Division of Endocrinology, Medical Center, University of Duisburg-Essen, Essen, Germany.
J Clin Pharmacol. 2012 Jul;52(7):1017-27. doi: 10.1177/0091270011408727. Epub 2011 Jun 14.
Pasireotide is a novel multireceptor-targeted somatostatin analogue that has shown efficacy in patients with acromegaly and Cushing's disease when administered by subcutaneous (SC) injection. This study assessed the safety, tolerability, and pharmacokinetics (PK) of a continuous infusion of pasireotide in healthy volunteers. In this single-center, open-label, dose escalation study, healthy male volunteers received a 7-day continuous SC infusion of pasireotide in sequential ascending-dose cohorts. Single and/or 8-hour blood samples were taken on days 1 to 10 to assess PK and on days 1, 2, and 7 and a control day to assess glucose metabolism. Adverse events were evaluated throughout. Forty-four participants were enrolled into 8 cohorts: pasireotide 450, 900, 1350, 1800 (3 cohorts were enrolled at this dose level), 2250, and 2025 µg/d. Doses were well tolerated up to 2025 µg/d. Adverse events were generally mild and gastrointestinal. Pasireotide steady-state clearance was reduced at high doses, and plasma concentrations increased disproportionately with increasing dose. Blood glucose levels increased after initiation of pasireotide infusion with attenuation by day 7. Insulin and glucagon levels decreased after pasireotide infusion, with insulin levels exhibiting a greater degree of suppression. Pasireotide has the potential to be administered as a long-acting release formulation, and future studies are warranted.
培高利特是一种新型的多受体靶向生长抑素类似物,在接受皮下(SC)注射的肢端肥大症和库欣病患者中显示出疗效。这项研究评估了健康志愿者中培高利特持续输注的安全性、耐受性和药代动力学(PK)。在这项单中心、开放标签、剂量递增研究中,健康男性志愿者连续 7 天接受培高利特 SC 持续输注,按顺序递增剂量组进行。在第 1 天至第 10 天每天采集单次和/或 8 小时血样,以评估 PK,并在第 1、2 和 7 天以及对照日评估葡萄糖代谢。整个过程中评估不良事件。44 名参与者被纳入 8 个队列:培高利特 450、900、1350、1800(3 个队列在该剂量水平上入组)、2250 和 2025µg/d。高达 2025µg/d 的剂量耐受性良好。不良事件通常为轻度和胃肠道。高剂量时培高利特稳态清除率降低,且血浆浓度随剂量不成比例增加。培高利特输注开始后血糖水平升高,第 7 天开始缓解。培高利特输注后胰岛素和胰高血糖素水平下降,胰岛素水平的抑制程度更大。培高利特有可能被开发为长效释放制剂,需要进一步研究。