Zhang Ruoqi, Li Yunxia, Jiang Xuehua, Wang Ling
West China School of Pharmacy, Sichuan University, Sichuan, China.
Chengdu University of Traditional Chinese Medicine, Sichuan, China.
Curr Ther Res Clin Exp. 2009 Oct;70(5):392-404. doi: 10.1016/j.curtheres.2009.10.004.
Rosuvastatin has been reported to be beneficial in the treatment of dyslipidemia. The Cmax and AUC0-t of rosuvastatin were reported to be ~2 to 4 times higher in Chinese subjects compared with white subjects after administration of a single 1-mg/kg dose.
The aims of this study were to assess the pharmacokinetics and tolerability of multiple doses of rosuvastatin in healthy Chinese volunteers.
This open-label, randomized-sequence, 3-way crossover trial consisted of three 7-day treatment periods and two 10-day washout periods. Healthy volunteers were randomly allocated to 1 of 3 daily treatment regimens: rosuvastatin 5, 10, or 20 mg. To assess the pharmacokinetics and tolerability of rosuvastatin, blood samples were drawn before dosing (hour 0) on days 5, 6, and 7 and 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, 15, 24, 36, 48, 72, and 96 hours after the final dose was administered on day 7. A validated HPLC-MS/MS method was used to determine rosuvastatin levels. A 2-compartment pharmacokinetic model was fitted to the plasma concentration-time profiles obtained for each volunteer. Adverse events (AEs) were monitored throughout the study via subject interview, vital signs, and blood sampling. Serious AEs were those requiring hospitalization, treatment discontinuation, or resulting in death.
Twelve healthy Chinese volunteers (6 men: mean [SD] age, 21.8 [1.7] years; weight, 62.3 [5.8] kg; height, 174.3 [7.2] cm; 6 women: age, 20.8 [1.2] years; weight, 53.2 [4.7] kg; height, 161.3 [4.3] cm) participated in and completed the trial. The mean (SD) steady-state Cmax was significantly greater after ro-suvastatin administration in the 20-mg group compared with the 5-mg group (37.69 [29.83] vs 6.17 [6.03] ng/mL; P = 0.04). The t1/2 was significantly greater in the 20-mg group (15.51 [6.43] hours) compared with the 5-mg group (5.65 [5.08] hours; P = 0.001) and the 10-mg group (8.58 [5.17] hours; P = 0.002). The mean AUC0-t was significantly greater in the 20-mg group compared with the 5-mg group (349.16 [257.20] vs 40.63 [39.31] ng/mL/h; P = 0.02). All AEs were considered by the investigators to be mild in intensity, with the exception of 2 cases of abdominal discomfort (1 man and 1 woman, both in the 5-mg dose group). Two women in the 20-mg group experienced dizziness and cold sweats simultaneously. In the 10-mg group, 1 woman had abdominal discomfort and nausea and 1 woman had jaw pain. All reported AEs were considered possibly related to study drug administration.
In this small study in healthy Chinese volunteers, rosuvastatin systemic exposure appeared to be dose-proportional over the dosing range of 5 to 20 mg with multiple-dose administration. There was no accumulation of rosuvastatin in the body with the 5- and 10-mg doses. However, the results suggest that rosuva-statin might accumulate when the dose is increased to 20 mg. No serious AEs occurred in any of the 3 dosing groups.
据报道,瑞舒伐他汀在治疗血脂异常方面有益。单次给予1mg/kg剂量后,中国受试者的瑞舒伐他汀Cmax和AUC0-t据报道比白人受试者高约2至4倍。
本研究的目的是评估多剂量瑞舒伐他汀在健康中国志愿者中的药代动力学和耐受性。
这项开放标签、随机序列、三向交叉试验包括三个7天治疗期和两个10天洗脱期。健康志愿者被随机分配到3种每日治疗方案中的1种:瑞舒伐他汀5mg、10mg或20mg。为了评估瑞舒伐他汀的药代动力学和耐受性,在第5、6和7天给药前(0小时)以及在第7天最后一剂给药后0.5、1、1.5、2、3、4、5、6、8、12、15、24、36、48、72和96小时采集血样。采用经过验证的HPLC-MS/MS方法测定瑞舒伐他汀水平。对每个志愿者获得的血浆浓度-时间曲线拟合二室药代动力学模型。在整个研究过程中,通过受试者访谈、生命体征和血液采样监测不良事件(AE)。严重AE是指需要住院、停药或导致死亡的事件。
12名健康中国志愿者(6名男性:平均[标准差]年龄,21.8[1.7]岁;体重,62.3[5.8]kg;身高,174.3[7.2]cm;6名女性:年龄,20.8[1.2]岁;体重,53.2[4.7]kg;身高,161.3[4.3]cm)参与并完成了试验。与5mg组相比,20mg组给予瑞舒伐他汀后的平均(标准差)稳态Cmax显著更高(37.69[29.83]对6.17[6.03]ng/mL;P = <0.001)。20mg组的t1/2显著长于5mg组(15.51[6.43]小时对5.65[5.08]小时;P = 0.001)和10mg组(8.58[5.17]小时;P = 0.002)。与5mg组相比,20mg组的平均AUC0-t显著更高(349.16[257.20]对40.63[39.31]ng/mL/h;P = 0.02)。除2例腹部不适(1名男性和1名女性,均在5mg剂量组)外,所有AE被研究者认为强度为轻度。20mg组的2名女性同时出现头晕和冷汗。在10mg组中,1名女性有腹部不适和恶心,1名女性有颌部疼痛。所有报告的AE被认为可能与研究药物给药有关。
在这项针对健康中国志愿者的小型研究中,多剂量给药时,瑞舒伐他汀的全身暴露在5至20mg给药范围内似乎与剂量成比例。5mg和10mg剂量的瑞舒伐他汀在体内无蓄积。然而,结果表明,当剂量增加到20mg时,瑞舒伐他汀可能会蓄积。3个给药组中均未发生严重AE。