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维格列汀在健康中国志愿者中的药代动力学和药效学

Pharmacokinetics and pharmacodynamics of vildagliptin in healthy Chinese volunteers.

作者信息

Hu Pei, Yin Qi, Deckert Fabienne, Jiang Ji, Liu Dongyang, Kjems Lise, Dole William P, He Yan-Ling

机构信息

Clinical Pharmacology Research Center, Peking Union Medical College, Peking, China.

出版信息

J Clin Pharmacol. 2009 Jan;49(1):39-49. doi: 10.1177/0091270008325152. Epub 2008 Oct 1.

DOI:10.1177/0091270008325152
PMID:18832295
Abstract

Vildagliptin is an orally effective, potent, and selective inhibitor of dipeptidyl peptidase IV (DPP-4) that improves glycemic control in patients with type 2 diabetes. This was a randomized, double-blind, placebo-controlled, time-lagged, parallel-group study in a total of 60 healthy Chinese participants. Single- and multiple-dose pharmacokinetics and pharmacodynamics, and safety and tolerability of vildagliptin were assessed following administration of 25, 50, 100, or 200 mg qd, or 50 mg bid. Vildagliptin was rapidly absorbed (tmax 1.5-2.0 hours) across the dose range of 25 to 200 mg and was quickly eliminated with a terminal elimination half-life (t1/2) of approximately 2 hours. Consistent with the short t1/2, no accumulation of vildagliptin was observed following the administration of multiple doses (accumulation factors were 1.00-1.05 across the 25- to 200-mg dose range). Vildagliptin AUC and Cmax values increased in an approximately dose-proportional fashion (dose proportionality constant beta 1.00-1.16). Administration of vildagliptin 25 to 200 mg led to rapid and near-complete (>95%) inhibition of DPP-4 activity for at least 4 hours after dosing, which was associated with increases in plasma active glucagon-like peptide-1 of up to 2- to 3-fold compared with placebo. The duration of DPP-4 inhibition increased with dose. Glucose and insulin levels were not affected by vildagliptin in healthy participants, consistent with the fact that the glucose-lowering effects of vildagliptin occur in a glucose-dependent fashion. Vildagliptin was well tolerated at the highest tested dose of 200 mg qd. Vildagliptin 25 to 200 mg qd exhibits approximately dose-proportional pharmacokinetics with no evidence of accumulation after multiple dosing in healthy Chinese participants. Vildagliptin demonstrates potent inhibition of DPP-4 activity with excellent tolerability at doses of up to and including 200 mg qd.

摘要

维格列汀是一种口服有效的、强效且具有选择性的二肽基肽酶IV(DPP - 4)抑制剂,可改善2型糖尿病患者的血糖控制。这是一项针对60名中国健康受试者的随机、双盲、安慰剂对照、时间滞后、平行组研究。在分别给予25、50、100或200 mg每日一次(qd)或50 mg每日两次(bid)后,评估了维格列汀的单剂量和多剂量药代动力学、药效学以及安全性和耐受性。在25至200 mg的剂量范围内,维格列汀吸收迅速(达峰时间tmax为1.5 - 2.0小时),且消除迅速,终末消除半衰期(t1/2)约为2小时。与短t1/2一致,多次给药后未观察到维格列汀蓄积(在25至200 mg剂量范围内蓄积因子为1.00 - 1.05)。维格列汀的AUC和Cmax值以近似剂量比例的方式增加(剂量比例常数β为1.00 - 1.16)。给予25至200 mg维格列汀后,给药后至少4小时内可快速且近乎完全(>95%)抑制DPP - 4活性,与安慰剂相比,这与血浆活性胰高血糖素样肽 - 1升高2至3倍有关。DPP - 4抑制的持续时间随剂量增加。在健康受试者中,维格列汀对血糖和胰岛素水平无影响,这与维格列汀的降糖作用以葡萄糖依赖方式发生这一事实相符。维格列汀在每日最高测试剂量200 mg时耐受性良好。每日25至200 mg维格列汀在健康中国受试者中表现出近似剂量比例的药代动力学,多次给药后无蓄积迹象。维格列汀在高达并包括每日200 mg的剂量下对DPP - 4活性具有强效抑制作用且耐受性良好。

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