Lentz Kimberley A
Pharmaceutical Candidate Optimization: Metabolism and Pharmacokinetics, Bristol-Myers Squibb Research and Development, 5 Research Parkway, Wallingford, CT, 06492-7660, USA.
AAPS J. 2008 Jun;10(2):282-8. doi: 10.1208/s12248-008-9025-8. Epub 2008 May 24.
Food can impact the pharmacokinetics of a drug product through several mechanisms, including but not limited to, enhancement in drug solubility, changes in GI physiology, or direct interaction with the drug. Significant food effects complicate development of new drugs, especially when clinical plans require control and/or monitoring of food intake in relation to dosing. The prediction of whether a drug or drug product will show a human food effect is challenging. In vitro models which consider physical-chemical properties can classify the potential for a compound to demonstrate a positive, negative or no food effect, and may be appropriate for screening compounds at early stages of drug discovery. When comparing various formulations, dissolution tests in biorelevant media can serve as a predictor of human drug performance under fasted and fed conditions. Few in vivo models exist which predict the magnitude of change in pharmacokinetic parameters in humans when dosing in the presence of food, with the dog appearing to be the most studied species for this purpose. Control of gastric pH, as well as the amount and composition of the fed state in dogs are critical parameters to improving the predictability of the dog overall as a food effect model. No single universal model is applicable for all drugs at all stages of drug development. One or more models may be required depending whether the goal is to assess potential for a food effect, determine the magnitude of change in pharmacokinetic parameters in the fed/fasted state, or whether formulation efforts have the ability to mitigate an observed food effect.
食物可通过多种机制影响药物产品的药代动力学,包括但不限于提高药物溶解度、改变胃肠道生理功能或与药物直接相互作用。显著的食物效应会使新药的研发变得复杂,尤其是当临床方案要求控制和/或监测与给药相关的食物摄入量时。预测一种药物或药物产品是否会显示人体食物效应具有挑战性。考虑物理化学性质的体外模型可以对化合物表现出正向、负向或无食物效应的可能性进行分类,并且可能适用于在药物发现的早期阶段筛选化合物。在比较各种制剂时,在生物相关介质中的溶出度测试可以作为预测人体在禁食和进食条件下药物性能的指标。很少有体内模型能够预测在进食情况下给药时人体药代动力学参数变化的幅度,狗似乎是为此目的研究最多的物种。控制狗的胃pH值以及进食状态的量和组成是提高狗作为食物效应模型总体预测能力的关键参数。没有一个单一的通用模型适用于药物研发的所有阶段和所有药物。根据目标是评估食物效应的可能性、确定进食/禁食状态下药代动力学参数的变化幅度,还是制剂研发是否有能力减轻观察到的食物效应,可能需要一个或多个模型。