University of Southern California, Keck School of Medicine, Los Angeles, CA 90089, USA.
Contraception. 2013 Jun;87(6):744-9. doi: 10.1016/j.contraception.2012.10.038. Epub 2012 Dec 8.
AG200-15 Agile Patch (AP) is a novel 7-day contraceptive patch providing ethinyl estradiol (EE) exposure comparable to low-dose combination oral contraceptives. This study determined whether application of the AP to three different anatomical sites (lower abdomen, buttock and upper torso) influences the pharmacokinetic profile of EE and levonorgestrel (LNG).
In this open-label, three-period, crossover study, 24 subjects were randomized to one of six treatment sequences; each included application of patch to abdomen, buttock and upper torso, with the AP worn on one site for 7 days. After a 7-day washout, a new patch was applied to the next anatomical site. Multiple blood samples were collected up to 240 h after patch application.
For plasma EE levels, median time to maximum drug concentration (Tmax, 24-48 h) and mean maximum concentration (Cmax, 47.9-61.5 pg/mL) were similar among application sites. Compared with lower abdomen, EE exposure was higher (16%-30%) at buttock and upper torso (15%-22%). For plasma LNG levels, median Tmax (72-120 h) and mean Cmax (1436-1589 pg/mL) were similar across application sites. Compared with lower abdomen, LNG exposure was higher at buttock (1%-7%) and upper torso (16%-17%). No serious adverse events (AEs) or AE-related discontinuations occurred. The most common treatment-emergent AEs were nausea, application site pruritus and headache, with frequencies comparable across anatomical sites.
Absorption from the abdomen was slightly lower versus other sites; however, exposure to EE and LNG for all sites was therapeutically equivalent. The AP was well tolerated at all three anatomical sites.
AG200-15 号 Agile 补丁(AP)是一种新型的 7 天避孕贴片,提供与低剂量复方口服避孕药相当的炔雌醇(EE)暴露。本研究旨在确定将 AP 贴于三个不同解剖部位(腹部、臀部和上半身)是否会影响 EE 和左炔诺孕酮(LNG)的药代动力学特征。
在这项开放标签、三周期、交叉研究中,24 名受试者随机分为 6 种治疗序列中的一种;每种序列均包括在腹部、臀部和上半身应用贴片,AP 在一个部位贴 7 天。经过 7 天的洗脱期后,在下一个解剖部位应用新的贴片。在贴剂应用后长达 240 小时采集多次血样。
对于血浆 EE 水平,达峰时间(Tmax,24-48 小时)和平均最大浓度(Cmax,47.9-61.5 pg/mL)的中位数在应用部位之间相似。与腹部相比,臀部和上半身(15%-22%)的 EE 暴露量较高(16%-30%)。对于血浆 LNG 水平,Tmax(72-120 小时)和 Cmax(1436-1589 pg/mL)的中位数相似。与腹部相比,臀部(1%-7%)和上半身(16%-17%)的 LNG 暴露量较高。未发生严重不良事件(AE)或与 AE 相关的停药。最常见的治疗后出现的 AE 是恶心、贴剂部位瘙痒和头痛,在各个解剖部位的发生率相当。
与其他部位相比,腹部的吸收略低;然而,所有部位的 EE 和 LNG 暴露量均具有治疗等效性。AP 在所有三个解剖部位均具有良好的耐受性。