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肝肾功能损害对依折麦布药代动力学的影响。

Effect of hepatic or renal impairment on the pharmacokinetics of evacetrapib.

作者信息

Small David S, Zhang Wei, Royalty Jane, Cannady Ellen A, Downs Delyn, Ortega Demetrio, Suico Jeffrey G

机构信息

Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 46285, USA.

Covance Inc., Evansville, IN, 47710, USA.

出版信息

Eur J Clin Pharmacol. 2016 May;72(5):563-72. doi: 10.1007/s00228-016-2017-1. Epub 2016 Feb 9.

Abstract

PURPOSE

The aim of this study is to investigate the effect of hepatic or renal impairment on the pharmacokinetics of a single 130-mg evacetrapib dose.

METHODS

Two open-label, parallel-design studies in males and females with normal hepatic function or Child-Pugh mild, moderate, or severe hepatic impairment, or with normal renal function or severe renal impairment. Non-compartmental pharmacokinetic parameters were estimated from plasma concentration-time data. Evacetrapib safety and tolerability were assessed.

RESULTS

Pharmacokinetic parameter estimates were comparable between controls and mildly hepatically impaired subjects. Geometric mean area under the concentration-time curve (AUC) was greater, half-life (t1/2) was longer, and maximum concentration (Cmax) was lower in subjects with moderate and severe hepatic impairment than in controls. Apparent clearance (CL/F) did not differ between controls and those with mild hepatic impairment, but CL/F decreased for moderate and severe impairment. Spearman correlation coefficient showed no relationship between CL/F and Child-Pugh score. In the renal study, AUC and t1/2 were similar between groups, while Cmax was 15 % lower in subjects with severe impairment. CL/F in severely renally impaired subjects differed by <6 % from that in controls. Spearman correlation coefficient showed no apparent relationship between CL/F and estimated creatinine clearance or glomerular filtration rate. Neither study noted changes in clinical laboratory parameters or clinically significant findings. Adverse event incidence was low, and all were mild or moderate in severity.

CONCLUSION

Evacetrapib exposure did not differ between mild hepatic impairment and normal hepatic function, but increased along the progression from mild to moderate to severe hepatic impairment. Severe renal impairment did not affect evacetrapib exposure.

摘要

目的

本研究旨在调查肝或肾功能损害对单次130毫克依伐卡托剂量药代动力学的影响。

方法

两项开放标签、平行设计的研究,受试者为肝功能正常或Child-Pugh轻度、中度或重度肝功能损害的男性和女性,或肾功能正常或重度肾功能损害的男性和女性。根据血浆浓度-时间数据估算非房室药代动力学参数。评估依伐卡托的安全性和耐受性。

结果

对照组与轻度肝功能损害受试者之间的药代动力学参数估计值具有可比性。中度和重度肝功能损害受试者的浓度-时间曲线下几何平均面积(AUC)更大、半衰期(t1/2)更长、最大浓度(Cmax)更低。对照组与轻度肝功能损害受试者之间的表观清除率(CL/F)无差异,但中度和重度损害时CL/F降低。Spearman相关系数显示CL/F与Child-Pugh评分之间无相关性。在肾脏研究中,各组之间的AUC和t1/2相似,而重度损害受试者的Cmax低15%。重度肾功能损害受试者的CL/F与对照组相差<6%。Spearman相关系数显示CL/F与估算的肌酐清除率或肾小球滤过率之间无明显相关性。两项研究均未发现临床实验室参数变化或具有临床意义的发现。不良事件发生率较低,且均为轻度或中度严重程度。

结论

轻度肝功能损害与正常肝功能之间依伐卡托的暴露量无差异,但随着肝功能损害从轻度进展到中度再到重度,暴露量增加。重度肾功能损害不影响依伐卡托的暴露量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0fdf/4834099/0b23505dbaad/228_2016_2017_Fig1_HTML.jpg

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