Allen Ann, Siederer Sarah, Yang Shuying
Int J Clin Pharmacol Ther. 2016 Apr;54(4):269-81. doi: 10.5414/CP202438.
Population pharmacokinetic (PK) methods were used to characterize the PK of fluticasone furoate (FF) and vilanterol (VI) in patients with asthma following once daily inhaled FF/VI and FF and to identify significant covariates that impact the PK.
Four of the five studies in the meta-analysis were conducted in patients with asthma (> 90%), the fifth in healthy subjects. FF data were described by a two-compartment model with first order absorption and elimination. VI data were described by a three-compartment model with zero-order absorption and first order elimination.
Race was a significant covariate on inhaled clearance (CL/F) of FF PK. AUC(0-24) for Asian patients was on average 33 - 53% higher than for non-Asians. Race was also a significant covariate on VI PK, with lower (81%) central volume of distribution (Vc/F) for Asian patients compared with non-Asians; VI C(max) was 220 - 287% higher in Asian patients. Treatment (combination or monotherapy), predicted percentage FEV(1), and other demographic variables did not influence the PK of FF or VI.
Combination of FF/VI does not appear to affect the PK of FF or VI. The effect of race on PK of FF or VI does not have impact on dosage adjustments for FF/VI in East Asian patients with asthma.
采用群体药代动力学(PK)方法,对每日一次吸入氟替卡松糠酸酯(FF)/维兰特罗(VI)和FF的哮喘患者中FF和VI的PK特征进行表征,并确定影响PK的显著协变量。
荟萃分析中的五项研究中有四项是在哮喘患者(>90%)中进行的,第五项是在健康受试者中进行的。FF数据采用具有一级吸收和消除的二室模型进行描述。VI数据采用具有零级吸收和一级消除的三室模型进行描述。
种族是FF PK吸入清除率(CL/F)的显著协变量。亚洲患者的AUC(0-24)平均比非亚洲患者高33%-53%。种族也是VI PK的显著协变量,与非亚洲患者相比,亚洲患者的中央分布容积(Vc/F)较低(81%);亚洲患者的VI C(max)高220%-287%。治疗(联合治疗或单药治疗)、预测的FEV(1)百分比和其他人口统计学变量均不影响FF或VI的PK。
FF/VI联合使用似乎不影响FF或VI的PK。种族对FF或VI PK的影响对东亚哮喘患者FF/VI的剂量调整没有影响。