聚乙二醇化尿酸酶在高尿酸血症和治疗失败痛风患者中的群体药代动力学和药效学分析
Population pharmacokinetic and pharmacodynamic analysis of pegloticase in subjects with hyperuricemia and treatment-failure gout.
作者信息
Yue Corinne Seng, Huang William, Alton Michelle, Maroli Allan N, Waltrip Royce W, Wright David, Marco Marika Di
机构信息
Université de Montréal, Faculté de pharmacie, Pavillon Jean Coutu, 2940 Chemin de la polytechnique, Montreal, Quebec, H3T 1J4 Canada.
出版信息
J Clin Pharmacol. 2008 Jun;48(6):708-18. doi: 10.1177/0091270008317589. Epub 2008 Apr 16.
Pegloticase is designed to convert urate into the easily excretable allantoin to treat hyperuricemia in gout. The aim of this analysis was to describe the pharmacokinetics and pharmacodynamics of pegloticase in 40 gout patients. Pegloticase was administered as intravenous infusions every 2 weeks at 4- and 8-mg doses or every 4 weeks at 8- or 12-mg doses for 12 weeks. Serum pegloticase concentrations, plasma urate, and serum antibody response were determined. Population pharmacokinetics and pharmacodynamics analyses were performed. Data were modeled simultaneously, and covariates were investigated (age, gender, race, body weight, ideal body weight, and antibody response). The dosing regimens to maintain uric acid levels below the therapeutic target of 6 mg/dL were then predicted by the model. The pharmacokinetics were best described by a 1-compartment linear model, while the pharmacodynamics model was fitted as a direct effect of pegloticase on uric acid concentrations with a suppressive maximum effect attributed to drug (E(max)) function. Pegloticase suppressed uric acid levels up to 83%. Weight only affected clearance and volume of distribution. No covariates affected pharmacodynamics. Simulation suggests pegloticase administered at 8 mg every 2 or 4 weeks as 2-hour intravenous infusions will maintain uric acid levels well under 6 mg/dL.
聚乙二醇尿酸酶旨在将尿酸转化为易于排泄的尿囊素,以治疗痛风中的高尿酸血症。本分析的目的是描述聚乙二醇尿酸酶在40例痛风患者中的药代动力学和药效学。聚乙二醇尿酸酶每2周静脉输注一次,剂量为4毫克和8毫克,或每4周静脉输注一次,剂量为8毫克或12毫克,共12周。测定血清聚乙二醇尿酸酶浓度、血浆尿酸和血清抗体反应。进行群体药代动力学和药效学分析。对数据进行同时建模,并研究协变量(年龄、性别、种族、体重、理想体重和抗体反应)。然后通过该模型预测将尿酸水平维持在6毫克/分升治疗目标以下的给药方案。药代动力学最好用单室线性模型描述,而药效学模型拟合为聚乙二醇尿酸酶对尿酸浓度的直接作用,并具有归因于药物的最大抑制效应(E(max))函数。聚乙二醇尿酸酶可将尿酸水平抑制高达83%。体重仅影响清除率和分布容积。没有协变量影响药效学。模拟表明,每2或4周静脉输注2小时给予8毫克聚乙二醇尿酸酶将使尿酸水平维持在6毫克/分升以下。