emerged as an important class of drugs because of the lower incidence of side effects when compared with traditional nonsteroidal anti-inflammatory drugs, which inhibit both cyclooxygenase 1 and COX-2. Because children often differ from adults with respect to drug disposition, the objective of this study was to determine the single-dose and steady-state pharmacokinetics of celecoxib in pediatric patients.
Celecoxib plasma concentrations were determined at intervals over 12 hours after a 250-mg/m(2) dose and again 1 week later after twice-daily dosing (steady state).
Peak plasma concentrations (1234 +/- 528 microg/L) were achieved 3 hours after drug administration. The area under the celecoxib plasma concentration-time curve was 7709 +/- 3176 microg/L x h, the elimination half-life (t(1/2)) was 3.7 +/- 1.1 hours, the apparent volume of distribution was 7.9 +/- 7.8 L/kg, and the lower oral clearance of the drug was 1.4 +/- 1.0 L x h(-1) x kg(-1). Statistical analysis revealed a significantly lower [corrected] apparent oral clearance and longer t(1/2) (P <.05) at steady state compared with pharmacokinetics after a single dose. In addition, when the results were compared in children and adults, the drug was cleared approximately twice as fast in children and had a t(1/2) that was approximately half as long.
This is the first report of celecoxib pharmacokinetics in children, and the results indicate that there are significant differences between children and adults with respect to celecoxib disposition; hence these data may have implications when dosing schedules are planned for this population.
塞来昔布是一类新型药物中的一员,这类药物可选择性抑制环氧化酶2(COX-2)。与抑制环氧化酶1和COX-2的传统非甾体抗炎药相比,COX-2抑制剂由于副作用发生率较低,已成为一类重要的药物。由于儿童在药物处置方面往往与成人不同,本研究的目的是确定塞来昔布在儿科患者中的单剂量和稳态药代动力学。
在给予250mg/m²剂量后12小时内每隔一段时间测定塞来昔布血浆浓度,1周后在每日两次给药(稳态)后再次测定。
给药后3小时达到血浆峰浓度(1234±528μg/L)。塞来昔布血浆浓度-时间曲线下面积为7709±3176μg/L·h,消除半衰期(t₁/₂)为3.7±1.1小时,表观分布容积为7.9±7.8L/kg,药物口服清除率较低,为1.4±1.0L·h⁻¹·kg⁻¹。统计分析显示,与单剂量药代动力学相比,稳态时表观口服清除率显著降低[校正后],t₁/₂更长(P<.05)。此外,将儿童和成人的结果进行比较时,该药物在儿童体内的清除速度约为成人的两倍,t₁/₂约为成人的一半。
这是关于塞来昔布在儿童体内药代动力学的首次报告,结果表明儿童和成人在塞来昔布处置方面存在显著差异;因此,这些数据在为该人群制定给药方案时可能具有重要意义。