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通过不同的多中心VIII因子活性测定法对两种巴氏灭菌VIII因子浓缩剂的药代动力学研究

Pharmacokinetics of two pasteurized factor VIII concentrates by different and multicenter assays of factor VIII activity.

作者信息

Messori A, Morfini M, Blomback M, Cinotti S, Longo G, Schimpf K, Schumacher K, Novakova-Banet A, Delvos U, Kjellman H

机构信息

Hematology Depart. & Hemophilia Center, USL 10/D, Florence, Italy.

出版信息

Thromb Res. 1992 Mar 15;65(6):699-708. doi: 10.1016/0049-3848(92)90109-n.

Abstract

We assessed the pharmacokinetic characteristics of a new high-purity pasteurized FVIII concentrate in comparison with an intermediate purity pasteurized concentrate, produced by the same manufacturer. The study was designed as a cross-over single-dose pharmacokinetic investigation in 8 non-bleeding patients with severe hemophilia A. All patients were given 25 IU/kg of each of the two concentrates, with an interval of at least one week between the two administrations. Decay curves were assessed by collecting 10 serial blood samples over 36 hours following the end of infusion. The concentration of Factor VIII in blood samples was determined in triplicate in three different laboratories using each of the following assay methods: a one-stage clotting assay, a two-stage clotting assay, and a two-stage chromogenic-peptide substrate assay. All pharmacokinetic parameters were calculated by model-independent methods. The two products were found to differ significantly both in the clearance, which was on average 13.8% lower for Haemate P, and in the in-vivo recovery, which was 11.7% lower for Factor VIII:C P on the average. In comparison with previous pharmacokinetic data obtained from other heated Factor VIII concentrates, the clearance of Haemate P was found to be significantly slower, while the half-life of both products was longer. No differences were observed in the Vd-area. These findings indicate that the purification procedures to which both products are subjected do not increase the in-vivo rate of plasma disappearance of Factor VIII.

摘要

我们评估了一种新型高纯度巴氏灭菌FVIII浓缩物与同一制造商生产的中等纯度巴氏灭菌浓缩物相比的药代动力学特征。该研究设计为一项交叉单剂量药代动力学研究,纳入8名非出血性重度A型血友病患者。所有患者均接受两种浓缩物各25 IU/kg的剂量,两次给药间隔至少一周。在输注结束后的36小时内采集10份连续血样,评估衰减曲线。血样中凝血因子VIII的浓度在三个不同实验室中,使用以下每种测定方法一式三份进行测定:一步凝血测定法、两步凝血测定法和两步显色肽底物测定法。所有药代动力学参数均通过非模型依赖方法计算。发现这两种产品在清除率方面有显著差异,Haemate P的清除率平均低13.8%,在体内回收率方面也有显著差异,VIII因子:C P的体内回收率平均低11.7%。与先前从其他加热的VIII因子浓缩物获得的药代动力学数据相比,发现Haemate P的清除率明显较慢,而两种产品的半衰期均较长。在Vd-面积方面未观察到差异。这些发现表明,两种产品所采用的纯化程序并未提高VIII因子在体内的血浆消失率。

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