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聚乙二醇化重组人生长激素与每日注射重组人生长激素在生长激素缺乏儿童中的比较药代动力学和药效学

Comparative pharmacokinetics and pharmacodynamics of a PEGylated recombinant human growth hormone and daily recombinant human growth hormone in growth hormone-deficient children.

作者信息

Hou Ling, Chen Zhi-Hang, Liu Dong, Cheng Yuan-Guo, Luo Xiao-Ping

机构信息

Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.

Department of Pharmacy, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China.

出版信息

Drug Des Devel Ther. 2015 Dec 18;10:13-21. doi: 10.2147/DDDT.S93183. eCollection 2016.

Abstract

OBJECTIVE

Recombinant human growth hormone (rhGH) replacement therapy in children generally requires daily subcutaneous (sc) injections, which may be inconvenient for patients. Jintrolong® is a PEGylated rhGH with the purpose of weekly sc injections. The aim of the current study was to examine the pharmacokinetics, pharmacodynamics, safety, and tolerability of multiple sc doses of Jintrolong® vs daily doses of rhGH.

DESIGN AND METHODS

Twelve children with growth hormone deficiency participated in this single-center, open-label, crossover Phase I trial. All subjects received daily sc injections of rhGH at 0.0286 mg/kg/d for 7 days, followed by a 4-week washout period and six weekly doses of Jintrolong® at 0.2 mg/kg/w.

RESULTS

In comparison with rhGH, sc injection of Jintrolong® produced a noticeably higher C max, significantly longer half-life (t 1/2), and slower plasma clearance, signifying a profile suitable for long-term treatment. The ratio of the area under the concentration vs time curve (AUC) after the seventh and first injections (AUC(0-∞)7th/AUC(0-∞)1st) of rhGH was 1.02, while the AUC(0-∞)6th/AUC(0-∞)1st of Jintrolong ® was 1.03, indicating no accumulation of circulating growth hormone. There was no significant difference in the change in insulin-like growth factor-1 expression produced by 7 days of sc rhGH and weekly Jintrolong® injections. There were no severe adverse events during the trial.

CONCLUSION

The elimination rate of Jintrolong® was slower than that of sc rhGH. No progressive serum accumulation of Jintrolong® was found. The changes in insulin-like growth factor-1 expression produced by rhGH and Jintrolong® were comparable, indicating similar pharmacodynamics. Our results demonstrate that Jintrolong® is suitable for long-term growth hormone treatment in children with growth hormone deficiency.

摘要

目的

儿童重组人生长激素(rhGH)替代疗法通常需要每日皮下注射,这对患者来说可能不太方便。金赛增®是一种聚乙二醇化rhGH,旨在实现每周皮下注射。本研究的目的是比较多次皮下注射金赛增®与每日注射rhGH的药代动力学、药效学、安全性和耐受性。

设计与方法

12名生长激素缺乏儿童参与了这项单中心、开放标签、交叉I期试验。所有受试者先接受7天的rhGH皮下注射,剂量为0.0286mg/kg/d,随后有4周的洗脱期,然后接受6周的金赛增®皮下注射,剂量为0.2mg/kg/周。

结果

与rhGH相比,皮下注射金赛增®产生的Cmax明显更高,半衰期(t1/2)显著更长,血浆清除率更慢,这表明其具有适合长期治疗的特性。rhGH第7次和第1次注射后浓度-时间曲线下面积(AUC)的比值(AUC(0-∞)7th/AUC(0-∞)1st)为1.02,而金赛增®的AUC(0-∞)6th/AUC(0-∞)1st为1.03,表明循环生长激素无蓄积。皮下注射rhGH 7天和每周注射金赛增®所产生的胰岛素样生长因子-1表达变化无显著差异。试验期间未发生严重不良事件。

结论

金赛增®的消除率比皮下注射rhGH慢。未发现金赛增®在血清中有进行性蓄积。rhGH和金赛增®产生的胰岛素样生长因子-1表达变化相当,表明药效学相似。我们的结果表明,金赛增®适用于生长激素缺乏儿童的长期生长激素治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4c5/4690642/e0c757559929/dddt-10-013Fig1.jpg

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