Ye Min, Wang Lu, Fu Qiang, Zhu Zhu, Li Peng, Li Taisheng
Department of Pharmacy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences-Peking Union Medical College, Beijing, China.
HIV Clin Trials. 2010 Jul-Aug;11(4):230-7. doi: 10.1310/hct1104-230.
The present study aimed to compare the pharmacokinetics of lamivudine in 300 mg once-daily and 150 mg twice-daily dosing regimens in HIV-infected Chinese patients.
HIV-infected patients received lamivudine 300 mg once daily or 150 mg twice daily as part of a highly active antiretroviral therapy regimen. After the patients received lamivudine for at least 3 months, serial blood samples were collected for 24 hours. The samples were measured by a validated high-performance liquid chromatography (HPLC) assay. The pharmacokinetics of once-daily versus twice-daily dosing was evaluated by noncompartment models.
Ten patients received lamivudine 300 mg once daily and 5 patients received 150 mg twice daily. The C(max) was significantly higher in the once-daily arm than the twice-daily arm (2.23 vs 1.61 μg/mL, P <.05), whereas the C(min) was markedly lower (0.05 vs 0.12 μg/mL, P <.05). The half-lives were 3.32 hours and 2.62 hours, and AUC₂₄ values were 11.8 μg/mL·h and 13.0 μg/mL·h in the 300 mg once-daily and 150 mg twice-daily regimens, respectively (P >.05).
The shorter half-life was observed first in Chinese HIV patients with once- and twice-daily regimens. The 300 mg once-daily regimen was associated with lower trough concentrations and remarkable interpatient variability. Further studies in large groups of HIV patients are needed to confirm the influence of shorter half-lives in Chinese patients on efficacy and toxicity.
本研究旨在比较拉米夫定在每日一次300mg和每日两次150mg给药方案下,在感染HIV的中国患者中的药代动力学。
感染HIV的患者接受拉米夫定每日一次300mg或每日两次150mg,作为高效抗逆转录病毒治疗方案的一部分。患者接受拉米夫定至少3个月后,连续采集24小时血样。样本通过经过验证的高效液相色谱(HPLC)测定法进行测量。通过非房室模型评估每日一次与每日两次给药的药代动力学。
10名患者接受每日一次300mg拉米夫定,5名患者接受每日两次150mg拉米夫定。每日一次给药组的C(max)显著高于每日两次给药组(2.23对1.61μg/mL,P<.05),而C(min)明显更低(0.05对0.12μg/mL,P<.05)。300mg每日一次和150mg每日两次给药方案的半衰期分别为3.32小时和2.62小时,AUC₂₄值分别为11.8μg/mL·h和13.0μg/mL·h(P>.05)。
在中国HIV患者的每日一次和每日两次给药方案中,首次观察到较短的半衰期。每日一次300mg给药方案与较低的谷浓度和显著的患者间变异性相关。需要在大量HIV患者中进行进一步研究,以确认中国患者较短半衰期对疗效和毒性的影响。