布地奈德和福莫特罗通过1个压力定量吸入器给药在哮喘和慢性阻塞性肺疾病患者中的药代动力学。

Pharmacokinetics of budesonide and formoterol administered via 1 pressurized metered-dose inhaler in patients with asthma and COPD.

作者信息

Tronde Ann, Gillen Michael, Borgström Lars, Lötvall Jan, Ankerst Jaro

机构信息

AstraZeneca R&D Lund, SE-221 87, Lund, Sweden.

出版信息

J Clin Pharmacol. 2008 Nov;48(11):1300-8. doi: 10.1177/0091270008322122.

Abstract

In 3 open-label studies, the systemic bioavailability of budesonide and formoterol administered via pressurized metered-dose inhaler (pMDI) or dry powder inhaler (DPI) formulations was evaluated in asthma (24 children, 55 adults) or chronic obstructive pulmonary disease (COPD; n = 26) patients. Treatments were administered at doses high enough to estimate pharmacokinetic parameters reliably. Two of the studies included an experimental budesonide pMDI formulation. In study 1 (asthma, adults), budesonide area under the curve (AUC) was 32% and 31% lower and maximal budesonide concentration (C(max)) 45% and 56% lower after budesonide/formoterol pMDI and budesonide pMDI versus budesonide DPI. Formoterol AUC and C(max) were 13% and 39% lower after budesonide/formoterol pMDI versus formoterol DPI. In study 2 (asthma, children), budesonide AUC and C(max) were 27% and 41% lower after budesonide/formoterol pMDI versus budesonide DPI + formoterol DPI. In study 3 (COPD/asthma, adults), budesonide AUC and C(max) were similar and formoterol AUC and C(max) 18% and 22% greater after budesonide/formoterol pMDI versus budesonide pMDI + formoterol DPI (COPD). Budesonide and formoterol AUC were 12% and 15% higher in COPD versus asthma patients. In conclusion, systemic exposure generally is similar or lower with budesonide/formoterol pMDI versus combination therapy via separate DPIs or monotherapy and comparable between asthma and COPD patients.

摘要

在3项开放标签研究中,通过压力定量吸入器(pMDI)或干粉吸入器(DPI)制剂给药的布地奈德和福莫特罗的全身生物利用度,在哮喘患者(24名儿童、55名成人)或慢性阻塞性肺疾病(COPD;n = 26)患者中进行了评估。治疗给药剂量高到足以可靠地估计药代动力学参数。其中两项研究纳入了一种实验性布地奈德pMDI制剂。在研究1(哮喘,成人)中,与布地奈德DPI相比,布地奈德/福莫特罗pMDI和布地奈德pMDI给药后,布地奈德曲线下面积(AUC)分别降低32%和31%,布地奈德最大浓度(C(max))分别降低45%和56%。与福莫特罗DPI相比,布地奈德/福莫特罗pMDI给药后,福莫特罗AUC和C(max)分别降低13%和39%。在研究2(哮喘,儿童)中,与布地奈德DPI +福莫特罗DPI相比,布地奈德/福莫特罗pMDI给药后,布地奈德AUC和C(max)分别降低27%和41%。在研究3(COPD/哮喘,成人)中,与布地奈德pMDI +福莫特罗DPI(COPD)相比,布地奈德/福莫特罗pMDI给药后,布地奈德AUC和C(max)相似,福莫特罗AUC和C(max)分别增加18%和22%。与哮喘患者相比,COPD患者的布地奈德和福莫特罗AUC分别高12%和15%。总之,与通过单独的DPI进行联合治疗或单一疗法相比,布地奈德/福莫特罗pMDI的全身暴露通常相似或更低,且在哮喘和COPD患者之间具有可比性。

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