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依曲韦林儿科和成人制剂的单剂量药代动力学及200毫克片剂的吞咽性:三项1期研究结果

Single-dose pharmacokinetics of pediatric and adult formulations of etravirine and swallowability of the 200-mg tablet: results from three Phase 1 studies.

作者信息

Kakuda Thomas N, Berckmans Cindy, De Smedt Goedele, Leemans Ruud, Leopold Lorant, Peeters Monika, Nijs Steven, Vyncke Veerle, van Solingen-Ristea Rodica, Hoetelmans Richard M W

出版信息

Int J Clin Pharmacol Ther. 2013 Sep;51(9):725-37. doi: 10.5414/CP201770.

Abstract

OBJECTIVES

Three studies were conducted to assess the pharmacokinetics, methods of administration and ease of swallowability of etravirine tablets.

METHODS

Two randomized studies in healthy adults investigated the single-dose pharmacokinetics of etravirine in various dosage strengths and the effects of dispersion in water and film-coating. A third study explored swallowability of etravirine 200-mg tablets in HIV-infected patients. First study: 37 volunteers received 1 × 100-mg non-coated tablet (reference), 4 × 25-mg noncoated tablets and 1 × 100-mg non-coated tablet dispersed in 100 ml water. Second study: 24 volunteers received 2 × 100-mg non-coated tablets (reference), 2 × 100-mg coated tablets, 1 × 200-mg non-coated and 1 × 200-mg coated tablet. Pharmacokinetic parameters were determined using non-compartmental analysis and least square means (LSM) ratios and 90% confidence intervals (CI) were calculated. Third study: 49 virologically-suppressed patients already on an etravirine-containing regimen rated the swallowability of two etravirine formulations (200-mg non-coated and 200-mg coated tablets).

RESULTS

In the first study LSM ratios (90% CI) for the etravirine area under the plasma concentration-time curve (AUC) administered either as 4 × 25-mg tablets or 100-mg tablet dispersed were: 0.91 (0.85 to 0.98) and 0.97 (0.90 to 1.03), respectively. In the second study, when comparing a 200-mg non-coated and coated tablet to 2 × 100-mg non-coated tablets, LSM ratios for etravirine AUC were 98 to 99%. In the third study, more patients rated the 200-mg than the 100-mg tablets as acceptable to swallow (70% vs. 43%).

CONCLUSIONS

Comparable etravirine exposures were observed regardless of formulation or method of administration (i.e., dispersion); 200-mg tablets were rated as easier to swallow than 100-mg tablets.

摘要

目的

开展三项研究以评估依曲韦林片的药代动力学、给药方法及吞咽难易程度。

方法

两项针对健康成年人的随机研究,调查了不同剂量强度的依曲韦林单剂量药代动力学以及在水中分散和薄膜包衣的影响。第三项研究探讨了依曲韦林200毫克片剂在HIV感染患者中的吞咽情况。第一项研究:37名志愿者服用1片100毫克非包衣片(对照)、4片25毫克非包衣片以及1片分散于100毫升水中的100毫克非包衣片。第二项研究:24名志愿者服用2片100毫克非包衣片(对照)、2片100毫克包衣片、1片200毫克非包衣片和1片200毫克包衣片。使用非房室分析确定药代动力学参数,并计算最小二乘均值(LSM)比率和90%置信区间(CI)。第三项研究:49名已接受含依曲韦林治疗方案且病毒学抑制的患者对两种依曲韦林制剂(200毫克非包衣片和200毫克包衣片)的吞咽情况进行评分。

结果

在第一项研究中,以4片25毫克片剂或分散的100毫克片剂给药时,依曲韦林血浆浓度-时间曲线下面积(AUC)的LSM比率(90%CI)分别为:0.91(0.85至0.�8)和0.97(0.90至1.03)。在第二项研究中,将200毫克非包衣片和包衣片与2片100毫克非包衣片进行比较时,依曲韦林AUC的LSM比率为98%至99%。在第三项研究中,认为200毫克片剂吞咽可接受的患者比100毫克片剂更多(70%对43%)。

结论

无论制剂或给药方法(即分散)如何,依曲韦林的暴露量相当;200毫克片剂比100毫克片剂更容易吞咽。

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