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年龄和性别对纤溶酶原激活剂兰替普酶在健康受试者中的药代动力学和药效学的影响。

The effects of age and gender on the pharmacokinetics and pharmacodynamics in healthy subjects of the plasminogen activator, lanoteplase.

机构信息

Bristol-Myers Squibb Research and Development, Princeton, New Jersey 08543-4000, USA.

出版信息

Br J Clin Pharmacol. 2011 Nov;72(5):775-86. doi: 10.1111/j.1365-2125.2011.04003.x.

Abstract

AIMS

To investigate the influence of age and gender on the intravenous pharmacokinetics and pharmacodynamics of the plasminogen activator, lanoteplase.

METHODS

Forty healthy subjects (10 each of young males, elderly males, young females and elderly females) received a single bolus 10 kU kg(-1) intravenous dose of lanoteplase. Plasma from blood serially collected for 24 h post-dose was analyzed for lanoteplase (antigen), fibrinogen, plasminogen and α2-antiplasmin concentrations, plasma plasminogen activation activity (PPAA) and rapid plasminogen activator inhibitor (PAI-1).

RESULTS

Lanoteplase mean total systemic clearance (CL(t)) values ranged from 1.9 to 2.8 l h(-1) and mean steady-state volume of distribution (V(ss)) values ranged from 12.3 to 15.6 l. Age-by-gender interactions were observed for lanoteplase CL(t) (P= 0.04), but no differences were observed for V(ss) or elimination half-life. Elderly females had a 27% lower mean CL(t) than young females (95% CI for the difference 0.17, 1.27 l h(-1)) and 32% lower CL(t) than elderly males (95% CI for the difference 0.15, 1.65 l h(-1)). PPAA AUC/dose values did not show an age-by-gender interaction. Haemostasis parameters indicated only a slight degree of systemic plasminogen activation.

CONCLUSIONS

Elderly females had a lower mean lanoteplase CL(t) than elderly males and young females. However, no difference was observed between young and elderly females for the AUC/dose of PPAA. In addition, there were no age-related or gender-related differences observed in the other pharmacodynamic parameters measured.

摘要

目的

研究年龄和性别对纤溶酶原激活剂拉诺替普酶静脉药代动力学和药效学的影响。

方法

40 名健康受试者(每组 10 名,包括年轻男性、老年男性、年轻女性和老年女性)接受单次 10 kU/kg 静脉推注拉诺替普酶。在给药后 24 小时内连续采集血样,分析拉诺替普酶(抗原)、纤维蛋白原、纤溶酶原和α2-抗纤溶酶浓度、血浆纤溶酶原激活活性(PPAA)和快速纤溶酶原激活抑制剂(PAI-1)。

结果

拉诺替普酶平均总系统清除率(CL(t))值范围为 1.9 至 2.8 l/h,平均稳态分布容积(V(ss))值范围为 12.3 至 15.6 l。年龄与性别对拉诺替普酶 CL(t)存在相互作用(P=0.04),但 V(ss)或消除半衰期无差异。老年女性的平均 CL(t)比年轻女性低 27%(差异的 95%置信区间为 0.17,1.27 l/h),比老年男性低 32%(差异的 95%置信区间为 0.15,1.65 l/h)。PPAA AUC/剂量值无年龄与性别相互作用。止血参数仅表明有轻微的全身纤溶酶原激活。

结论

老年女性的平均拉诺替普酶 CL(t)低于老年男性和年轻女性。然而,在 PPAA AUC/剂量方面,年轻女性与老年女性之间没有差异。此外,在测量的其他药效学参数方面,没有观察到年龄相关或性别相关的差异。

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