Albany Medical College Neurology Group, 47 New Scotland Avenue, MC 70, Physicians Pavilion, 1st Floor, Albany, NY 12208, USA.
Expert Opin Drug Deliv. 2012 Sep;9(9):1147-60. doi: 10.1517/17425247.2012.709231. Epub 2012 Jul 18.
Gabapentin immediate-release formulations (G-IR) administered three times a day is an efficacious treatment for postherpetic neuralgia (PHN), but its potential benefits may not be fully realized due to tolerability issues as well as its pharmacokinetic (PK) properties such as its short half-life, and regional and saturable absorption in the proximal small intestine. The gastroretentive once-daily formulation of gabapentin (G-GR) allows for less frequent dosing while maintaining efficacy and may also reduce adverse events (AEs) associated with high plasma concentration of gabapentin occurring during the waking hours. G-GR slowly releases the drug from the tablet to the upper small intestine, where gabapentin is best absorbed, over approximately 10 h.
This report reviews the development of the gastroretentive technology used in the once-daily formulation of gabapentin (G-GR), and describes the clinical development of G-GR from PK studies through the Phase III efficacy and safety studies, with comparisons made with G-IR.
The technology takes advantage of the normal physiology of the stomach in the fed state to provide gastroretention, which in turn allows for gradual release of the active ingredient over several hours to the small intestine where gabapentin is best absorbed. The GR technology used in G-GR resulted in a decreased dosing frequency from three times per day for the IR product to once daily in the treatment of PHN, while maintaining the same efficacy with an apparent reduced incidence of AEs common to G-IR therapy.
每日三次服用即释型加巴喷丁(G-IR)是治疗疱疹后神经痛(PHN)的有效方法,但由于其耐受性问题以及药代动力学(PK)特性,如半衰期短、在近端小肠的区域和饱和吸收等,其潜在益处可能无法完全实现。加巴喷丁的胃滞留型每日一次制剂(G-GR)允许减少给药频率,同时保持疗效,还可能减少与加巴喷丁在清醒时间内血浆浓度高相关的不良反应(AE)。G-GR 从片剂缓慢释放药物到上小肠,加巴喷丁在那里吸收最好,大约 10 小时。
本报告回顾了用于加巴喷丁每日一次制剂(G-GR)的胃滞留技术的开发,并描述了从 PK 研究到 III 期疗效和安全性研究的 G-GR 的临床开发,与 G-IR 进行了比较。
该技术利用进食状态下胃的正常生理学提供胃滞留,从而使活性成分在数小时内逐渐释放到小肠,加巴喷丁在小肠中吸收最好。用于 G-GR 的 GR 技术使 IR 产品的每日给药频率从三次减少到治疗 PHN 的每日一次,同时保持相同的疗效,明显减少了 G-IR 治疗常见的 AE。