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BRAF抑制剂达拉非尼的群体药代动力学:剂量、时间、协变量的影响及其与代谢物的关系。

Population pharmacokinetics of dabrafenib, a BRAF inhibitor: effect of dose, time, covariates, and relationship with its metabolites.

作者信息

Ouellet Daniele, Gibiansky Ekaterina, Leonowens Cathrine, O'Hagan Anne, Haney Patricia, Switzky Julie, Goodman Vicki L

机构信息

GlaxoSmithKline, Research Triangle Park, NC, USA.

出版信息

J Clin Pharmacol. 2014 Jun;54(6):696-706. doi: 10.1002/jcph.263. Epub 2014 Jan 17.

Abstract

Dabrafenib is a BRAF kinase inhibitor indicated for the treatment of BRAF V600E mutation-positive melanoma. The population pharmacokinetics of dabrafenib, including changes over time and relevant covariates, were characterized based on results from four clinical studies using a nonlinear mixed effects model with a full covariate approach. Steady-state exposures of dabrafenib metabolites (hydroxy-, carboxy-, and desmethyl-dabrafenib) were characterized separately. The pharmacokinetics of dabrafenib were adequately described by non-inducible and inducible apparent clearance that increased with dose and time. Total steady-state clearance (CL/F) at 150 mg BID dose was 34.3 L/h. Based on the induction half-life (67 hours), steady state should be achieved within 14 days of dosing. Capsule shell was the most significant covariate (55%) while sex and weight had only a small impact on exposure (<20%). The AUC ratio (hypromellose:gelatin capsule) is predicted to be 1.80 and 1.42 following single and repeat dosing, respectively. Age, renal (mild and moderate), and hepatic (mild) impairment were not significant covariates. Steady-state pre-dose concentration (%CV) of dabrafenib and of hydroxy-, carboxy-, and desmethyl-dabrafenib at 150 mg BID were 46.6 ng/mL (83.5%), 69.3 ng/mL (64.1%), 3608 ng/mL (14.7%), and 291 ng/mL (17.2%), respectively. Capsule shell, concomitant medications, older age, and weight were predictors of metabolite exposure.

摘要

达拉非尼是一种BRAF激酶抑制剂,适用于治疗BRAF V600E突变阳性的黑色素瘤。基于四项临床研究的结果,采用具有完全协变量方法的非线性混合效应模型,对达拉非尼的群体药代动力学进行了表征,包括随时间的变化和相关协变量。分别对达拉非尼代谢物(羟基 -、羧基 - 和去甲基 - 达拉非尼)的稳态暴露进行了表征。达拉非尼的药代动力学通过随剂量和时间增加的非诱导性和诱导性表观清除率得到了充分描述。150mg每日两次剂量下的总稳态清除率(CL/F)为34.3L/h。根据诱导半衰期(67小时),给药14天内应达到稳态。胶囊壳是最显著的协变量(55%),而性别和体重对暴露的影响较小(<20%)。单次和重复给药后,羟丙甲纤维素:明胶胶囊的AUC比值预计分别为1.80和1.42。年龄、肾脏(轻度和中度)和肝脏(轻度)损害不是显著的协变量。150mg每日两次剂量下,达拉非尼以及羟基 -、羧基 - 和去甲基 - 达拉非尼的稳态给药前浓度(%CV)分别为46.6ng/mL(83.5%)、69.3ng/mL(64.1%)、3608ng/mL(14.7%)和291ng/mL(17.2%)。胶囊壳、伴随用药、年龄较大和体重是代谢物暴露的预测因素。

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