Department of Clinical Pharmacology, F. Hoffmann-La Roche Ltd, Basel, Switzerland.
Br J Clin Pharmacol. 2010 Dec;70(6):825-33. doi: 10.1111/j.1365-2125.2010.03763.x.
Dalcetrapib, which targets cholesteryl ester transfer protein activity, is in development for prevention of cardiovascular events. Because dalcetrapib will likely be prescribed with other lipid-modifying therapies such as ezetimibe, a study was performed to investigate potential pharmacokinetic interactions between dalcetrapib and ezetimibe. Lipids changes and tolerability were secondary endpoints.
Co-administration of dalcetrapib 900 mg (higher than the phase III dose) with ezetimibe was investigated in a three period, three treatment crossover study in healthy males: 7 days of dalcetrapib, 7 days of dalcetrapib plus ezetimibe, 7 days of ezetimibe alone. A full pharmacokinetic profile was performed on day 7 of each treatment.
Co-administration of dalcetrapib with ezetimibe was associated with minimal changes in dalcetrapib exposure compared with dalcetrapib alone. Least squares mean ratio (LSMR) (90% confidence interval) was 93.6 (87.1, 100.7) for AUC(0,24 h) and 99.0 (85.2, 115.0) for C(max) . Ezetimibe exposure was reduced with co-administration of ezetimibe with dalcetrapib compared with ezetimibe alone: LSMR 80.3 (74.6, 86.4) for AUC(0,24 h) and 88.9 (80.9, 99.9) for C(max) for total ezetimibe. High-density lipoprotein cholesterol increases associated with co-administration of dalcetrapib with ezetimibe (+29.8%) were comparable with those with dalcetrapib alone (+25.6%), while the reduction in low-density lipoprotein cholesterol with co-administration (-35.9%) was greater than with ezetimibe alone (-20.9%). Dalcetrapib was generally well tolerated when administered alone and when co-administered with ezetimibe.
Co-administration of dalcetrapib with ezetimibe was not associated with clinically significant changes in pharmacokinetic parameters or tolerability and did not diminish the lipid effects of either drug.
达塞曲匹(Dalcetrapib)靶向胆固醇酯转移蛋白活性,目前正处于预防心血管事件的开发阶段。由于达塞曲匹可能与依折麦布等其他调脂治疗药物联合使用,因此进行了一项研究,以调查达塞曲匹与依折麦布之间潜在的药代动力学相互作用。血脂变化和耐受性为次要终点。
在一项三周期、三治疗交叉的健康男性研究中,共评估了达塞曲匹 900mg(高于 III 期剂量)与依折麦布联合使用的情况:达塞曲匹 7 天,达塞曲匹加依折麦布 7 天,单独使用依折麦布 7 天。在每个治疗的第 7 天进行了全面的药代动力学评估。
与单独使用达塞曲匹相比,达塞曲匹与依折麦布联合使用时,达塞曲匹的暴露量变化很小。AUC(0-24h)的最小二乘均值比(LSMR)(90%置信区间)为 93.6(87.1,100.7),C(max)为 99.0(85.2,115.0)。与单独使用依折麦布相比,达塞曲匹与依折麦布联合使用时依折麦布的暴露量降低:AUC(0-24h)的 LSMR 为 80.3(74.6,86.4),C(max)为 88.9(80.9,99.9)。达塞曲匹与依折麦布联合使用时,高密度脂蛋白胆固醇升高(+29.8%)与单独使用达塞曲匹时相当(+25.6%),而联合使用时低密度脂蛋白胆固醇降低(-35.9%)大于单独使用依折麦布时(-20.9%)。达塞曲匹单独使用或与依折麦布联合使用时通常耐受性良好。
达塞曲匹与依折麦布联合使用不会导致药代动力学参数或耐受性发生有临床意义的变化,也不会减弱两种药物的降脂作用。