Kinoshita Shuji, Kondo Kazuoki
Department of Clinical Pharmacology, Development Division, Mitsubishi Tanabe Pharma Corporation , 17-10 Nihonbashi-Koamicho, Chuo-ku, Tokyo 103-8405 , Japan +81 3 6748 7763 ; +81 3 3663 6449 ;
Expert Opin Drug Metab Toxicol. 2015 Jan;11(1):7-14. doi: 10.1517/17425255.2015.982531. Epub 2014 Nov 26.
To investigate the pharmacokinetic/pharmacodynamic interactions of the antidiabetic agents canagliflozin (a sodium-glucose cotransporter-2 inhibitor) and teneligliptin (a dipeptidyl peptidase-4 inhibitor) in Japanese healthy adult men.
Open-label, one-way crossover study used canagliflozin (200 mg/day p.o.) and teneligliptin (40mg/day p.o). A single dose of object drug (either canagliflozin or teneligliptin) was administered on day 1 followed by washout and continuous administration of precipitant drug (days 1 - 9). Both drugs were concomitantly administered on day 7.
No changes in AUC0 - 72h and Cmax were observed for canagliflozin+teneligliptin versus monotherapy; geometric mean ratios for AUC0 - 72h and Cmax were 0.982 and 0.982 for the plasma concentration of canagliflozin and 0.983 and 0.976 for the plasma concentration of teneligliptin, respectively. Plasma concentrations of active and total glucagon-like peptide-1 (GLP-1) increased with canagliflozin+teneligliptin versus teneligliptin alone. Mean AUC0.5 - 4h increased post-meal, on combination therapy, from 9.6 to 12.5 pmol·h/l (active GLP-1) and from 21.5 to 32.3 pmol·h/l (total GLP-1). Adverse events developed in four subjects; all were mild and resolved but one subject withdrew due to generalized erythema.
GLP-1 levels increased with the canagliflozin+teneligliptin combination, and no PK interaction was observed. This combination may show favorable antidiabetic effects without increasing systemic exposure.
在日本健康成年男性中研究抗糖尿病药物卡格列净(一种钠-葡萄糖协同转运蛋白2抑制剂)和替格列汀(一种二肽基肽酶4抑制剂)的药代动力学/药效学相互作用。
开放标签、单向交叉研究使用卡格列净(口服,200毫克/天)和替格列汀(口服,40毫克/天)。在第1天给予单剂量的受试药物(卡格列净或替格列汀),随后洗脱,然后连续给予沉淀药物(第1 - 9天)。两种药物在第7天同时给药。
与单药治疗相比,卡格列净+替格列汀联合用药时,AUC0 - 72h和Cmax无变化;卡格列净血浆浓度的AUC0 - 72h和Cmax几何平均比值分别为0.982和0.982,替格列汀血浆浓度的分别为0.983和0.976。与单独使用替格列汀相比,卡格列净+替格列汀联合用药时活性和总胰高血糖素样肽1(GLP-1)的血浆浓度升高。联合治疗时,餐后平均AUC0.5 - 4h从9.6升高至12.5皮摩尔·小时/升(活性GLP-1),从21.5升高至32.3皮摩尔·小时/升(总GLP-1)。4名受试者出现不良事件;均为轻度且已缓解,但有1名受试者因全身红斑退出研究。
卡格列净+替格列汀联合用药可使GLP-1水平升高,且未观察到药代动力学相互作用。该联合用药可能在不增加全身暴露的情况下显示出良好的抗糖尿病效果。