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乌美溴铵和维兰特罗单药及联合用药的安全性、耐受性、药效学和药代动力学:一项随机交叉试验。

Safety, tolerability, pharmacodynamics and pharmacokinetics of umeclidinium and vilanterol alone and in combination: a randomized crossover trial.

机构信息

Respiratory Medicines Development Center, GlaxoSmithKline, Research Triangle Park, North Carolina, United States of America.

出版信息

PLoS One. 2012;7(12):e50716. doi: 10.1371/journal.pone.0050716. Epub 2012 Dec 17.

Abstract

UNLABELLED

Umeclidinium bromide (GSK573719; UMEC), a new long-acting muscarinic receptor antagonist (LAMA), is in development with vilanterol (GW642444; VI), a selective long-acting β(2) agonist (LABA), as a once-daily inhaled combination therapy for the treatment of chronic obstructive pulmonary disease (COPD). A single dose healthy volunteer study was conducted to assess the safety and tolerability, pharmacodynamics (PD) and pharmacokinetics (PK) of inhaled umeclidinium (500 µg) and vilanterol (50 µg) when administered separately and in combination using a novel dry powder inhaler (NDPI). Co-administration of single inhaled doses of umeclidinium and vilanterol to healthy Japanese subjects was well tolerated and not associated with meaningful changes in systemic exposure or PD effects compared with administration of either compound individually. Pharmacokinetic assessments showed rapid absorption for both drugs (Tmax = 5 min for both umeclidinium and vilanterol) followed by rapid elimination with median tlast of 4-5 h for umeclidinium and median tlast of 1.5-2.0 h for vilanterol. Assessments of pharmacokinetic interaction were inconclusive since for umeclidinium, Cmax following combination was higher than umeclidinium alone but not AUC whereas for vilanterol, AUC following combination was higher than vilanterol alone but not Cmax. There were no obvious trends observed between individual maximum supine heart rate and umeclidinium Cmax or vilanterol Cmax when delivered as umeclidinium 500 µg and vilanterol 50 µg combination or when delivered as umeclidinium or vilanterol alone.

TRIAL REGISTRATION

Clinicaltrials.gov NCT00976144.

摘要

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乌美溴铵(GSK573719;UMEC)是一种新的长效毒蕈碱受体拮抗剂(LAMA),正在与维兰特罗(GW642444;VI)联合开发,维兰特罗是一种选择性长效β2 受体激动剂(LABA),用于治疗慢性阻塞性肺疾病(COPD)的每日一次吸入联合治疗。进行了一项单次健康志愿者研究,以评估吸入乌美溴铵(500μg)和维兰特罗(50μg)的安全性、耐受性、药效学(PD)和药代动力学(PK),这些药物分别单独使用和联合使用新型干粉吸入器(NDPI)时。健康日本受试者同时吸入单剂量乌美溴铵和维兰特罗,耐受性良好,与单独使用任一化合物相比,系统暴露或 PD 效应无明显变化。药代动力学评估显示两种药物均快速吸收(乌美溴铵和维兰特罗的 Tmax 均为 5 分钟),随后快速消除,乌美溴铵的中位 tlast 为 4-5 小时,维兰特罗的中位 tlast 为 1.5-2.0 小时。由于乌美溴铵联合用药后 Cmax 高于乌美溴铵单药,但 AUC 不高于乌美溴铵单药,而维兰特罗联合用药后 AUC 高于维兰特罗单药,但 Cmax 不高于维兰特罗单药,因此对药代动力学相互作用的评估没有定论。当乌美溴铵 500μg 和维兰特罗 50μg 联合使用时或当乌美溴铵或维兰特罗单独使用时,个体最大仰卧心率与乌美溴铵 Cmax 或维兰特罗 Cmax 之间没有观察到明显的趋势。

试验注册

Clinicaltrials.gov NCT00976144。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/316d/3524248/46a57661c9b2/pone.0050716.g001.jpg

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