Devarakonda Krishna, Vandenbossche Joris, Richarz Ute
Clinical Pharmacology & Pharmacokinetics, Mallinckrodt Inc., 325 James McDonnell Blvd 302W-3, Hazelwood, MO 63042 USA.
Clinical Pharmacology, Janssen Research & Development, Beerse, Belgium.
Springerplus. 2013 Nov 21;2:625. doi: 10.1186/2193-1801-2-625. eCollection 2013.
Conventional measures such as maximum plasma concentration (C max ) and area under the concentration versus time curve (AUC) may be insufficient to fully describe the pharmacokinetic (PK) profile of extended-release (ER) formulations. A complementary measure, the half-value duration (HVD), corresponds to the period of time during a dosing cycle that plasma concentration is at or above half the value of the maximal concentration (i.e. ≥50% C max ). The current post-hoc analysis uses data from 2 previously published studies comparing the PK profiles and HVD of OROS hydromorphone ER (16 mg administered once daily) and immediate-release (IR) hydromorphone (4 mg administered every 6 hours), calculating single-dose and steady-state condition values. Bioequivalence was demonstrated between the 2 formulations. Mean steady-state once-daily OROS hydromorphone ER concentrations were elevated for most of the 24-hour dosing period and for significantly longer than with the dose-equivalent IR hydromorphone regimen. The duration of time spent ≥50% C max was, on average, 2.7 times longer at steady state for the ER formulation, which also maintained steady-state hydromorphone plasma concentrations, with 65% lower mean degree of fluctuation versus IR hydromorphone. Both formulations appeared to be well tolerated.
常规指标,如最大血药浓度(Cmax)和血药浓度-时间曲线下面积(AUC),可能不足以全面描述缓释(ER)制剂的药代动力学(PK)特征。一个补充指标,半值持续时间(HVD),是指在给药周期内血浆浓度等于或高于最大浓度值一半(即≥50% Cmax)的时间段。当前的事后分析使用了两项先前发表研究的数据,比较了奥施康定缓释氢吗啡酮(每日一次服用16毫克)和即释(IR)氢吗啡酮(每6小时服用4毫克)的PK特征和HVD,计算了单剂量和稳态条件下的值。证明了两种制剂之间的生物等效性。在24小时给药期的大部分时间里,每日一次服用奥施康定缓释氢吗啡酮的平均稳态浓度升高,且显著长于等效剂量的即释氢吗啡酮给药方案。在稳态时,ER制剂血浆浓度≥50% Cmax的持续时间平均长2.7倍,其还维持了氢吗啡酮的稳态血浆浓度,与即释氢吗啡酮相比,平均波动度低65%。两种制剂似乎耐受性均良好。