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利福平在墨西哥结核病患者和健康志愿者中的药代动力学

Pharmacokinetics of rifampicin in Mexican patients with tuberculosis and healthy volunteers.

作者信息

Medellín-Garibay Susanna E, Milán-Segovia Rosa Del Carmen, Magaña-Aquino Martín, Portales-Pérez Diana Patricia, Romano-Moreno Silvia

机构信息

Facultad de Ciencias Químicas, UASLP, San Luis Potosí, SLP, México.

出版信息

J Pharm Pharmacol. 2014 Oct;66(10):1421-8. doi: 10.1111/jphp.12275. Epub 2014 May 20.

Abstract

OBJECTIVE

The aim of this study was to compare the pharmacokinetics (PK) of rifampicin (RIF) between healthy volunteers and patients with tuberculosis (TB).

METHODS

RIF was administered as a single 600-mg dose to 24 healthy volunteers and 24 TB patients, followed by serial blood sampling. Plasma concentrations were analysed using a chromatographic method, and the PK parameters were estimated using WinNonlin software.

KEY FINDINGS

Peak plasma concentration ranged from 6.4 to 19.9 mg/l, which was subtherapeutic for 15% of the study participants in both groups, mostly in men (71.4%). The mean area under the concentration-time curve (AUC0-24h ) did not show differences between these groups (P > 0.05). The absorption rate was slower in TB patients and the volume of distribution normalized by total body weight (Vd/kg) was greater than healthy volunteers (P < 0.05). A greater Vd and clearance were found in male subjects. The lag time (tlag) and the time before reach Cmax (Tmax) were longer for female TB patients (P < 0.05).

CONCLUSION

The main differences in PK parameters of RIF between Mexican TB patients and healthy volunteers were demonstrated in absorption and distribution processes. In addition, differences in PK parameters observed by sex should be considered for further dosing recommendations.

摘要

目的

本研究旨在比较健康志愿者和肺结核(TB)患者中利福平(RIF)的药代动力学(PK)。

方法

对24名健康志愿者和24名TB患者单次给予600mg剂量的RIF,随后进行系列血样采集。采用色谱法分析血浆浓度,并使用WinNonlin软件估算PK参数。

主要发现

血浆峰浓度范围为6.4至19.9mg/l,两组中15%的研究参与者该浓度低于治疗水平,其中大部分为男性(71.4%)。这些组之间的浓度-时间曲线下平均面积(AUC0-24h)无差异(P>0.05)。TB患者的吸收速率较慢,按总体重标准化的分布容积(Vd/kg)大于健康志愿者(P<0.05)。男性受试者的Vd和清除率更高。女性TB患者的滞后时间(tlag)和达到Cmax之前的时间(Tmax)更长(P<0.05)。

结论

墨西哥TB患者和健康志愿者之间RIF的PK参数在吸收和分布过程中存在主要差异。此外,进一步的给药建议应考虑观察到的PK参数的性别差异。

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