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两种霉酚酸酯制剂在稳定期肾移植受者中的比较药代动力学研究。

Comparative pharmacokinetic study of two mycophenolate mofetil formulations in stable kidney transplant recipients.

机构信息

Division of Nephrology and Dialysis, Department of Medicine III, Medical University Vienna, Austria.

出版信息

Transpl Int. 2012 Jun;25(6):680-6. doi: 10.1111/j.1432-2277.2012.01475.x. Epub 2012 Apr 16.

Abstract

We compared steady-state pharmacokinetics of mycophenolate mofetil (MMF) - Myfenax(®) (Teva) and CellCept(®) (Roche) - in stable kidney transplant recipients (KTRs). This was an international, multi-centre, randomized, open-label, two-treatment, two-sequence crossover study with a 3-month follow-up. We included KTRs at least 12 months post-transplantation with stable renal graft function for at least 3 months. The maintenance treatment consisted of MMF in combination with tacrolimus with or without steroids. At the end of the two treatment periods, 6-h or 12-h PK studies of mycophenolic acid (MPA) were performed. A total of 43 patients (mean age: 50.7 ± 13.5 years; 19 females, 24 males) were randomized. Estimates of test to reference ratios (90% CIs) were 0.959 (0.899; 1.023) hμg/ml for AUC((0-tau)) and 0.873 (0.787; 0.968) μg/ml for C(max). Estimates for AUC((0-6h)) were 0.923 (0.865; 0.984) hμg/ml and 0.985 (0.877; 1.106) μg/ml for C(min). Thus, AUC((0-tau)), AUC((0-6h)), and C(min) of MPA were within the predefined margins. C(max) was somewhat outside of these margins in this set of patients. The numbers and types of adverse events were not different between the two treatments. The steady-state pharmacokinetics of MPA as well as adverse events are comparable for Myfenax(®) and CellCept(®) in tacrolimus-treated stable KTRs.

摘要

我们比较了稳定期肾移植受者(KTR)中美法莫替丁(MMF)-Myfenax®(Teva)和 CellCept®(罗氏)的药代动力学。这是一项国际、多中心、随机、开放标签、两治疗、两序列交叉研究,随访 3 个月。我们纳入了移植后至少 12 个月、稳定肾移植功能至少 3 个月的 KTR。维持治疗包括 MMF 联合他克莫司,联合或不联合类固醇。在两个治疗期结束时,进行了 6 小时或 12 小时的霉酚酸(MPA)药代动力学研究。共有 43 名患者(平均年龄:50.7±13.5 岁;19 名女性,24 名男性)被随机分组。试验与参比比值(90%CI)的估计值分别为 AUC(0-tau)为 0.959(0.899;1.023)hμg/ml 和 Cmax 为 0.873(0.787;0.968)μg/ml。AUC(0-6h)的估计值分别为 0.923(0.865;0.984)hμg/ml 和 0.985(0.877;1.106)μg/ml。因此,MPA 的 AUC(0-tau)、AUC(0-6h)和 Cmin 均在预定范围内。该组患者的 Cmax 略超出这些范围。两种治疗方法的不良事件数量和类型无差异。在接受他克莫司治疗的稳定 KTR 中,Myfenax®和 CellCept®的 MPA 稳态药代动力学和不良事件相当。

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