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ABT-594 在糖尿病周围神经性疼痛患者中的群体药代动力学。

Population pharmacokinetics of ABT-594 in subjects with diabetic peripheral neuropathic pain.

机构信息

Department of Clinical Pharmacokinetics and Pharmacodynamics, Abbott, Abbott Park, IL 60064-6104, USA.

出版信息

J Clin Pharm Ther. 2012 Aug;37(4):475-80. doi: 10.1111/j.1365-2710.2011.01325.x. Epub 2011 Dec 7.

Abstract

WHAT IS KNOWN AND OBJECTIVE

ABT-594 is a non-opioid, non-NSAID analgesic. The objective of this work was to characterize the population pharmacokinetics of ABT-594 in subjects with neuropathic pain.

METHODS

Efficacy, safety and pharmacokinetics of ABT-594 in subjects with painful diabetic polyneuropathy were evaluated in a randomized, double-blind, placebo-controlled, parallel-group, multi-centre, 7-week Phase 2 study. Subjects (N=266) were approximately equally divided into four groups to receive BID regimens of placebo or 150, 225 and 300 μg of ABT-594. ABT-594 concentrations were determined from all subjects, whereas a subset of subjects provided intensive pharmacokinetic samples on two occasions. One- and two-compartment models were explored for characterizing plasma ABT-594 concentration-time profiles. The relative importance of covariates (age, weight, body surface area, creatinine clearance, gender, nicotine use and albumin concentrations) was examined by use of the likelihood ratio test. Model building was accomplished using stepwise forward selection (P<0·05) and backward elimination (P<0·005) of covariates. Population analyses were performed using NONMEM.

RESULTS AND DISCUSSION

Optimal characterization of the plasma concentration data was achieved using a one-compartment base model. Creatinine clearance and age were found to be significant covariates in the forward selection process; backward elimination process identified only creatinine clearance as a significant covariate.

WHAT IS NEW AND CONCLUSION

A population pharmacokinetic model was developed to characterize ABT-594 concentrations in subjects with neuropathic pain. As ABT-594 is primarily eliminated as unchanged drug in the urine, creatinine clearance and age were significant covariates of clearance with creatinine clearance being the optimal predictor of ABT-594 clearance.

摘要

已知和目的

ABT-594 是一种非阿片类、非 NSAID 类镇痛药。本研究的目的是描述神经病理性疼痛患者 ABT-594 的群体药代动力学特征。

方法

在一项随机、双盲、安慰剂对照、平行组、多中心、7 周 2 期研究中,评估 ABT-594 对患有痛性糖尿病多发性神经病的患者的疗效、安全性和药代动力学。大约将 266 名患者均等分为四组,分别接受 BID 方案的安慰剂或 150、225 和 300μg ABT-594。从所有受试者中测定 ABT-594 浓度,而部分受试者在两次时提供了强化药代动力学样本。采用单室和双室模型来描述 ABT-594 血浆浓度-时间曲线。采用似然比检验考察协变量(年龄、体重、体表面积、肌酐清除率、性别、吸烟状况和白蛋白浓度)的重要性。采用逐步正向选择(P<0.05)和反向剔除(P<0.005)来建立模型。采用 NONMEM 进行群体分析。

结果与讨论

使用单室基础模型能够最佳地描述血浆浓度数据。在正向选择过程中发现肌酐清除率和年龄是显著的协变量;反向剔除过程仅发现肌酐清除率是显著的协变量。

创新与结论

建立了一个 ABT-594 用于描述神经病理性疼痛患者浓度的群体药代动力学模型。由于 ABT-594 主要以原形药物经尿液排泄,因此肌酐清除率和年龄是清除率的重要协变量,其中肌酐清除率是 ABT-594 清除率的最佳预测因子。

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