Mallalieu Navita L, Lennon Siân, Guy Thorold, Liu Mei, Luedin Eric, Davies Brian E
Department of Clinical Pharmacology, Roche, Nutley, NJ 07110, USA.
Br J Clin Pharmacol. 2009 Apr;67(4):469-72. doi: 10.1111/j.1365-2125.2009.03367.x.
To investigate the effect of age and gender on the tolerability, safety and pharmacokinetics (PK) of tomopenem (RO4908463/CS-023), a novel carbapenem antibiotic, and its major metabolite.
Forty-two subjects were assigned to one of the following three groups: young men, elderly men and elderly women. The PK, safety and tolerability of an intravenous infusion of 1500 mg tomopenem and its resultant major metabolite (open beta-lactam ring) were assessed.
Minor differences in exposure of both tomopenem and the major metabolite were seen. The area under the curve (AUC) of tomopenem was 22% higher in elderly men compared with young men, and 19% higher in elderly women relative to the elderly men. Total clearance of tomopenem decreased with decreasing creatinine clearance. In the two male groups, renal clearance values of tomopenem were similar (3.52 and 3.67 l h(-1)) and higher than in the elderly female group (2.83 l h(-1)). The mean half-lives ranged from 2.03 (healthy young men) to 2.41 h (elderly men). The difference in AUC of tomopenem can be explained by differences in the mean creatinine clearances of 116 (young men), 101 (elderly men) and 84.7 (elderly women) ml min(-1) 1.73 m(-2), respectively.
While some PK parameters were statistically different among the three groups, the differences were mostly minor and unlikely to be clinically meaningful. The difference in the PK can be largely attributed to the difference in creatinine clearance of these groups.
研究年龄和性别对新型碳青霉烯类抗生素托莫培南(RO4908463/CS-023)及其主要代谢产物的耐受性、安全性和药代动力学(PK)的影响。
42名受试者被分为以下三组之一:年轻男性、老年男性和老年女性。评估了静脉输注1500 mg托莫培南及其产生的主要代谢产物(开放β-内酰胺环)的PK、安全性和耐受性。
托莫培南及其主要代谢产物的暴露量存在细微差异。与年轻男性相比,老年男性中托莫培南的曲线下面积(AUC)高22%,相对于老年男性,老年女性中高19%。托莫培南的总清除率随肌酐清除率降低而下降。在两个男性组中,托莫培南的肾清除率值相似(3.52和3.67 l h⁻¹),高于老年女性组(2.83 l h⁻¹)。平均半衰期范围为2.03(健康年轻男性)至2.41 h(老年男性)。托莫培南AUC的差异可分别由平均肌酐清除率116(年轻男性)、101(老年男性)和84.7(老年女性)ml min⁻¹ 1.73 m⁻²的差异来解释。
虽然三组之间的一些PK参数在统计学上存在差异,但差异大多较小,不太可能具有临床意义。PK的差异在很大程度上可归因于这些组肌酐清除率的差异。