Gillespie Michael, Song Sharon, Steinfeld Jonathan
Teva Global Respiratory R&D, Teva Pharmaceuticals, Frazer, Pennsylvania, USA.
Allergy Asthma Proc. 2015 Sep-Oct;36(5):365-71. doi: 10.2500/aap.2015.36.3889.
A novel inhalation-driven multidose dry powder inhaler (MDPI) that eliminates the need for the patient to coordinate device actuation with inhalation has been developed for delivery of inhaled asthma medications.
To characterize the pharmacokinetics of single-dose fluticasone propionate (Fp) MDPI compared with single doses of Fp dry powder inhaler (DPI) and a metered-dose inhaler (MDI) in healthy subjects.
This was a single-center, open-label, randomized, three-period crossover, single-dose pilot study in healthy adults ages 18 to 45 years. Eligible subjects (N = 18) were randomized to one of six treatment sequences that contained three treatment arms: Fp MDPI 400 μg/inhalation × two inhalations (800 μg total dose); Fp DPI 250 μg/inhalation × four (1000 μg total dose); and Fp MDI 220 μg/inhalation × four (880 μg total dose). Pharmacokinetics (area under concentration-versus-time curve [AUC], maximum plasma concentration [Cmax], time to Cmax [tmax], and elimination half-life [t½]), safety, and tolerability were assessed for each treatment.
Plasma Fp concentration-versus-time curves were comparable across treatments. Geometric mean AUC0-t and Cmax for Fp MDPI 800 μg were 19% and 18% higher, respectively, compared with Fp DPI 1000 μg, and 47% and 82% higher, respectively, compared with Fp MDI 880 μg. Median tmax (60.0-60.6 minutes) and median t1/2 (9.1-9.8 hours) were comparable across the three treatments. Single-dose Fp was well tolerated, with no new safety issues noted.
Single-dose administration of Fp MDPI 800 μg produced systemic exposure comparable with those for Fp DPI 1000 μg and Fp MDI 880 μg.
已研发出一种新型吸入驱动多剂量干粉吸入器(MDPI),该吸入器无需患者将装置启动与吸气动作进行协调,用于递送吸入性哮喘药物。
在健康受试者中,对比单剂量氟替卡松丙酸酯(Fp)MDPI与单剂量Fp干粉吸入器(DPI)和定量吸入器(MDI)的药代动力学特征。
这是一项针对18至45岁健康成年人的单中心、开放标签、随机、三周期交叉、单剂量试点研究。符合条件的受试者(N = 18)被随机分配至六个治疗序列之一,每个序列包含三个治疗组:Fp MDPI 400μg/吸×2吸(总剂量800μg);Fp DPI 250μg/吸×4吸(总剂量1000μg);以及Fp MDI 220μg/吸×4吸(总剂量880μg)。对每种治疗评估药代动力学(浓度-时间曲线下面积[AUC]、最大血浆浓度[Cmax]、达峰时间[tmax]和消除半衰期[t½])、安全性和耐受性。
各治疗组的血浆Fp浓度-时间曲线具有可比性。与Fp DPI 1000μg相比,Fp MDPI 800μg的几何平均AUC0-t和Cmax分别高19%和18%;与Fp MDI 880μg相比,分别高47%和82%。三种治疗的中位tmax(60.0 - 60.6分钟)和中位t1/2(9.1 - 9.8小时)具有可比性。单剂量Fp耐受性良好,未发现新的安全问题。
单剂量给予800μg Fp MDPI产生的全身暴露与给予1000μg Fp DPI和880μg Fp MDI相当。